Pregnant women should seek advice before fasting,doctors say

Many pregnant women fast though advised not to, say doctors, who see many pregnant patients with nausea, dizziness or hypoglycaemia or low blood pressure during Ramadan.

ABU DHABI // Many pregnant women are fasting despite being advised not to, say doctors, and many do not seek medical advice on whether they are fit to fast.

Doctors say they treat pregnant patients for conditions such as nausea, dizziness, hypoglycaemia and low blood pressure during Ramadan, and recommend that pregnant women consult them before fasting to avoid these problems. But many patients do not have check-ups before the holy month starts.

“Pregnant ladies fast and they come here saying they are tired or dizzy and some even collapse,” Dr Fady Georges Hachem, consultant in obstetrics and gynaecology at Burjeel Hospital said. “This is very common. Sometimes they are shaking or have poor vision.

“We recommend that pregnant women have a basic check-up and see how they react to fasting,” he said.

Dr Hachem believes that having suhoor is important for pregnant women as they need more energy and are at risk of hypoglycemia.

“Dehydration can make them collapse, especially if they are working or exercising,” he said.

Even basic activity can be too much for pregnant women who are diabetic, and those who are breastfeeding need to have a substantial suhoor and iftar. Slow-burning carbohydrates, found in whole grains, are a good option for suhoor, while one can have more protein for iftar.

Dr Nazura Siddiqi, a specialist gynaecologist at LLH Hospital in Mussaffah, believes the climate, the patient profile and the season in which Ramadan falls determine whether a pregnant woman can fast.

“I know many patients who don’t even bother to ask their doctors if they are physically fit to fast. I have seen patients who fasted against my advice as their relatives said they should. Some of them suffer from nausea, and fasting causes them to have hyper acidity, which increases the nausea,” said Dr Siddiqi.

Whether the woman can fast or not also depends on the trimester of her pregnancy.

“If the patient is sick and vomiting in the first trimester and she fasts, she can have low blood sugar. Also, the child’s organs are formed in this trimester. If the child has inadequate nutrition, he or she will face increased risk of cardiovascular diseases and might be prone to disorders,” she said.

A woman who has recently given birth and is pregnant again may not be able to fast.

“I encourage patients to take frequent meals. Undernourished patients have underweight babies or reduced fluid due to poor nutrition,” said Dr Siddiqi.

If the patient has no complications and adequate weight gain, she can try to fast, Dr Siddiqi said, though the patient should avoid venturing outdoors.

Noora, a 33-year-old Emirati in Abu Dhabi, said she fasted during her pregnancies and does not regret it. Though she consulted her doctor the first time, she did not do so for her following pregnancies because she thought she understood her body well.

“I know a majority of women who fast and many don’t consult doctors. I checked with my doctor the first time, paid attention to the food I ate and had supplements,” said Noora, who has four children – two daughters, 9 and 7, and two sons, aged five and three months.

She fasted last Ramadan while she was pregnant and she said it was tougher and more tiring, as it was during summer.

“I knew I could break my fast and that kept me comfortable, though in the end I did not need to break a fast. I listened to my body, rested more and avoided heavy food,” said Noora. Her advice to women who are fasting is to “listen to your body and if you are ill you can fast later”.

A Iranian study on the effects of fasting during pregnancy from 2010 found no “inappropriate effect on intrauterine growth and birth-time indices”, though risk of low birth weight was one and a half times more for infants of mothers who fasted during the first trimester, as compared with those who did not fast.