By Dr. Nazura Siddiqi – Specialist OB/GYN

The holy month of Ramadan is looked forward to eagerly by Muslims all over the world. Fasting in Ramadan is one of the five pillars of Islam although pregnant and breast feeding women are exempt if it poses a health risk.

Very often my patients ask me whether they should be fasting. Most of them would like to fast especially as it is difficult for them to make up those days after delivery. Many studies have been done all over the world to understand the effect of fasting in pregnancy. Some studies show little or no effect on newborn babies whose mothers fasted during pregnancy. Others suggest health problems later in life, or that fasting in pregnancy may have some effect on the intelligence or academic ability of a child.

HERE IS WHAT THE MEDICAL RESEARCH HAS TOLD US SO FAR:

• The Apgar score (an assessment of the baby’s condition at birth) of babies of women who fasted in pregnancy was no different from babies of women who didn’t fast.
• Fasting in pregnancy may cause a baby to have a lower birth weight, especially if the mother fasted in her first or last trimester. Other studies found the difference in birth weight to be very small.
• Babies born to mothers who fasted either in pregnancy or at the time of conception may grow up to be slightly shorter and thinner. But again, this difference is very small.
• The chemical balance of the blood changes when you fast. But the changes don’t appear to be harmful to you or your baby.
• There is some concern that fasting may affect how well a baby grows in the uterus (womb), or that fasting may be linked to premature labour. Some studies suggest that more babies are born early if their mothers fast during Ramadan, though the country you live in also plays a part.
• If Ramadan coincides with summer, this means the days are long and hot, putting you at greater risk of dehydration. Obviously, in a hot country like UAE with fasts lasting 14-15 hours there is an increased risk. My own experience has shown that there is reduced weight gain in the fetus if mother is fasting especially in the later months of pregnancy. I have noticed that fasting in early pregnancy is associated with higher incidence of nausea, vomiting and dehydration which can be detrimental for the mother and the fetus. Fasting in late pregnancy is associated with poor maternal weight gain and poor growth in the fetus.

FASTING AFFECTS DIFFERENT PEOPLE IN DIFFERENT WAYS

A woman’s health before she conceives, the stage of pregnancy during which she fasts, and the length of the fast each play a role.

Most Islamic leaders say that you should fast if you are healthy enough to do so. But they also say that if you are unwell you must not fast. You should not ignore this special permission if you feel unwell, or if you fear that fasting could harm you or your baby.

Only you can judge how healthy you feel, and what the right decision is for you. Talk to your family, midwife or doctor, and listen to their advice.

HOW SHOULD YOU PREPARE FOR FASTING

It is important to check with your doctor if your health permits you to fast. It is better to avoid fasting if you are prone to Diabetes during pregnancy or have Anaemia as fasting can cause complications.

You may need to have more frequent check-ups during your fast to monitor your blood sugar levels.

If you are working, talk to your employer about managing your work during Ramadan through reducing your working hours or having extra breaks. In UAE, we are benefited by the shorter working hours during Ramadan.

Consult a dietitian to work out your dietary needs. Maintaining a food diary, to note what you are eating and drinking is helpful.

WARNING SIGNS YOU SHOULD LOOK FOR:

Contact your doctor as soon as possible if:

• Weight gain in pregnancy is very important. If you’re not putting on enough weight, or are losing weight, contact your doctor. Try to weigh yourself regularly at home.
• You become very thirsty, and urinating less frequently, or if your urine becomes dark-coloured and strong-smelling. This is a sign of dehydration, and it can make you more prone to urinary tract infections (UTIs) or other complications.
• You develop a headache or other pains, or a fever.
• You become nauseous or start vomiting.

IN LATER MONTHS OF PREGNANCY

You should contact your doctor straight away if:

• There noticeable change in your baby’s movements, such as if your baby is not moving around or kicking as much.
• You notice contraction-like pains. This could be a sign of premature labour.
• You feel dizzy, faint, weak, confused or tired, even after you have had a good rest as this may mean that your blood sugar levels are very low. Break your fast immediately and drink water containing salt and sugar, or an oral re-hydration solution.

WHAT’S THE BEST WAY TO BREAK YOUR FAST:

Choose a variety of healthy foods and have plenty to drink at Suhoor and Iftar. Have a healthy bedtime snack too, and make sure not to miss your suhoor.

• Choose foods that release energy slowly. Complex carbohydrates, such as whole grains and seeds, and high-fibre foods, such as vegetables and dried fruits, will help you keep going. This will also help to prevent constipation.
• Avoid having lots of sugary foods that will raise your blood sugar levels quickly.
• Rather than high-fat, refined foods, choose healthier options such as potatoes or vegetables.
• Make sure you get plenty of protein from beans, nuts and well-cooked meat and eggs. This will help your baby to grow well.
• Try to drink about 1.5 – 2 litres of water or other fluids between dusk and dawn, and avoid caffeinated drinks such as tea and coffee. Caffeine makes you lose more water when you urinate so you may be more likely to become dehydrated, especially if it’s hot.

The ultimate choice is yours. If you still cannot decide I often advise my patients to keep a trial fast. If any warning signs are present it is better to avoid fasting.

 

About the author

Dr. Nazura Siddiqi is a Specialist with over 19 years of experience in Obstetrics and Gynecology. Dr. Nazura received the basic MBBS degree from Kolkata in 1992 and postgraduate degree in obstetrics and gynecology in 1996. After practicing for several years as junior then Senior Consultant she decided to study further and passed her MRCOG exam in 2010.

Before joining Bareen International Hospital, she was working as Specialist for LLH Hospital Musaffah for last two years. Her area of expertise includes infertility and high risk pregnancies and she was performing more than 500 deliveries per year including pregnancies complicated by diabetes, hypertension, uterinetumors, bleeding disorders, heart disease. She also has vast experience in all kinds of gynecological disorders such as menstrual disorders, hormone problems, obesity, tumors, breast problems, and routinely performed abdominal and vaginal hysteromy, myomectomy, laprotomies and other gynecological surgeries.