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 2024, Ramadan will most likely start around March 10th and end April 9th. During Ramadan, observant Muslims abstain from food, drink (including water and coffee), and sexual acts from dawn 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.
Muslims who are healthy and physically able should fast in Ramadan. There are exceptions – including but not limited to women on their menses, those who are ill (either with chronic or acute illnesses), those who are traveling, the elderly, and prepubertal children.
Pregnant women and women who are breastfeeding are not exempt from fasting1, however, if it becomes harmful to the mother and child, then maternal health should be prioritized and she should not continue fasting. They may also continue fasting because of the communal and spiritual connection they feel while fasting in Ramadan.
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, twelve to twenty hours a day, can be challenging and pose health risks and concerns. 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.
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. Some 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.
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 few weeks 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.
* This is not personalized medical advice. Please speak with a practicing Muslim physician in conjunction with an Islamic scholar, and have a conversation about whether fasting while pregnant is safe for you. That way, you can make an informed decision about fasting while pregnant.
[1] Written by Deena Kishawi, MD. She is an obstetrician and gynecologist practicing in Chicago. She works to provide evidence-based management and guidelines for her patients, while also ensuring it is in concordance with Islamic values. She is also actively involved with the Darul Qasim bio-ethics group.
The author is from the Shafi’ee Madhab which has this provision.
