Pregnancy and Fasting on Yom Kippur

Fasting on Yom Kippur is one of the few mitzvot whose punishment is karet, the most severe form of punishment for a sin. This said, even on Yom Kippur, in the case of pikuach nefesh, we will find that leniencies exist permitting (or even requiring) one to eat. 

In this article we will briefly discuss the status of a pregnant woman on Yom Kippur, and the different approaches to her fasting¹. Through this discussion we will see the importance of both Yom Kippur and the Jewish value of life come to fore². 

The Mitzvah
The mitzvah to fast on Yom kippur is a mitzvah deoryata, a Torah level obligation. The verses in Vayikra state: 
(27) Mark, the tenth day of this seventh month is the Day of Atonement. It shall be a sacred occasion for you: you shall afflict your soul… (29) Indeed, any person who does not practice self- affliction throughout that day shall be cut off from his kin³;
From this word ‘self-affliction’, our Sages derived the five prohibitions, one of them being not to eat and drink. Being deorayta, Yom Kippur is different from our other fast days which were ordained by the Sages and in which we are lenient – anyone who is sick is exempt. When it comes to Yom Kippur, only those whose lives would be jeopardized because of the fast may not fast. In addition, the punishment for eating on Yom Kippur is most severe- karet- being spiritually cut off from the Jewish nation. We will see how this last point plays out when we discuss the leniencies for those who need them below. 

Pregnancy and Fasting 
Pregnancy takes a toll on a woman’s body and health, and of course we know that the mother’s health is directly linked to that of the fetus. The halachic debate on fasting while pregnant takes both the mother and the baby into account. The potential health related side effects from fasting are the reason that pregnant women are exempt from fasting on the minor fasts. However, when it comes to Yom Kippur (and Tisha B’Av), “Rava taught: Pregnant and breastfeeding women fast the full day on [Tish’a Be-Av] as they fast the full day on Yom Kippur.”⁴ 

Indeed, this is the accepted general ruling – in the case of a low risk, normal pregnancy. However, in a case where they may even be a safek, a concern, that there could be danger to the mother or the fetus, we may find leniencies. Based on discussions in the Mishna⁵, the Shulchan Aruch rules; “A pregnant woman who smells [food] (Rema: and her face changes even if she does not say, I need [to eat]), we whisper in her ear that it is Yom Kippur, and if she is calmed with this reminder – good, if not we give her food until she is calmed⁶.

Fasting when pregnant, even in a healthy and normal pregnancy, is challenging. Pregnant women (and anyone else who needs to) should do their best to make sure they are able to fast, by preparing with proper food and drink intake in the days leading up to the fast, and on the fast itself, staying home and resting, even at the expense of being in shul. Here the halacha again shows us how central a place this fast has in our religious lives, prioritizing it over communal prayer and even over the communal prayer of the spouse of a pregnant woman.

Other examples of leniencies exist in the Rishonim, and the debate has continued as more medical research has been conducted. Two main concerns appear to exist, even in the case of a normal, low risk pregnancy. The first is that fasting can induce preterm labor by causing contractions as a result of dehydration. The second is that a pregnant woman near the end of her term might begin her labor dehydrated. Taking this into account, some Rabbanim, including Rav Nebenzhal, Rav Yisrael Yaakov Fischer and Rav Nachum Rabinovich, tend to allow more leniencies, including allowing a pregnant woman who feels sick or nauseous because of the fast to break it (either in shiurim- see below- or with no limitation) without consulting either a halachic or medical authority, or general psakim to allow for shiurim even before feeling unwell. Holding a more extreme approach, Rav Fischer writes, “For the generations have become weak, and tens of women who have fasted have miscarried following the fast. We don’t need to also ask a physician, and it is clear that it is prohibited to fast on Yom Kippur…And we maintain that “in matters of piku’ach nefesh we don’t follow the majority” [of cases, but rather are concerned for a minority].”⁷
On the other hand, the Tzitz Eliezer held strongly that this was not the correct approach and that hundreds of years of established Halacha, as well as the knowledge that the vast majority of women do not miscarry as a result of fasting, were not reason enough to issue such an overarching ruling of leniency on such a central mitzvah⁸.

“… it is a very great leniency to issue a general ruling permitting pregnant women to eat on Yom Kippur based on … “the generations have become weak,” and not just to permit [eating] but to require it…We know in contrast from every single place about hundreds and thousands of pregnant women who fast on Yom Kippur and don’t miscarry, God forbid. How can we … uproot great, established halachot in this matter … to establish because of this based on our own judgment that nature has changed with this?…Therefore in my opinion the matter is clear in accordance with halacha that one should not issue a general permission…”
As the Nishmat’s Yoatzot Halacha website says, “both Halacha and medicine are case specific.” Each woman should consult with both her rav and her doctor to see what is right for her. It is best for the doctor to be a God-fearing individual. 

Shiurim 
Even when one is obligated to eat on Yom Kippur, the eating must be done in ‘shiurim’- an amount of food or drink less than a kezayit or reviit. This renders it not to be considered eating and thus avoids the punishment of karet. This also means that a person would not be bought to a state of satisfaction’, and so one still partakes in the mitzvah of ‘afflicting one’s’ soul, and in trying, to the best of her ability to use the day to separate from one’s physical self and focus on one’s soul and closeness with Hashem. If one is considered to be a choleh sheyesh bo sakana, one is obligated to eat and drink as normal.

Fasting Comes First
Fasting when pregnant, even in a healthy and normal pregnancy, is challenging. Pregnant women (and anyone else who needs to) should do their best to make sure they are able to fast, by preparing with proper food and drink intake in the days leading up to the fast, and on the fast itself, staying home and resting, even at the expense of being in shul. Here the halacha again shows us how central a place this fast has in our religious lives, prioritizing it over communal prayer and even over the communal prayer of the spouse of a pregnant woman. Rav Moshe Sternbuch writes: “Today, it is proper for a pregnant woman who is concerned that she will feel weak, or with any choleh she-ein bo sakana, that they be careful not to make any strenuous effort at all on Yom Kippur, especially with caring for her children, but she should rest and lie down. The husband should be quick to occupy himself with this [childcare] and in this type of arrangement she generally won’t feel special weakness and will be able to fulfill the mitzva of the day [fasting] as is fitting⁹.

Conclusion
The above debate impresses upon us two central values of Judaism. One is the value of life, which we see in so many aspects of halacha. At the same time, this discussion brings home the centrality of Yom Kippur itself and the recognition of its importance and holiness. Being physical creatures, we run the risk of becoming preoccupied with food- or lack thereof – on fast days. But when this happens, we have lost sight of the goal. In the haftara for Yom Kippur we read the words of Yishayahu, who begins by chastising the nation for complaining that Hashem has not accepted their fast- for it was not a fast of teshuva. “This is the fast I desire: To unlock fetters of wickedness, And untie the cords of the yoke, To let the oppressed go free; To break off every yoke. (7) It is to share your bread with the hungry, And to take the wretched poor into your home; When you see the naked, to clothe him, And not to ignore your own kin.”¹⁰

Yom Kippur is not about the absence of food and other pleasures- rather that is our physical expression of our spiritual goal- to come close to Hashem in teshuva. In some cases this goal must be accomplished through eating, even on Yom Kippur. In both cases, we must ensure we keep the real goal at the forefront of our actions. 
May we be signed and sealed for a shana tova umetuka.

1. This article is in no way a halachic ruling and one should always consult a competent halachic and medical authority when questions of this nature arise.  ↩︎
2. This article is a very brief summary of the halachic discourse. For more on nursing, pregnant and postpartum women fasting see here: https://www.deracheha.org/exemption-from-major-fasts/ and here: https://www.deracheha.org/exemption-from-minor-fasts/  ↩︎
3. Leviticus 23:27-32 ↩︎
4. Pesachim 54b ↩︎
5. Yoma 8,5 ↩︎
6. Shulchan Aruch OC 617:12 ↩︎
7. Responsa Even Yisrael VII:36:4 ↩︎
8. Responsa Tzitz Eliezer 17:20 (4) ↩︎
9. Responsa Teshuvot Ve-hanhagot 2:292 ↩︎
10. Isaiah 58, 6-7 ↩︎