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16 January 2025Fasting during pregnancy is a deeply personal decision influenced by religious beliefs, health considerations, and cultural expectations. For many Muslim women, the holy month of Ramadan presents both a spiritual opportunity and a physical challenge, particularly for those in the early stages of pregnancy. We explore some of the religious exemptions, medical advice, and support for women who choose to fast, drawing from discussions within our steering groups and insights from the Real Birth Company’s soon to be released RealBirth V4 digital health technology.
Religious Perspectives on Fasting in Pregnancy
Islamic teachings provide a compassionate allowance for pregnant women, exempting them from fasting if it could affect their health or that of their baby. The Quran makes it clear that missed fasts can be observed at a later time or, alternatively, compensated through fidya, which involves acts of charity or support. However, despite this exemption, many women still choose to fast during early pregnancy, believing it to be the best decision for them. One participant in our steering group explained that she decided to fast throughout Ramadan, apart from a few days, and found that doing so in early pregnancy was preferable to postponing it until she was breastfeeding. Although she acknowledged experiencing more tiredness, she felt confident in her choice, particularly as she had fasted through previous pregnancies and understood what to expect. Her experience shows just how personal this decision is, shaped by her past pregnancies, her faith, and what feels right for her own well-being.

Other Faiths
Other faiths also offer exemptions or adaptations for pregnant women when it comes to fasting. In Judaism, for example, women are not required to fast on significant fasting days such as Yom Kippur if it could pose a health risk. Similarly, in Hindu traditions, fasting practices can be modified, with many choosing to consume fruits or liquids rather than abstain entirely from food and drink. These allowances reflect a common understanding across religious traditions that health and well-being of the mother and baby must remain a priority, even during periods of spiritual observance.
Pregnancy Trimesters and Fasting Considerations
The impact of fasting can vary depending on the stage of pregnancy. In the first trimester, when nausea, fatigue, and dehydration can be more pronounced, fasting may feel particularly challenging. Some women, including our steering group participants, highlighted that many women find that fasting in early pregnancy is manageable, though they may feel more tired than usual. It’s a time of significant change for both mother and baby, so ensuring good nutrition remains essential. Checking in with a healthcare professional can help provide reassurance and guidance on how to balance fasting with well-being, but some people felt that the support they needed was not there. It was also discussed how really important it is, as health care professionals, to approach the topic with cultural sensitivity to avoid making women feel judged.
During the second trimester, energy levels may improve, making fasting somewhat easier to sustain. This is a time when the body has adjusted to pregnancy, and for some women, fasting feels more achievable. However, the need for adequate nutrition remains really important to support both maternal health and the baby’s growth.
In the final trimester, fasting can become more physically demanding. The baby is developing rapidly, and the body's energy requirements increase significantly. Dehydration and dizziness can become more common, making it difficult to maintain a full fast without feeling unwell. At this stage, many women decided not to fast as their health and their baby’s well-being must come first.
Medical Guidance and Midwife Support
Midwives and healthcare professionals play an essential role in supporting women who are considering fasting during pregnancy. Ensuring that expectant mothers feel informed and respected in their choices is vital. Women should be encouraged to stay hydrated and to choose foods that are rich in nutrients when breaking their fast. Keeping a close watch on their energy levels and being mindful of signs of dehydration or dizziness is important, as is monitoring the baby’s movements to ensure their well-being. Consulting with religious leaders can also provide reassurance, helping women to navigate both faith and medical considerations when making their decision. If a woman ever feels unsupported in her decision, whether she chooses to fast or not, she should feel empowered to request a different midwife or obstetrician who aligns with her needs and beliefs.

Alternative Ways to Observe Ramadan
For those who find that fasting is not an option, whether due to medical advice or personal well-being, there are many other meaningful ways to embrace the spirit of Ramadan. Prayer and reflection can provide a deep sense of spiritual connection, offering an opportunity to engage with faith in a way that feels fulfilling. Acts of charity and involvement in the community, such as preparing meals for others or supporting those in need, can help maintain the essence of giving and kindness that Ramadan embodies. Engaging with Islamic lectures and discussions can also be a valuable way to feel connected to the spiritual atmosphere of the holy month, even if fasting is not possible.
The insights gathered from our steering group emphasised the importance of focusing on the challenges of fasting rather than framing the discussion around risks or negatives, which can feel discouraging. By shifting the conversation in this way, women can feel empowered in their choices, whether they decide to fast or not. In response to this RealBirth V4 now includes dedicated sections throughout the programme on Ramadan, delving into its significance and offering practical guidance for those who may be unable to fast due to medical reasons.
Conclusion
The decision to fast during pregnancy is one that each woman must make for herself, guided by her faith, her health, and her personal circumstances. Religious teachings offer flexibility, allowing women to prioritise their well-being without feeling as though they are compromising their spiritual commitment. By providing clear medical advice, offering emotional support, and recognising the broader significance of Ramadan beyond fasting, we can ensure that all women feel included and valued in their faith. No matter the choice they make, every expecting mother should feel respected, supported, and confident that she is making the best decision for herself and her baby.