Yom Kippur:[1]

A pregnant woman must fast on Yom Kippur for the entire day [just like any other person]. [There is no allowance for her to eat or drink less than the Shiur, unless it is a case of danger, as will be explained. This applies even in today’s times.[2] If a woman fears she may have a miscarriage due to the fast, she is to speak with her doctor and with a competent Rav. The Rav is to review her miscarriage history[3], and take note of any warnings from her doctor.[4] If a doctor told the woman it is forbidden for her to fast due to fear of miscarriage, she is to verify with the doctor whether eating and drinking less than the Shiur will suffice to prevent danger. Likewise, she is to verify whether she could fast if she remains in bed for the entire duration of the fast.]

A pregnant woman who craves after a food:[5] If a pregnant woman smells a certain food and craves after it, it is possible for her to miscarry if she is not given this food to eat, which can endanger her life as well.[6] Thus, if necessary to calm down her craving, and explaining to her that it is Yom Kippur does not suffice, then she may be given to eat the food even on Yom Kippur if necessary to remove her and her fetus from danger. Likewise, she may even be given non-Kosher food to eat if she smells it and craves after it, and not giving her to eat the food can cause her life or the life of her fetus to be in danger, and there is no other way of calming her down, and explaining to her that the food is not Kosher does not suffice.[7]

Q&A

When may a pregnant woman break her fast?

In general, and absent of medical directive, if a pregnant woman begins to feel dizzy or begins to experience labor [i.e. contractions, as explained in the next Q&A] or low/high blood pressure, or stops feeling the baby’s heartbeat[8], she is to break her fast in accordance to the Shiurim, as explained below.

 

If a pregnant woman began to have contractions, is she to break her fast?[9]

The following is the general Rabbinical directive, in cases that a doctor has not directed otherwise: 

From beginning of pregnancy[10] up to 9th month:[11] If a pregnant woman prior to the completion of her 9th month [before week 37 from conception[12]], feels contractions that can lead to miscarriage or early birth, or feels pressure to push out the baby, then she is to eat in accordance to the Shiurim dictated below. If eating the Shiurim does not suffice, she may eat and drink any amount of food until her body calms down.

After the 9th month:[13] A pregnant woman who has completed her 9th month [past week 37 from conception[14]] is not allowed to break her fast unless she has entered into active labor to the point she cannot walk, is on the birthing stool, or has broken her waters, just as is the law regarding transgressing Shabbos. When she reaches this point, she may eat regularly.[15] However, prior to reaching this state, she may not eat or drink even less than the Shiur, even if she feels contractions and is in the midst of labor[16], unless a doctor directs her to do so due to fear for her life or the life of the child.

Practical list of Shiurim for food and drink for a pregnant woman:[17]

Food:[18] A pregnant woman who may eat less than the Shiur, is to eat less than the size of a Kusebes, which is less than 30 cc and less than 30 grams, within the amount of time it takes to eat a Peras of bread, which is nine minutes: The food is measured based on volume and[19] weight.[20] Hence, the Shiur is [less than[21]] the amount of food to fill 30 cc in a measuring cup [or typical match box], and this amount itself is not to weigh more than 30 grams.[22] One is not to eat more than this amount of food within nine minutes.

Drink: A pregnant woman who may drink less than the Shiur, is to drink within nine minutes less than the amount of water that can fill one cheek [i.e. Malei Lugmav]. Hence, before Yom Kippur, she is to fill a single cheek with water, pour it into a cup, and mark the water level on the cup.[23] [In general, for the average person who does not have a small mouth, this amounts to less than 42cc.[24]] When there is Halachic need to drink based on the Shiurim, one is to drink less than this marked amount of liquid within every 9 minutes. One is not to drink the exact amount marked, as this is the Shiur Kareis for liquid.

Eating and drinking within the nine minutes: All foods join each other to make up the minimum measurement of 30cc, and all liquids join each other to make up the minimum measurement of Malei Lugmav for Kareis liability. Nevertheless, foods and liquids do not join each other. [See above Halacha 4D] Accordingly, a woman may both eat and drink less than the Shiur of eating and drinking within the 9 minutes as they do not join each other, and there is no need to take turns between eating and drinking every 9 minutes. 

The amount of time to eat the Shiurim:

All the food and liquid that one consumes within nine minutes is counted as part of the Shiur. Meaning, that one should make sure not to eat more than the Shiur of liquid or food within nine minutes, and hence the shiur restarts every nine minutes after completing eating or drinking less than the Shiur.[25] If nine minutes is too long of an interval, one may go down to 8, 7.5, 6, 5, 4.5,4 minutes, as is medically necessary.[26]

Preparing the Shiurim before Yom Kippur:[27]

A pregnant woman is to prepare the Shiurim before Yom Kippur. She is to fill one cheek with water and place it into a cup and then mark the water level.[28] Alternatively, she is to fill both cheeks with water and measure half of that amount.[29]

How to measure the food:

One is to crumble the food and enter it into an area which holds 30cc, which is the common size of a match box.

May one take medicine on Yom Kippur?[30]

One who is currently sick: If one is bedridden, or feels ill/weak in his entire body, then he may swallow a tasteless or bitter pill [without water, as will be explained].[31] If the pill has a non-bitter taste, then he is to wrap it in precut tissue [as one may not cut it on Shabbos or Yom Kippur] and swallow it with the tissue.[32] This allowance applies even if the illness does not involve danger. If, however, one is not bedridden, and does not feel ill in his entire body, then he may not take medication, even if he is in pain or is suffering from a headache and the like.[33]

One who is not currently sick but suffers from a medical condition: Those who are not sick but suffer from a medical condition which requires a daily dose of medication, are to verify with their doctor if they can fast, and skip the dose on Yom Kippur, without any health risks involved. In the event that the doctor states that skipping the medicine can lead to medical complications that can lead to a life-threatening situation, then he must take the pill even on Yom Kippur.[34] If swallowing the pill in one of the above-mentioned methods is not possible, one may swallow it with water.[35] [Likewise, if skipping a dose can lead to illness, even non-life threatening, then one may take it on Yom Kippur, although without water, as explained below.[36]]

How to take the pill: One who is permitted to take a pill on Yom Kippur, as stated above, must swallow the pill plain, without water, and if the pill has a non-bitter taste, he is to swallow it in a precut piece of tissue. He may not swallow the pill with water, unless the illness poses a danger of life and he cannot manage to swallow it without the water.[37] Alternatively, some Poskim[38] suggest that before Yom Kippur, one can crush the bitter pill into powder, add it to the water, and then drink the bitter mixture. This applies even if one illness does not pose any danger of life.

____________________________________________________________________

[1] Admur 617:1; Michaber 317:1; Pesachim 54b; See Encyclopedia Hilchatit Refuit Vol. 3 Erech Hirayon p. 15; See Toras Hayoledes Chapter 53

[2] Tzitz Eliezer 17:20; Teshuvos Vehanhagos 2:292; Piskeiy Teshuvos 617:1; Rav Ovadia Yosef

Opinion of Rav Fisher: Rav Yaakov Yisrael Fisher [brought in Sefer Pnei Baruch; Piskeiy Teshuvos 617 footnote 1] was of the opinion that today pregnant women no longer have to fast, and may eat less than the Shiur on Yom Kippur, due to fear of miscarriage. Practically, this ruling is not accepted amongst Poskim or Moreh Horaas and rather each case must be judged individually by a competent Rav. [Poskim ibid] However, Rav Yaakov Yosef ruled after a thorough investigation amongst doctors, and discovering a dispute amongst them as to the dangers of fasting, that regarding Tishe Beav which is a Rabbinical fast, one may be lenient, while regarding Yom Kippur one is to be stringent.

[3] Some Poskim permit a woman to eat and drink less than the Shiur if she already miscarried twice in the past. [Tzitz Eliezer ibid; Pnei Baruch in name of Orchos Chaim 617:1; Daas Torah 317; Piskeiy Teshuvos 317:1; Poskim in Nitei Gavriel 38:6]

[4] Rav SZ”A ruled one may allow a woman to eat less than the Shiur if her Dr. says that the fast can lead to miscarriage, or an early birth that is prior to the 9^th month. [Piskeiy Teshuvos 617 footnote 2]

[5] Admur 617:2; Michaber 617:2; Rambam Yom Kippur 2:9; Mishneh Yuma 82a [8:5]; Ketzos Hashulchan 147:2 p. 7; Shevach Habris 1:9

[6] The reason: The reason for this is because also the fetus has smelled the scent of this food and craves after it and if she doesn’t eat it, it is possible that the fetus will try to exit the womb in order to eat it. This will endanger the life of both the mother and fetus. For this reason, she may be given to eat the food even on Yom Kippur. [Admur ibid]

[7] Issur Viheter Hearuch 60:5; Kaf Hachaim 617:7 in name of Levush; Ketzos Hashulchan ibid; See Erech Hashulchan 617:1 brought in Kaf Hachaim ibid; See also Besamim Rosh 353 that in today’s times we don’t even try to calm her down as it is a matter of danger and we give her to eat right away whether on Yom Kippur war with a non-Kosher  food, brought in Pischeiy Olam 617:2 and Kaf Hachaim ibid

[8] See Toras Hayoledes 53:8

[9] See Toras Hayoeldes 53:9-10

[10] From when is a woman considered pregnant in this regard? There is no difference in this regard whether she is in the beginning or end of her pregnancy. [M”B 617:1] The laws of fasting relevant to a pregnant woman begin to apply from the moment she knows she is pregnant, even if this is prior to the passing of 40 days from the time of conception. [Daas Torah 617:1; Sheivet Halevy 7:80; Nitei Gavriel 38:4] However, there are Poskim who question whether prior to 40 days we allow her to break her fast to prevent miscarriage. [Shaar HaTziyon 617:1; See also M”B 550:3; Kaf Hachaim 550:5]

[11] Ruling of Rav Asher Lemel Cohen

[12] See coming footnotes for explanation

[13] M”B 617:9; Mamar Mordechai 617:3; Alef Lamateh 617:5; Sdei Chemed 3:2; Meishiv Halacha 242; Minchas Yehuda 29; Nitei Gavriel 38:5; so ruled Rav A. L. Cohen

[14] According to Halacha, a child is considered premature, and an 8^th month child, until nine full months have passed from conception. [See Y.D. 374:8; See Meil Tzedaka 5, brought in Pischeiy Teshuvah 374:9 that we follow the Hebrew months in this regard, and not a number of weeks or days. Thus, since the months vary between 29 and 30 days, determining how many weeks/days need to pass depends on how many days were in each of the nine months of her pregnancy. If, for example, there were five 30-day months and four 29-day months, then it is exactly 38 weeks, which is 266 days. If, however, there were more or less than five 30 day months, then it would be more or less than 38 weeks. Thus, we determine the completion of nine months based on the passing of Hebrew months, and not based on weeks or days.] Medically, however, a child is only considered premature if born prior to week 37 from her last period, which is approximately week 35 from conception. Nonetheless, a child born in week 37-38 from the last period is termed an “early term baby” and quite often the child is not yet developed enough to be born. It is only considered full term in weeks 39-40 from the last period, which fits the Halachic definition of 37-38 weeks from conception. 

[15] See Poskim ibid that compare a woman giving birth to a regular Yoledes within three days, of which the law is that she may eat regularly. However, see Minchas Yehuda and Nitei Gavriel ibid who record she is to eat less than the Shiur. Vetzaruch Iyun.

[16] Piskeiy Teshuvos 317:1 footnote 3; Rav A. L. Cohen

The reason: As there is no danger involved for her or the child if she gives birth in her 9^th month, and hence there is no reason to permit her to eat in order to stop contractions.

[17] Toras Hayoledes 55

[18] Piskeiy Teshuvos 618; Shiurei Torah 3:10

[19] So is implied from Shiureiy Torah ibid towards end that by a food which weighs more than water it is to be less than 30 grams and less than 30 cc.

[20] Shiurei Torah 3:10, unlike Kaf Hachaim [and so rules Yalkut Yosef] who measures all based on weight; See Nishmas Avraham 612:2 footnote 16

[21] As 2:3 of an egg, which is the Shiur of the Kuseves [618:13] is 30 cc. [Shiureiy Torah ibid] Vetzaruch Iyun as Admur there writes 2:3 of an egg or a little more is the Shiur of a Kuseves, hence there is no exact Shiur. In any event seemingly to be on the safe side one is to eat less than that amount, and so is implied in Shiureiy Torah ibid. However, from Piskeiy Teshuvos 618:8 it is implied that one may eat that amount Vetzaruch Iyun.

[22] So is implied from Shiureiy Torah ibid towards end that by a food which weighs more than water it is to be less than 30 grams and less than 30 cc.

[23] See Shiureiy Torah 3:17 footnote 32 [p. 198] for the exact method of how this is to be measured [He Suggests filling the entire mouth with water, spitting it out, and less than half of the measurement is considered the minimum amount that one may have below the Shiur]

[24] Shiureiy Torah ibid

^[25] Chasam Sofer 6:16; M”B 618:21; Shiurei Torah 3:15 [p. 203]; Aruch Hashulchan 202:8; Kaf Hachaim 210:5; Piskeiy Teshuvos 210:1; Sefer Haminhagim ibid and footnotes 342-344;

Opinion of 6-7 minutes: The Tzemach Tzedek [Shaar Hamiluim 1:8-10] records 6-7 minutes regarding the Shiur of Achilas Peras. [Ketzos Hashulchan 36 footnote 5; 59 footnote 4; Shiureiy Torah ibid footnote 35; Sefer Haminhaghim [English] p. 93 regarding Tisha B’av]

[26] Shiureiy Torah ibid

[27] Rav Cohen

[28] M”B 618:21; Rav Cohen

[29] Shiureiy Torah 3:17 footnote 32; Nitei Gavriel 41:5

[30] Sdei Chemed Yom Kippur 3:8; Yeshuos Yaakov 612; Kesav Sofer 111; Pischeiy Teshuvah Y.D. 155:6; Shoel Umeishiv Mahdura Daled 1:55; Orchos Chaim 618:1; Eretz Tzevi 88; Kaf Hachaim 554:34 in name of in name of Kesonos Yosef 4, Ikarei Hadaat 29:36, Pischei Olam 554:6 regarding regular fast days; Meishiv Shalom 179; Igros Moshe 3:91; Tzitz Eliezer 10:25; Shevet Halevi 10:89; SSH”K 39:8; Nishmas Avraham 612:7; Toras Hayoledes 52:9 footnote 27; Piskeiy Teshuvos 612:2; Nitei Gavriel 37:23; 39:12-15; Encyclopedia Hilchatit Refuit Erech Yom Kippur Volume 3 p. 794; Toras Hayoledes 55:9

See regarding the status of the prohibition of consuming inedible items on Yom Kippur: Admur 612:8 and Michaber 612:6 based on Rambam that it is forbidden; Tur 612 in name of Avi Ezri [i.e. Ravayah] that there is no even rabbinical prohibition involved; Beis Yosef 612 that possibly there is no prohibition even according to Rambam if less than the Shiur; Meishiv Shalom 179 that according to the final ruling of the Michaber [and Admur] who omitted all the above leniency’s, one is to be stringent even by less than the Shiur; Shevet Halevi 10:89 that one who is lenient for the sake of a mitzvah is not to be protested;

[31] Poskim ibid

The reason: One who is bedridden, or weak in his entire body has the Halachic definition of a Choleh Sheiyn Bo Sakana, of which we rule that the Rabbinical prohibitions against taking medicine on Shabbos, and against eating Rabbinical prohibited foods, is lifted. Thus, being that swallowing a bitter pill is only Rabbinically forbidden on Yom Kippur, as it is not a food, and is not being eaten in the normal method, it therefore may be swallowed by an ill person. [ibid]

[32] Rav SZ”A in SSH”K ibid; Nishmas Avraham ibid; Piskeiy Teshuvos ibid

[33] Piskeiy Teshuvos ibid; Nitei Gavriel ibid

The reason: This is due to two prohibitions 1) The prohibition against eating, which Rabbinically includes even bitter and inedible foods. 2) The prohibition against taking medication on Shabbos and Yom Kippur. 

[34] Igros Moshe ibid based on ruling of Rav Akiva Eiger

The reason: As we view a potential life-threatening illness that can come as a result of not eating, or not taking medicine, as a life-threatening situation, for which one can break his fast on Yom Kippur. [ibid]

[35] Igros Moshe ibid

[36] Nishmas Avraham O.C. 612:7; Encyclopedia Hilchatit Refuit Erech Yom Kippur Volume 3 p. 795

[37] Igros Moshe ibid; SSH”K ibid; Nishmas Avraham ibid; Piskeiy Teshuvos ibid

[38] Kaf Hachaim 554:34 in name of Poskim regarding Tisha B’av; Heard from Rav Yaakov Yosef that the same applies on Yom Kippur, and so seems Pashut; Nishmas Avraham 5 612:2; SSH”K ibid; Piskeiy Teshuvos ibid; Nitei Gavriel ibid; Encyclopedia Hilchatit Refuit Erech Yom Kippur Volume 3 p. 795 footnotes 340-343