Fasting on YK and risk of premature labor

amother

Clear ↓

Thu, Sep 21 2023, 1:42 pm

There were studies done in Israel that show a very very small risk from Yom Kippur specifically. If you have additional risk factors or are a particularly terrible faster there might be what to talk about. But for your average low risk pregnant woman, the risk of preterm labor is very small.

Think about it. Tens of thousands of women have been fasting pregnant on Yom Kippur for thousands of years. How many do you know that went into preterm labor from fasting?

ETA: here's the relevant study. In laymen's terms, the risk of preterm birth doubled from .092% to .2%. It's a statistically significant increase but the absolute risk of preterm labor remains very small.
https://www.tandfonline.com/do.....=true

amother

Calendula

Thu, Sep 21 2023, 1:47 pm

Quote:

My doctor said fasting if you’re not already at risk for pre-term labor should be fine.

Yes, this is also what my doctor told me (she is not Jewish)
The risk of pre term labor for fasting for 26 hours one time is insignificant if there are no other risk factors involved. Doctors are always going to err on the side of caution - there's no reason for them not to.
I was pregnant on Yom Kippur in a few of my pregnancies and never had an issue

amother

↑ Clear ↓

Thu, Sep 21 2023, 1:56 pm

And now for those of you who prefer anecdotal evidence to statistics....

I fasted on Tisha Bav just before my due date and was still very overdue. And if you do an imamother search, you will see many others like me.

amother

NeonOrange

Thu, Sep 21 2023, 2:04 pm

I fasted on tisha baav and yom kippur and my child was due right after succos and I went two weeks overdue.
My doctor at the time (non jewish, high risk of course said no fasting but there was no medical reason other than pregnancy so my rav said to fast)

This time around, I am 3 months pregnant with a very complicated situation and any wrong move could put me and baby in jeopardy so my doctor ( Frum) said shiurim and my rav agreed after he heard why.

So it depends on each situation

amother

Nasturtium ↓

Thu, Sep 21 2023, 2:11 pm

I'm in the same boat OP although I'm a bit further along than you. I have also read the research that women between 22- 27 weeks are at a higher risk for preterm labor due to fasting. My rabbi gave me parameters of when and how to do shiurim but that's only for if I'm really not feeling well. Fasting on YK is a pretty big deal and I'm honestly surprised that so many people got a blanket heter for shiurim without any other risk factors.

That said, I'm super nervous to fast...

amother

↑ Nasturtium ↓

Thu, Sep 21 2023, 2:13 pm

amother Clear wrote:

Totally different scenario since we are talking about fasting during a very specific window (22-27 weeks) and not around one's due date. Although I'd imagine you felt pretty awful fasting at that point regardless.

amother

Seafoam ↓

Thu, Sep 21 2023, 2:38 pm

amother OP wrote:

Finally got a call back from my doctor and he is not concerned about not eating but didn't want me to refrain from drinking. I asked about shiurim and he thought that would be fine.

Relayed this to my Rav and he said I still have to fast, no shiurim 🤷‍♀️ Not sure why he said to ask my doctor in the first place.

He wanted you to ask your doctor because it's possible the doctor would tell you that you have an increased risk of preterm labor and therefore it's contraindicated for you to fast.

The Torah that tells us to fast when we're not pregnant is the same Torah that tells us to fast when we are pregnant, unless someone receives a psak otherwise. Hashem does not make mistakes. No one is putting their baby at risk if their rav tells them that the Torah wants them to fast. Anyone who goes into labor prematurely from fasting yk was clearly meant to go into labor at that moment, and the fasting did not accelerate it in any way (unless they ignored a psak not to fast).

sara_s

Thu, Sep 21 2023, 2:39 pm

This may not be statistically proven but I had to go to the emergency room on YK after trying to fast, and the ob/gyn emergency room was picked and the doctors and staff were all in a bad mood about pregnant women fasting. And this was Shaarei Zedek which is a religious hospital. Personally since then I do shiurim on YK when pregnant. I have a feeling that an academic study would show a much higher rate of birth in Israel on YK and Motzai YK.

amother

Snapdragon

Thu, Sep 21 2023, 2:45 pm

sara_s wrote:

My mom heard this as well from an L&D nurse in a hospital in NY. The hospital knows to expect many women on late yom Kippur day/motzei yom Kippur.

imaima

Thu, Sep 21 2023, 2:46 pm

amother Cinnamon wrote:

Interesting study/survey about physicians approaches to fasting...

https://pubmed.ncbi.nlm.nih.gov/30580227/

BTW I'm currently heading into my 9th month and will IYH be fasting.

Delivering in your 9th month is less of an issue than at 23 week

amother

Tangerine

Thu, Sep 21 2023, 3:19 pm

I'm 32 weeks and my (frum) Dr told me to do shiurim for drinks-- don't need to eat unless I'm unwell. I've fasted previous YKs but it was very early in pregnancy. I assume the guidance is different at different points (and based on your medical history). It's not such a problem to go into labor if you're full term.

amother

Copper

Thu, Sep 21 2023, 4:54 pm

Cheiny wrote:

I had the same issue and was terrified because my relative had a miscarriage on YK (nothing to do with fasting, though), my Dr wanted me to not fast, I asked my Rov and he said I must fast, and to stay in bed all day on YK and everything will be fine. And it was BH.

Ohmygoodness... I'm going to be like 35 weeks and have the same sitch (the bolded...) and I have a history of preterm labor.
I told my husband what was the point of me asking if I'm going to need to fast anyways??? Confused

amother

Olive ↓

Thu, Sep 21 2023, 5:09 pm

amother OP wrote:

I'll be 23 weeks on YK. My rav says to ask my doctor, my doctor is impossible to reach (I've called and messaged 4 times, they say they'll ask him and get back to me but they never do).

When I googled though I found link after link from reliable medical sources saying that fasting is never recommended during pregnancy, that even refraining from eating for just 13 hours can put you at greater risk of premature labor, and that weeks 22-27 are an especially risky time.

Why then is the standard that pregnant women do fast on YK? And what should I tell my rav? (He says to start shiurim if you're having regular contractions but at that point isn't it a little too late??)

If you have a regular pregnancy there is really no risk.

amother

↑ Olive ↓

Thu, Sep 21 2023, 5:11 pm

amother OP wrote:

BH! I'm happy you were fine.
Fasting increases the RISK of premature labor, which does not mean every woman will experience it.
But why are we risking a baby's life?

Are you generally anxious ?

I don’t understand how one could think not to fast on Yom Kippur??
What planet am I on?
I’ve always fasted. It’s fine

amother

Mint ↓

Thu, Sep 21 2023, 5:12 pm

The risk of preterm labor is extremely extremely low at 23 weeks. Rather than asking whether or not to fast, I would ask the rav for clear parameters of what would need to happen to start shiurim or break the fast.

I'll be 32 weeks YK. My (frum) ob said to fast until I have 5 contractions in an hour then start drinking but I've been getting that already when being on my feet to much. My rav said to start shiurim with liquids as soon as I start feeling worse than my typical and stop when the feeling goes away and not to wait until active labor. Same rav by Tish b'av when I was closer to 5/6mo said to fast until it's either break it or head to the hospital. My Drs stance on that fast was "you can start out fasting, just find out how dead you need to be to break it"

amother

Watermelon ↓

Thu, Sep 21 2023, 5:21 pm

I am at a slightly higher risk for preterm labor (I'm 25 weeks), but not using a high risk doctor. I messaged the office about fasting and (not my own Dr, another on staff) answered that it should be fine to fast. That was it.

I spoke to my Rav on tzom gedalya if I should break it about 5 PM because my head was pounding and I couldn't even stand up from the pain. He said of course. But that had nothing to do with preterm labor, obviously.

Now I'm unsure what I should do for Yom Kippur. I've fasted many fasts while pregnant with no issues, all different times of pregnancy. But this is the first with a slight risk... But, the Dr seemed completely unconcerned.

amother

Ivory

Thu, Sep 21 2023, 5:21 pm

OP are you high risk or just anxious in general?
In a healthy pregnancy, there really is nothing to worry about. My OB said there is no concern at all.
Last time I fasted during pregnancy, I did have some contractions throughout the day. My rav said I should continue to fast and the contractions went away when I broke my fast.

amother

Clematis

Thu, Sep 21 2023, 5:24 pm

I was pregnant on yk twice. The first time I had already had a preterm labor scare that they were able to stop about a month before. I was told to do shiurim on a strict schedule, stopping only to sleep through the night, and stay in bed. I drank less than an ounce but every 10 minutes or so throughout the whole day and I felt more hydrated than I ever did on a non fast day!

Since that baby ended up being full term despite the earlier scare, I was no longer considered at risk of preterm delivery for future pregnancies so the next time I was instructed to stay in bed but not eat or drink anything. I was fine.