As the Ninth of Av approaches in the year 5783 (תשפ"ג), the PUAH Institute publishes guidelines for fasting for the benefit of the public, including pregnant women, nursing mothers, and women undergoing fertility treatments.
(In personal cases where there is a special medical background - it is necessary to consult with a physician and ask a rabbi.)
Pregnant Women and Nursing Mothers:
A. According to the Gemara (Talmud) (Pesachim 54a), the ruling of the "Shulchan Aruch" (Code of Jewish Law) (Orach Chaim 554, 5), and the majority of leading halakhic authorities, as a general rule, pregnant women and nursing mothers are obligated to fast on the Ninth of Av. Therefore, they should try to prepare well on the day before the fast by eating and drinking sufficiently, and they should ensure optimal conditions during the fasting period, such as resting and staying in a well-ventilated place.
B. A pregnant woman experiencing severe vomiting, intense nausea, severe diarrhea, severe headaches, or if fasting causes her to become weaker than usual during non-pregnancy fasts - she is exempt from fasting, even if she is in the early stages of pregnancy.
C. A pregnant woman whose pregnancy is medically defined as "high-risk" should clarify with her doctor the reason for this classification, and based on the doctor's response, she should consult a rabbi regarding the fasting obligation.
D. A pregnant woman who has experienced miscarriages in the past or is experiencing or has experienced severe bleeding or contractions during this pregnancy should consult with a doctor regarding fasting. Based on the doctor's response, she should then seek guidance from a rabbi. If cramps or contractions begin during the fast, she should immediately stop fasting and drink plenty of fluids.
E. A pregnant woman who conceived as a result of in vitro fertilization (IVF) is exempt from fasting during the first few weeks of pregnancy until the heartbeat is detected. This is because there is an increased risk for the embryo during the early stages of pregnancy resulting from IVF. After the heartbeat is detected, she follows the same guidelines as a regular pregnant woman, as mentioned above.
A woman who conceived through intrauterine insemination (IUI) follows the same guidelines as a regular pregnant woman.
F. Nursing mother - If she feels during the fast that her milk supply is decreasing and she is concerned that she might have difficulty nursing, and the baby is not accustomed to taking any milk substitutes - she should drink. If she knows from past experience that fasting will certainly dry up her milk supply - she is exempt from fasting.
(A nursing mother who can easily pump milk is advised to prepare before the fast bottles of expressed milk to make fasting easier for her).
G. Even a woman exempt from fasting, it seems that if she has medical approval and the strength to do so, she should start fasting to participate with the public in the fast and mourning for the destruction of the Temple, and she should stop fasting when she feels the need to eat or drink (if she can fast until midday, there is merit in doing so).
H. When she eats or drinks, she is allowed to eat and drink as much as is necessary, and there is no obligation for her to eat less than the required amount. However, she should not eat "delicacies" and the like. Additionally, she should not eat meat or drink wine/grape juice.
I. A woman who has given birth is exempt from fasting within 30 days after childbirth.
J. A woman who underwent a miscarriage of an embryo that developed up to the 40th day and beyond is exempt from fasting within 30 days after the miscarriage.
A woman undergoing fertility treatments:
A. A woman who requires taking medications for fertility treatments is allowed to take tasteless medications during the fast, and this is not considered eating.
Ideally, if medically possible, she should take the medications before the start and after the end of the fast. However, if she must take the medication specifically during the fast, she should initially take it without water. If she cannot do so, she can take it with a small amount of bitter liquids (such as water with a high concentration of chamomile tea, etc.).
B. A woman undergoing fertility treatments with pills or injections does not have a reason to refrain from fasting. However, if her doctor states that there is a concern for ovarian hyperstimulation or similar issues, she should not fast.
C. It is permissible to undergo fertility treatments before the Ninth of Av, and certainly before other fasts, even though it might be necessary to eat or drink during the fast of the Ninth of Av.
D. A couple needing to undergo insemination or in vitro fertilization, and the treatment falls on the Ninth of Av, should consult with a rabbi.
For any question, the rabbinical team of Machon Puah will be at your service at phone number 02-6515050.