Ramadan and Pregnancy

Sarah Azad, MD

This Ramadan will start in the last week of March, and the fasts will last 14-16 hours.   Fasting during pregnancy brings up a lot of questions.

Every pregnancy is different.  Each person has various medical issues, weight issues, and issues with their pregnancy, so please bring up fasting during one of your appointments, ideally, 2-4 weeks before Ramadan begins.

Fasting during pregnancy is not unsafe.   When women are scheduled for cesarean sections, they used to be routinely advised to fast (no water, no food) for 8 hours.  But, day after day, 14–16 hour fasts are not the same.

Much of what you can do depends on how far along you are in your pregnancy.  The most challenging time to fast is in the first 6-14 weeks of pregnancy.  This time of pregnancy is when the stomach causes the most trouble with nausea, vomiting, etc.  Some patients have relatively minimal symptoms, while others need regular medications.  If you’re in this stage of pregnancy, and you have been eating every 1-2 hours just to keep the nausea at bay, fasting may not be reasonable.   For those who would really like to fast, some patients who can’t fast the first two weeks of Ramadan can by the time the last ten days come around.

If you feel well and want to fast, AND your physician agrees it’s safe to fast for you and your specific health conditions this pregnancy, here are the rules (not guidelines) for safe fasting in pregnancy:

  1. You should be up for sahoor (the pre-dawn meal) and should have a liter of water during that time.  It’s hard to drink that much quickly, so give yourself time.   Something that also works is to drink a glass, pray two rakah, drink a glass, etc.
  2. You should have another liter of water after iftar before you sleep.
  3. If you haven’t had at least 2 liters of water between iftar and sahoor, you should not fast that day.
  4. During the day, be aware of signs of significant dehydration.
    1. Lightheadedness or dizziness that lasts more than 30-40 seconds.   Should this occur, you should break your fast and start drinking water.
    2. Another sign of dehydration after 20-24 weeks of pregnancy is contractions.  Sometimes, when the body is dehydrated, the uterus starts to contract.  For women further along in their pregnancy, you should break your fast and start drinking water if you start to feel regular contractions or cramping.
  5. Weigh yourself once a week, just before sunset, with the same clothes or no clothes.  You should not be losing weight.  If you do find you are losing weight, then you should consider fasting every other day or two out of three days so that you can keep up adequate nutrition for your growing baby.


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