Dr. Melka and Dr. Fox discuss whether it’s safe for pregnant women to fast, particularly with regards to Jewish fast days. On fast days, observers do not eat or drink for up to 25 hours, depending on the holiday. Dr. Fox and Dr. Melka explain when it is and isn’t safe for pregnant women to fast and how they advise their Jewish patients.
“Jewish Fast Days: Can Pregnant Women Try to Fast?” – with Dr. Stephanie Melka
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In this episode, Dr. Stephanie Melka returns to Healthful Woman to discuss whether pregnant women can fast with Dr. Fox. While many religions have fast days, many of Drs. Fox and Melka’s patients who are concerned with fasting are Jewish. Dr. Melka explains that she grew up Catholic, so she is largely a “newcomer” to the Jewish traditions of fast days now that she lives and works near a larger Jewish community.
Dr. Fox explains that on Jewish fast days, you’re not supposed to fast if you are sick, as the goal is not to do harm to yourself. In the past, all pregnant women were expected not to fast, because pregnancy was more dangerous. However, Dr. Fox now says that while “it’s inappropriate to say every woman can fast, it’s also important not to say every pregnant woman should not fast.”
When Can Pregnant Women Fast?
Dr. Melka explains that typically, she asks patients what they were planning to do first, then guides them based on what they have in mind, as every patient and rabbi has a different opinion. She says that so long as the patient has no complications or risk factors, is healthy overall, and has fasted before, there are few reasons why she should not fast. However, she advises patients to break their fast if they feel unwell, meaning they are dizzy, feel faint, or start having contractions. “Anything you don’t usually feel while fasting” is a sign a patient should break their fast, Dr. Melka explains. She recommends that they eat something and drink water, and can then attempt to continue their fast if they choose.
The biggest risk to pregnant woman while fasting is the lack of hydration. Dr. Fox explains that there is a “loophole” in Jewish fast days, as about an ounce of liquid every 10 minutes or so is allowed. He says that “I don’t think I’ve ever come across a situation where a patient or rabbi disagreed on that front” and that rabbis “tend to be pretty lenient when it comes to pregnant women.”
When Not to Fast While Pregnant
Drs. Fox and Melka explain several conditions which would bar a woman from fasting while pregnant. These include carrying multiples, previous preterm birth, cerclage, taking certain medications, diabetes, and those experiencing a lot of vomiting.
One of the biggest risks of fasting while pregnant is that a woman might begin contracting or going into labor. If she is at term, this becomes more of a personal choice regarding whether she would be comfortable going into labor if it did occur. However, Dr. Melka advises women to break their fast regardless if they experience contractions and feel sick.
Regarding taking medicine on fast days, Dr. Melka says “it’s so incredibly individualized.” She advises women taking supplements or other less critical medicines that they can forgo taking them for a day, but more important medications, like blood pressure medication or any injectable, should not be skipped.
Seeking Advice on Fast Days
Generally speaking, Dr. Fox says “there are some doctors who tell patients, ‘you can never fast.’” He finds that “it’s not that they’re wrong, it’s just that it’s impractical.” If patients find that their doctor or rabbi is not understanding their concerns, “it’s worth it to do some more investigating.”