Ramadan and Fasting in Pregnancy

What is Ramadan??

Ramadan is the holiest month in Islam. Globally, there are 1.9 billion Muslims and one of the tenets of Islam is to fast during the holy month of Ramadan. Because the Islamic calendar is lunar-based, the dates of this month change from year to year. In 2022, Ramadan starts April 2nd and ends May 1st. During Ramadan, observant Muslims abstain from food and drink (including water and coffee) from sunrise to sunset. In some areas around the globe, the fast can be upwards of twenty hours, while in other parts it can be twelve hours.?

Who should fast in Ramadan??

Muslims who are healthy and physically able should fast in Ramadan. There are exceptions - including but not limited to pregnant women, women who are breastfeeding, women on their menses, those who are ill (either with chronic or acute illnesses), those who are traveling, and prepubertal children.?

Why do pregnant women want to fast?

Women who are pregnant or breastfeeding may still opt to fast. Although they are not required to, they may participate in it because of the communal and spiritual connection they feel while fasting in Ramadan.?

Is it safe to fast while pregnant??

When women are scheduled for a cesarean section, they are instructed to fast before their operation. It is not unsafe to fast while pregnant. However, fasting thirty consecutive days, for twelve to twenty hours a day, can be challenging. There are several things to consider when determining whether it is safe to fast while pregnant. If there are complications in your pregnancy such as fetal growth restriction, inadequate weight gain during pregnancy, hyperemesis gravidarum, gestational diabetes, or oligohydramnios, you should not fast.?

Do I have to be in my second trimester (or beyond) to fast?

For many women, the toughest part of pregnancy is the first trimester because of persistent nausea and vomiting. Some women will eat small meals or drink every few hours to help with the nausea and vomiting. This usually resolves by the second trimester, allowing some women to fast. For some, they fast in Ramadan not knowing they are pregnant (yet)! This is a personalized decision and a conversation you should have with your physician before Ramadan starts.?

Alright, I have a healthy pregnancy and want to fast. Should I do it??

In order to optimize the health of baby and mom, there are some important factors to consider when fasting. I like to counsel my patients to try a practice day a week or two before Ramadan and see me in clinic before the month starts so we can talk about how their “practice day” went and what they ate at iftar and afterward. On this practice day, my patients are told to track everything that they eat and drink from iftar (the meal at sunset) to suhoor (the pre-dawn meal). This includes how many cups of water they drank, how much they ate, how many calories, etc.

Rules for fasting while pregnant:

1. You must drink at least two liters of water daily. This will be hard if you don’t space out your water intake. Break your fast with a cup of water, drink a cup of water before and after praying (maghrib, isha, taraweeh, qiyam), and drink water during suhoor.?
2. If you do not drink at least two liters of water, do not fast the following day.
3. You must be eating calorie-dense foods and an adequate amount of calories. Weigh yourself once a week while wearing the same clothes. If you are losing weight, consider fasting every other day or every third day in order to meet the adequate nutrition for you and baby.?
4. If you feel any regular uterine contractions, this could be a sign of dehydration. Break your fast and drink water. If the contractions persist for two or more hours, go to the hospital.?
5. If you feel lightheaded, dizzy, or faint for longer than 30 seconds, break your fast. This is a sign that your blood sugar is too low or you are severely dehydrated.?
6. Take it easy. While fasting, do not participate in rigorous physical activity.?
7. Ultimately, the health of you and your baby is the priority. Do not continue fasting if you feel unwell or fatigued.?

* This is not medical advice. Please speak with your doctor and have a personalized conversation about whether fasting while pregnant is safe for you.