1. Pregnancy health and Ramadan
Dr Sherif Tawfeek
Senior consultant in Obstetrics and Gynaecology at Christchurch Women’s Hospital
Senior Lecturer at university of Otago

2. Does the pregnancy carry a risk to women?
WHO: About 830 women die from pregnancy or childbirth- related complications around the world every day.

3. Key facts
Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth.
Pregnancy can lead to serious medical condition e.g. sever anaemia DM, BP, VTE
99% of all death occur in developing countries.
Death is higher in women living in rural areas and among poorer communities.
Young face a higher risk of complications and death
Between 1990 and 2015, maternal mortality worldwide dropped by about 44%.

4. Maternal Mortality Rate per 100,000 live birth (Highest)

5. Maternal Mortality Rate Lowest

6. Why do women die Lack of care and health facilities
Pregnancy can lead to serious medical condition e.g. sever anaemia DM, BP, VTE
Severe bleeding (mostly bleeding after childbirth)
Infections (usually after childbirth)
High blood pressure during pregnancy (pre-eclampsia and eclampsia)
Complications from delivery
Unsafe abortion.

7. Why do women not get the care they need?
Do not believe in medical professional
In Addition:
Poverty
Distance
Inadequate services
Cultural practices
Lack of information

8. Pregnancy process Pregnancy Postnatal (After child birth)
Pre-conception (Before pregnancy)
Antenatal (pregnancy)
Intra-partum
(Giving birth)
Postnatal
(After child birth)
Post-partum
Late

9. What are the challenges for pregnant women during fasting
Low calories / Imbalanced nutrition
Less fluid intake
Reduced vitamins and mineral supplements

10. Factors to be considered:
Gestation of pregnancy during Ramadan
Hot or cold days
Short or long days
Nutrition status
Baby status
Physical activities
Pre-existing medical condition
Emotional changes

11. Pre-existing medical condition
Severe anaemia or malnutrition
Heart condition
Peptic ulcer
Diabetes requiring medication
Chronic kidney problem
Chronic liver condition
History of clots formations
Infection

12. Potential problems to mothers:
Tiredness and lethargy
Low blood sugar
Nausea and vomiting
Anaemia
Diabetic
Constipation
Urinary tract infection
High blood pressure
Emotional changes

13. Potential problems to fetus:
Reduce fetal movements
Possibility of small size baby and placenta
Reduced fluid around the baby
Increase risk of stillbirth (baby die)

14. Does fasting Ramadan putting the pregnancy at risk?
A study by scientists in the United States, based on census data from the US, Iraq and Uganda, found that pregnant women who fast are likely to have smaller babies who are more prone to learning disabilities in adulthood.
The researchers from Columbia University found that this trend was most marked if mothers-to-be fasted early on in their pregnancy and during the summer when longer days meant they went more hours without food.

15. Does fasting Ramadan putting the pregnancy at risk?
A study by scientists in the United States, based on census data from the US, Iraq and Uganda, found that pregnant women who fast are likely to have smaller babies who are more prone to learning disabilities in adulthood.
The researchers from Columbia University found that this trend was most marked if mothers-to-be fasted early on in their pregnancy and during the summer when longer days meant they went more hours without food.

16. Does fasting Ramadan putting the pregnancy at risk?
A study by scientists in the United States, based on census data from the US, Iraq and Uganda, found that pregnant women who fast are likely to have smaller babies who are more prone to learning disabilities in adulthood.
The researchers from Columbia University found that this trend was most marked if mothers-to-be fasted early on in their pregnancy and during the summer when longer days meant they went more hours without food.

17. How can the pregnant woman fast safely?
Prepare well for Ramadan
Seek medical advice
Optimize your health and get pre-existing medical issues well controlled
May fast part of Ramadan
Be prepared to break your fast anytime
Re-organize your work, family and social life
Ask for help (family, husband or kids)

18. What does pregnant woman should eat ?
“Sahoor”:
Eat high fiber, whole grains, vegetable (Complex carbs), fruits, nuts Avoid excess salt, sugar, and caffeine Drink water, milk, and juice just before dawn Plenty of fluids
“Iftar”
Plenty water and dates
Eat high fiber, (simple carbs) fruits and milk
Balanced, nutritious include protein with low fat
Plenty of fluids
- Activity: avoid strenuous physical activity;
get adequate sleep - Stay cool during day
Vitamin supplements

21. Warring signs Decrease fetal movement
Irritability, headache, excessive hunger or thirst
Nausea/vomiting
Dysuria, fever, flanks pain
Weakness, fatigue, light headedness, dizziness
Preterm contractions

22. Does fasting affect breast feeding
No significant differences were seen in the content of major nutrients of milk taken during and after
Ramadan. There was a slight increase and a slight decrease respectively in the concentrations of
triglycerides and cholesterol after the end of Ramadan, although these changes were also not
significant.

23. Thank you