Fasting during Ramadan by pregnant women… medical controversy and recommendations that resolve the decision

Fasting during the month of Ramadan during pregnancy raises widespread controversy in medical circles, in light of the varying results of scientific studies between supporting the absence of serious effects and warning of potential risks to the health of the mother and fetus.

A recent study issued by the Joint School of Public Health at Old Dominion University, entitled “The Effects of Ramadan Fasting During Pregnancy on Pregnancy and Childbirth Outcomes,” indicated the absence of a clear scientific consensus on the effect of fasting on pregnancy, stressing that the available research did not provide conclusive evidence that could be relied upon to make general medical recommendations for Muslim pregnant women.

In contrast, other studies have shown that there may be negative effects in certain circumstances. A study published by the American Journal of Obstetrics and Gynecology in June 2023, entitled “Ramadan Fasting and Pregnancy: An Evidence-Based Guide for the Obstetrician,” stated that fasting was not clearly associated with lower birth weight or increased risk of premature birth, but it was associated with increased maternal stress and dehydration, in addition to lower levels of amniotic fluid necessary for fetal growth.

A Moroccan study entitled “Ramadan fasting in the last three months of pregnancy and colostrum concentrations after birth” also showed that fasting may lead to an increase in the level of the hormone cortisol in colostrum, which may affect the hormonal environment of the infant.

In the same context, a study issued in 2022 by the Endocrinology Department at St. George General Hospital in Australia warned of the danger of fasting for pregnant women with diabetes, due to the sharp fluctuations it may cause in blood sugar levels, exposing the mother and fetus to health complications.

On the other hand, a study published in 2024 in the first issue of the Journal of Obstetrics and Gynecology, entitled “The Effect of Ramadan Fasting on Oxidative Stress Levels in the Second Trimester of Pregnancy,” did not find strong evidence indicating a negative effect of fasting on the health of the mother or fetus during this stage of pregnancy.

Medical instructions

Obstetrics and Gynecology Consultant, Dr. Suzy Mahfouz, advises pregnant women who are in good health and want to fast to follow a set of guidelines, including paying attention to a complete suhoor meal that contains proteins, whole grains, and vegetables, and avoiding salty foods. It also recommends breaking the fast gradually, staying away from fatty foods and sweets, making sure to drink sufficient amounts of fluids between iftar and suhoor, and getting enough rest.

She stressed the need to stop fasting immediately if you feel severe dizziness, persistent vomiting, or weak fetal movement.

Situations in which breakfast is preferred

On the other hand, Mahfouz recommends not fasting in cases of persistent vomiting, signs of dehydration such as a change in urine color, severe low blood pressure, diabetes and high blood pressure, in addition to cases of poor fetal growth or insufficient blood flow to it.

Despite the conflicting scientific results, the decision for a pregnant woman to fast remains an individual matter that depends on the assessment of the health condition of each woman individually, after consulting a specialist doctor. Many scholars also allow a pregnant woman to break her fast if she fears harm to herself or her fetus, and they even require it if it is proven that there is a real danger.