There is no single answer for every pregnant woman. A 2018 review of 22 studies found no clear link between fasting in Ramadan and lower birth weight or preterm birth, but the evidence has gaps, especially for women with diabetes. Whether fasting suits you is a decision to make with your clinician, and your religious scholar can advise on the faith side.
This is health information to help you learn and plan. It is not a substitute for your own clinician. If you notice a warning sign, get care now.
What does the research say?
The 2018 review pooled 22 studies covering 31,374 pregnancies. The difference in birth weight between fasting and non-fasting mothers was very small. Preterm birth was about the same in both groups (odds ratio 0.99, 95% CI 0.72 to 1.37). The authors said the evidence on other outcomes was not sufficient. No included study reported deaths around birth. Glazier et al. 2018
A 2023 review written for obstetricians reached similar conclusions on birth weight and preterm birth. It found that fasting is mainly linked with tiredness and dehydration, with a small drop in weight gain. It also noted conflicting data on gestational diabetes, not enough data on high blood pressure in pregnancy, and possible changes in some fetal tests. Shahawy et al. 2023
What this means: On average, the studies are reassuring. They cannot predict what will happen in your pregnancy. Some questions are still open.
Who should talk to a clinician before deciding?
These situations are not rules. They are reasons to plan with your clinician before you decide.
- Gestational diabetes (diabetes that first appears in pregnancy), especially if you take any medicine to lower blood sugar. A 2022 review found only five small studies of fasting in pregnancy. Most of them looked at women with gestational diabetes. Kumar and Diamond 2022 and NHS: gestational diabetes
- Pre-eclampsia or high blood pressure in pregnancy. The NHS lists high blood pressure as an early sign of pre-eclampsia, a pregnancy complication. NHS: pre-eclampsia
- Severe or repeated vomiting. The NHS says to tell your midwife or doctor if you are being sick often and cannot keep food down, because of the risk of dehydration. NHS: severe vomiting in pregnancy
Questions to bring to your appointment:
- Does my health history or this pregnancy make fasting a concern for me?
- If I fast, when and how often should I check my blood sugar?
- Which symptoms mean I should stop fasting and call you?
- Who do I contact outside clinic hours?
- My glucose screening test may fall during Ramadan. What should I do? The NHS says the glucose test needs no food or drink for 8 to 10 hours, so tell your team about any fasting. NHS: gestational diabetes
If you and your clinician decide to fast
This is a shared plan. Take these points to your team:
- Meals: Ask a dietitian or your clinician what suhoor (the pre-dawn meal) and iftar (the sunset meal) should look like for you.
- Fluids: Ask how much fluid is right for you between sunset and dawn. Signs of dehydration are in the box below.
- Records: Note any blood sugar readings your team asks for, and any symptoms. Bring the notes to appointments.
Gestational diabetes and Ramadan
Gestational diabetes usually causes no symptoms. Most cases are found by screening blood tests. Some women notice high blood sugar signs: increased thirst, needing to pee more often, a dry mouth, tiredness, blurred eyesight, or genital itching. Many of these are common in pregnancy anyway. NHS: gestational diabetes
Low blood sugar (a hypo) is one of the main concerns. A hypo is usually a blood sugar below 4 mmol/L. Its signs include hunger, dizziness, feeling anxious or irritable, sweating, shaking, tingling lips, a racing heartbeat, tiredness, blurred vision, and confusion. NHS: low blood sugar A 2022 review of five small studies found lower average blood sugar and more frequent low blood sugar during fasting. It said the data on serious low blood sugar needing hospital care were limited. Kumar and Diamond 2022
The same 2022 review says the current medical recommendation is against Ramadan fasting for pregnant women with diabetes. Ask your diabetes and maternity team which guidance they follow for you before Ramadan begins.
When to see a doctor
Contact your midwife or doctor before Ramadan if you are unsure whether fasting is safe for you. Contact them if you are worried about any symptom. NHS: gestational diabetes
Seek care now: Stop fasting and get medical help now if you have any of these: - Your baby moves less than usual, or the movements stop. RCOG guideline 57 - Vaginal bleeding, or fluid leaking from the vagina. CDC - Severe belly pain that does not go away. CDC - You are less than 37 weeks pregnant and have regular tightening of the womb, or think you might be in labour. NHS: signs that labour has begun - Dizziness or fainting. CDC - Trouble breathing, chest pain, or a fast-beating heart. CDC - A severe headache that does not go away, vision changes or flashing lights, pain below your ribs, or sudden swelling of your face, hands or feet. NHS: pre-eclampsia - Low blood sugar symptoms with confusion, a seizure or fit, or passing out. NHS: low blood sugar - Signs of dehydration: dark yellow or strong-smelling pee, peeing much less, dizziness when you stand that does not go away, or unusual tiredness. NHS: dehydration - Vomiting so that you cannot keep food or fluids down for 24 hours, or no pee for more than 8 hours. NHS: vomiting and morning sickness - New or worse thirst, frequent peeing, dry mouth, or blurred eyesight with high blood sugar. NHS: gestational diabetes If you are confused, cannot stay awake, have a seizure, or cannot reach your team, contact local emergency services or go to the nearest emergency department. Do not wait for Femio or another online service to respond.
Femio cannot assess an emergency. Read more about pregnancy warning signs that need urgent care. See how Femio's health content is checked on the clinician review page and the editorial policy. Terms like "hypo" are explained in the glossary. If you feel unsafe, use the help-now page.
Frequently asked questions
Does fasting harm the baby?
The reviews did not find a clear effect on birth weight or preterm birth. They did not have enough data on every outcome, including deaths around birth. Talk to your clinician about your own pregnancy.
Do I have to fast?
Egypt's Dar al-Ifta says a woman who is unable to fast because of pregnancy or nursing may refrain from fasting, and should make up the missed days when she is able. Dar al-Ifta Your religious scholar can advise on the religious side. Your clinician can advise on the medical side.
Can I fast if I have gestational diabetes?
That is a decision to make with your clinician. A 2022 review states that the current medical recommendation is against Ramadan fasting for pregnant women with diabetes. Your team can weigh that against your blood sugar readings and your health. Kumar and Diamond 2022
What if I feel unwell during the day?
Check the box above. If any sign appears, stop fasting and get medical help now.