In this episode of the Healthful Woman podcast, Dr. Nathan Fox speaks with Dr. Stephanie Melka, a maternal-fetal medicine specialist, about whether it’s safe to fast during pregnancy. For many Jewish women, certain fast days mean going without food and drink for up to 25 hours, and pregnancy raises understandable questions about what’s best for mom and baby. Dr. Melka, who grew up Catholic and calls herself a “newcomer” to these traditions, shares the practical guidance she and Dr. Fox give their patients, along with the signs that it’s time to stop.
Why There’s No One-Size-Fits-All Answer
Both doctors agree that blanket rules don’t serve patients well. As Dr. Fox puts it, “it’s inappropriate to say every woman can fast, it’s also important not to say every pregnant woman should not fast.” He notes that “there are some doctors who tell patients, ‘you can never fast,'” but that approach overlooks how many healthy pregnant women can safely observe a fast with the right precautions.
Religious guidance often leaves room for flexibility, too. Dr. Fox explains that rabbis “tend to be pretty lenient when it comes to pregnant women,” and there is a built-in accommodation that can make a fast more manageable: drinking about an ounce of liquid every 10 minutes or so is generally permitted. Women who want to observe a fast are encouraged to speak with both their doctor and their rabbi to find an approach that works medically and religiously.
Who May Be Able to Fast Safely
Healthy pregnancies without risk factors. Dr. Melka explains that women who are in good overall health, have no pregnancy complications or risk factors, and have fasted before may be good candidates to try fasting.
Knowing when to stop. The key is listening to your body. Women should break their fast if they feel unwell, including feeling dizzy or faint or starting to have contractions. Dr. Melka’s rule of thumb is simple: “Anything you don’t usually feel while fasting” is a signal to stop, eat, and drink.
When Fasting Isn’t Recommended
Higher-risk pregnancies. Dr. Melka and Dr. Fox generally advise against fasting for women who are carrying twins or other multiples, have a history of preterm birth, have a cerclage in place, or have diabetes. Women experiencing significant vomiting, such as those with hyperemesis gravidarum, should not fast either, since they are already at risk for dehydration.
Medications during a fast. When it comes to medications, Dr. Melka stresses that “it’s so incredibly individualized.” Non-critical supplements can usually be skipped for the day. However, critical medications such as blood pressure medication or injectables should not be skipped. If you’re unsure, talk with your provider well before the fast day. Planning ahead with a nutrition consultant can also help you prepare for the meals before and after a fast.
Learn More
Listen to the full episode of the Healthful Woman podcast to hear more from Dr. Melka and Dr. Fox on fasting during pregnancy. You can also explore more of our pregnancy podcasts, including Dr. Melka’s episode on preparing for your postpartum visit.
If you are expecting and have questions about fasting, medications, or staying healthy during religious observances, Carnegie Women’s Health provides compassionate, personalized care for women at every stage of life. Contact Carnegie Women’s Health through the online appointment request form to schedule a visit.
