Perspectives on Obstetrical Care During Ramadan: Identifying the Gaps
Problem
Fasting during Ramadan in pregnancy and breastfeeding varies among Muslim women. Clinicians should provide competent and appropriate obstetric care to Muslim patients as they navigate the decision to fast.
Purpose
Our objective is to review the literature to assess the current knowledge base among physicians about the implications of fasting for Ramadan and provide suggestions for shared-decision making with patients.
Search strategy
MeSH terms were utilized to search through PubMed, Google Scholar, and EBSCO databases. Studies were screened by two authors independently and excluded if they were not written in English and/or were more than 20 years old, and included if they discussed perspectives or guidelines on obstetric care during Ramadan. Results were extracted and grouped into themes for analysis.
Results of literature search
423 total records were identified from the databases. 40 records were removed before screening due to their eligible date or language of publication. After individually screening 372 total articles, 350 were excluded based on abstract review. 33 studies were included in our review in total.
Synthesis of evidence
The population of women who fast while pregnant or breastfeeding during Ramadan is highly variable. Articles were frequently inaccurate when citing Islamic rulings regarding Ramadan fasting during pregnancy and breastfeeding. It was frequently implicated that pregnant women insist on fasting against medical advice. Providers rarely initiated discussion about Ramadan and patients hesitated to ask due to fear of discouragement and disrespect surrounding religious practices.
Implications for practice
There are not enough clear guidelines for patients desiring to fast while pregnant or breastfeeding during Ramadan. Current research lacks understanding of the cultural and religious significance of Ramadan and patients’ determination to fast; collaboration with religious advisors is necessary to understand this population’s needs. Providers should initiate discussions on lifestyle modifications and parameters for keeping or breaking the fast.
Perspectives on Obstetrical Care During Ramadan: Identifying the Gaps