First of all, congratulations!   Pregnancy is an exciting time for a woman as her body goes through the changes of each trimester.   At the same time, pregnancy puts a lot of strain on a woman’s body.   And then, the blessings of Ramadan are upon you….and you’re nauseated! During winter months, when the day is 10-12 hours, fasting is not as concerning an issue as it is during the summer months.   Of course, nutrition and hydration are always important in pregnancy, but a 10 hour fast is not that much longer than the recommended 8 hours of sleep at night (for which we don’t give women any guidelines).   Nor is it much longer than the required 8 hours fast before the glucose test for diabetes that we ask all women to do at the end of their second trimester.    So really, the question is about fasting long, hot days.

Now, every pregnancy is different.  Each person has different medical issues, different weight issues, and different issues with their fetus, so fasting during Ramadan is something you want to bring up with your obstetrician at least 2-4 weeks before Ramadan begins.   If they’ve heard of it before, they’ll probably already have recommendations for you.   If not, it’ll give them some time to look into it, or to ask other colleagues for some guidance.   But it’s definitely something you want to bring up and something you want to decide with your doctor.

Next, remember that in the shariah, fasting is required in Ramadan.   When you are pregnant, you may take an exception or rukhsah and not fast.   So if you can, the default is to fast.  And if you think it’s hard to fast pregnant in the summer, try fasting in the summer while you’re nursing and with a baby around (which is where you’ll be in Ramadan one year from now!).   So unless you want to be sitting there with several years in a row of Ramadan to make up, you should really try to fast as much of Ramadan as you can.

Also, a lot of what you can do depends on where you are in pregnancy.  Absolutely the hardest time to fast is 6-14 weeks of pregnancy.  This is when the stomach causes the most trouble: nausea, vomiting, queasiness, reflux, etc.  Some patients have quite minimal symptoms, while others are on around the clock anti-nausea meds.   But 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.   However, some patients can’t fast the first two weeks of Ramadan, but by the time the last 10 days come around, they are able too.

Of course, there are exceptions, but as you can tell, I generally encourage my patients to fast in Ramadan.  In the summer, I do give a few rules.   These are rules for my patients, not guidelines.
1.  All my pregnant patients must wake up for sahoor (the pre-dawn meal) and must have 1 liter of water during that time.  It’s hard to drink that much that fast, so give yourself time.   something that also works, is to drink a glass, pray 2 rakah, drink a glass, etc.)
2.  All my pregnant patients must have another liter of water after iftar, before they sleep.
3.  If either of the above are not done for that particular day, my patients are not allowed to fast that day.
4.  During the day, I instruct my patients to be wary of signs of significant dehydration.  Primarily: lightheadedness or dizziness.   Should this occur, they have to break their fast and start taking down water.
5.  Another sign of dehydration after 20-24 weeks of pregnancy is contractions.  Sometimes, when the body is dehydrated, the uterus starts to contract.  So for women further along in their pregnancy, if they start to feel regular contractions or cramping, they also have to break their fast and start drinking a lot of water.

And God knows best.

DISCLAIMER:  Information in questions, answers, and other posts on this site are for general information, and are not intended to substitute for informed professional medical advice, and do not establish a physician-patient relationship. The site is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.