The normal case is that Muslim women who are pregnant and nursing must fast. They should also take the means to ensure this.
Shaykh Faraz Rabbani has outlined from Ibn `Abidin’s Radd al-Muhtar the case of when a pregnant or nursing woman is exempt from fasting. She may leave fasting if she has a good reason to fear harm for herself or her child. This is through
1. advice from reliable Muslim medical opinion (or a non-Muslim medical opinion if it confirm’s one’s own good reason for fear)
2. previous experience
3. or clear and unmistakable signs
It’s very important that women observe how their bodies react to fasting and not ignore obvious warning signs. Sometimes one can see two extremes when it comes to pregnancy/lactation and fasting. Either women automatically assume they cannot fast when pregnant or lactating, and they make no effort to see how their bodies will handle the fast. Or they fast and ignore all warning signs until their health is actually compromised. This is not the way it should be. Women need to strike a balance and understand that every woman’s experience will be different.
Some sisters have shown that they have been able to fast while pregnant and lactating. Other sisters, however, simply cannot fast and maintain good health during pregnancy or sufficient milk supply during lactation. In this case, women should keep track of the days they miss and plan to make them up later.
Again, being in tune with one’s body is really important. Looking out for obvious warning signs does not mean women should wait until they’ve landed in the hospital. What it does mean is that they have to check things like the frequency and color of their urine, frequency and consistency of stools, and the presence of any type of contractions when pregnant. When nursing, they should also look at the frequency and color of their urine, and be aware of the color of their milk, its quantity, the strength of their let-down reflex, and their baby’s state: contented vs. agitated.
Clear warning signs include:
1. dark urine (when pregnant or nursing)
2. constipation (when pregnant or nursing)
3. cramps and contractions (for pregnant women)
6. a baby who seems agitated, that is, it’s clear that no matter how often you nurse the baby, she or he is not calming down
At the first sign of trouble, it’s permitted to break your fast and make up the days later.
Please note that this advice comes from an observant Muslim OBGYN who has advised many pregnant and nursing women during Ramadan.
In the end, pregnant and nursing women who are not able fasting can still do many things to make the most of their Ramadan. Ramadan is a time when one draws closer to Allah — and this can be done in many forms. She may perform the tarawih prayer, extra prayers and recite Qur’an. She can also do acts of charity and service for others. In addition to the outward forms of worship, many scholars have stressed the importance of inner acts of worship, such as reflecting on one’s bad habits and working steadily towards eliminating them.
And Allah knows best,