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      Perceptions and practices of fasting in Ramadan during pregnancy in Pakistan

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          Abstract

          Background:

          Islam clearly exempts fasting in Ramadan during sickness, pregnancy, and breastfeeding. Yet, some women prefer to fast despite realizing their increase in nutritional demand during pregnancy. Nurses and other healthcare providers face a difficult task of providing appropriate medical advice to Muslim women regarding the safety and impact of their fasting. The present study was conducted to examine the concepts and practices of maternal fasting during pregnancy in Pakistani Muslim women.

          Materials and Methods:

          A cross-sectional study was done in 2008 on 353 females from gynecology departments of hospitals in major cities of two provinces of Pakistan. Non-probability convenient sampling technique was used and a questionnaire was used to collect data from females who had experienced pregnancy during Ramadan at least once in life. Questions related to perceptions and practices of fasting in pregnancy along with demographic data were asked. Analysis was done on SPSS version 16. Chi-square test was used to assess associations and P < 0.05 was considered statistically significant. All ethical considerations were taken into account for the respondents.

          Results:

          Out of the total, 309 (87.5%) fasted during their pregnancies while 43 (12.5%) did not fast at all. Among those who fasted, 42.5% ( n = 150) fasted for the whole month, 23.8% ( n = 84) fasted on alternate days, 10.5% ( n = 37) fasted only on weekends/holidays, and 10.8% ( n = 38) fasted on particular special days. The majority perceived no harm and risk caused by fasting to them or to fetus during pregnancy. Although adverse effects during fasting were frequently reported, only 24% break their fast. A significant association was found between gravida and education with fasting ( P w< 0.05). A total of 88% of women believed that fasting during pregnancy (in good health) is “obligatory” while 12% thought otherwise.

          Conclusion:

          Pakistani Muslim women showed a strong compassion for fasting in pregnancy despite overall decrease in maternal health indicators. There is a need for nurses and other healthcare providers in all Muslim countries and especially in non-Muslim countries with cultural diversity to be fully aware of the effects of fasting in pregnancy so that they can act promptly ensuring safe and healthy delivery.

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          Most cited references35

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          Gender differences in the utilization of health care services.

          Studies have shown that women use more health care services than men. We used important independent variables, such as patient sociodemographics and health status, to investigate gender differences in the use and costs of these services. New adult patients (N = 509) were randomly assigned to primary care physicians at a university medical center. Their use of health care services and associated charges were monitored for 1 year of care. Self-reported health status was measured using the Medical Outcomes Study Short Form-36 (SF-36). We controlled for health status, sociodemographic information, and primary care physician specialty in the statistical analyses. Women had significantly lower self-reported health status and lower mean education and income than men. Women had a significantly higher mean number of visits to their primary care clinic and diagnostic services than men. Mean charges for primary care, specialty care, emergency treatment, diagnostic services, and annual total charges were all significantly higher for women than men; however, there were no differences for mean hospitalizations or hospital charges. After controlling for health status, sociodemographics, and clinic assignment, women still had higher medical charges for all categories of charges except hospitalizations. Women have higher medical care service utilization and higher associated charges than men. Although the appropriateness of these differences was not determined, these findings have implications for health care.
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            Gender, pregnancy and the uptake of antenatal care services in Pakistan.

            An integrated analysis of detailed ethnography and large-scale survey data is presented to explore the gendered influences on women's uptake of antenatal care (ANC) services in Punjab, Pakistan. Pregnancy and its associated decisions were shown to be normatively the older women's domain, with pregnant women and their husbands being distanced from the decision-making process. Women who successfully claimed ANC did so not by overtly challenging the dominant construction of young femininity, but rather by using existing gendered structures and channels of communication to influence authority figures. The quality of a woman's inter-personal ties, particularly with her mother-in-law and husband, were found to be important in accessing resources, including ANC. Gendered influences were moderated by social class. Family finances were an important determinant of ANC use, as was women's education. Wealthier, higher status women also found it easier to circumvent gendered proscriptions against their mobility while pregnant. As well as illuminating the ways in which the sociocultural construction of gender acts to constrain women's access to ANC, the empirical findings are used to highlight significant inadequacies in the 'autonomy paradigm' that has dominated much of the research into women's reproductive health in South Asia.
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              Research in Islamic fasting and health.

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                Author and article information

                Journal
                Iran J Nurs Midwifery Res
                Iran J Nurs Midwifery Res
                IJNMR
                Iranian Journal of Nursing and Midwifery Research
                Medknow Publications & Media Pvt Ltd (India )
                1735-9066
                2228-5504
                Nov-Dec 2012
                : 17
                : 7
                : 467-471
                Affiliations
                [1]Department of Community Health Sciences, Hamdard College of Medicine and Dentistry, Shahrah-e-Madinat al-Hikmah, Mohammed Bin Qasim Ave, Karachi, Pakistan
                [1 ]Department of Community Health Sciences, Shifa International Hospital, Islamabad, Pakistan
                [2 ]Department of Community Health Sciences, Sheikh Zayed Hospital, Rahim Yar Khan, Peshawar, Pakistan
                [3 ]Department of Community Health Sciences, Khyber Medical University, Peshawar, Pakistan
                Author notes
                Address for correspondence: Dr. Syed Muhammed Mubeen, Hamdard University, Shahrah e Madinat al Hikmah, Mohammed Bin Qasim Ave, Karachi, Pakistan. E-mail: dr_mubeen@ 123456hotmail.com
                Article
                IJNMR-17-467
                3730448
                23922591
                636e28dd-706b-4b4c-b94e-8d034b541269
                Copyright: © Iranian Journal of Nursing and Midwifery Research

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Original Article

                Nursing
                fasting,islam,pakistan,pregnancy,women
                Nursing
                fasting, islam, pakistan, pregnancy, women

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