Pregnant women are explicitly exempt from fasting during Ramadan in Islam, but the majority choose to fast anyway. Estimates suggest that 50 to 90 percent of pregnant Muslim women fast to some extent during Ramadan, depending on the country. The decision is deeply personal, shaped by faith, cultural expectations, and individual health circumstances.
What Islamic Teaching Actually Says
Islam clearly exempts pregnant and breastfeeding women from the obligation to fast. A well-known Hadith states: “Allah has relieved the traveler of obligation of fasting and half of prayers and he has relieved the pregnant and nursing women of obligation of fasting.” The exemption is not a loophole or a modern reinterpretation. It is built into the tradition itself.
That said, the exemption is optional, not mandatory. A pregnant woman may still choose to fast if she feels able. If she does skip fasting, she is generally expected to make up the missed days after her pregnancy. In some schools of Islamic jurisprudence, a pregnant woman in her final two months who cannot fast due to potential harm to herself or the baby must also pay fidyah, a form of compensation that involves providing a meal to a poor person for each missed day. Fidyah can be paid as money, as long as it is specifically used to purchase food.
How Many Pregnant Women Fast
Despite the exemption, fasting rates among pregnant Muslim women are remarkably high. In Iran and the Netherlands, roughly 50 to 70 percent of pregnant women fast during Ramadan. In England, Singapore, the United States, Gambia, and Yemen, that figure climbs to 70 to 90 percent. In one large study, about 79 percent of women whose pregnancies overlapped with Ramadan fasted to some extent during the month.
The reasons vary. Many women feel a strong spiritual connection to Ramadan and don’t want to miss it. Social and family pressure plays a role in some communities. Others simply feel physically capable and see no reason to stop. In one study from Pakistan, among women who chose not to fast, about 82 percent planned to make up their missed days after delivery, showing how seriously the obligation is taken even by those who defer it.
What the Research Shows About Safety
The largest reviews of the evidence suggest that Ramadan fasting during pregnancy does not clearly increase the risk of preterm birth. Pooled data from multiple systematic reviews found odds ratios for preterm birth between 0.93 and 0.99, meaning essentially no increased risk. There is also little strong evidence that fasting reduces birth weight overall.
One nuance worth noting: a meta-analysis found that fasting during the third trimester, or across both the second and third trimesters, was associated with a small reduction in birth weight of about 60 to 80 grams. That’s roughly 2 to 3 ounces, which is modest but measurable. Some studies also detected small decreases in certain fetal growth markers, like head size and thigh bone length, though the overall evidence was not strong enough to confirm a consistent negative effect.
Research on longer-term outcomes for children exposed to fasting in the womb is limited and generally low quality. Most studies found no association between Ramadan fasting and cognitive or physical development in offspring. A few studies did observe lower amniotic fluid levels in fasting women, which can be a concern because low fluid levels are linked to complications. However, these findings were not consistent across all research.
Practical Concerns for Women Who Fast
The main physiological challenges of fasting during pregnancy are dehydration and prolonged gaps without food. Ramadan fasting means no food or water from dawn to sunset, which can span 12 to 18 hours depending on the season and location. For a pregnant woman whose body is already working harder to maintain blood volume and support a growing baby, that’s a significant stretch without fluids.
Healthcare providers familiar with Ramadan fasting in pregnancy generally recommend drinking up to three liters of water between the pre-dawn meal (suhoor) and the evening meal (iftar). Spreading fluid intake across the non-fasting hours, rather than drinking large volumes all at once, helps with absorption. Prioritizing nutrient-dense foods at both meals, including protein, complex carbohydrates, fruits, and vegetables, helps compensate for the compressed eating window.
Fasting can also affect certain prenatal monitoring results. Some fetal tests, including nonstress tests and biophysical profiles, may show different readings in fasting women due to lower amniotic fluid levels. If you have a prenatal appointment during Ramadan, let your provider know you are fasting so they can interpret results in the right context.
Warning Signs That Mean You Should Break Your Fast
Regardless of your intention to fast, certain symptoms during pregnancy signal that your body or baby needs immediate attention. You should break your fast and contact your doctor if you experience:
- Reduced fetal movement or a noticeable change in your baby’s usual pattern of kicks
- Severe dizziness, fainting, or persistent headaches that don’t resolve with rest
- Signs of dehydration like dark urine, decreased urination, dry mouth, or rapid heartbeat
- Uterine contractions or vaginal bleeding
- Severe nausea or vomiting that prevents you from keeping food down at iftar
- Extreme weakness or confusion
These symptoms don’t necessarily mean something is seriously wrong, but they do mean fasting is putting too much strain on your body that day. Islam’s exemption exists precisely for situations like these. Breaking a fast to protect your health or your baby’s health is not only permitted but expected, and you can make up the day later or pay fidyah.
How to Decide What’s Right for You
The decision to fast or not is both medical and personal. Your trimester matters: the third trimester is when research most consistently shows small effects on birth weight, and it’s also when your body’s caloric and fluid demands are highest. Women with gestational diabetes, high-risk pregnancies, or a history of preterm birth face additional considerations that make fasting riskier.
Many women take a flexible approach, fasting on days they feel well and breaking the fast on days they don’t. Others fast for part of Ramadan and skip the rest. There is no all-or-nothing requirement. A conversation with your midwife or obstetrician before Ramadan starts can help you assess your individual risk based on your health, your stage of pregnancy, and any complications you may have. If your provider is unfamiliar with Ramadan fasting, you may need to explain that it involves complete abstinence from food and water during daylight hours, since some clinicians assume it’s only a food restriction.