Ramzi Theory: Predicting Your Baby's Sex?

By Dr. Kenosha Gleaton, OBGYN

Finding out the sex of a baby can be a very exciting part of the pregnancy journey. Whether you’re planning a gender reveal or you’re beginning to pick out things for your nursery, you may be wondering how and when you can find out your baby’s sex. Let’s discuss the Ramzi theory as well as proven methods for determining the sex of a baby. 

What is the Ramzi Theory?

The Ramzi theory suggests that you can predict a baby’s sex early on in pregnancy by examining the location of the placenta. If you need a refresher, the placenta is a temporary organ that develops during pregnancy. [1] The role of the placenta is to provide oxygen and nutrients to the fetus, while also removing waste from the blood. The placenta can be found near the side, front, back, or top of the uterus. [1] 

The Ramzi theory gets its name from Saam Ramzi Ismail. [2-3] According to Ismail’s theory, a placenta on the left side of the uterus indicates that a fetus is female, while a placenta on the right side indicates a fetus is male. [2-3] This is based on a study of over 1,000 pregnant people who had two ultrasounds done, one around week 6 and the other around weeks 18-22 of pregnancy. [2] Unfortunately, the initial study that formed this theory did not undergo peer review, and no major medical organizations recognize the theory as valid. [2] 

How Does the Ramzi Theory Work?

The Ramzi theory is based on basic sex differentiation, the process by which embryos begin to develop male or female structures. [4] Sex differentiation begins in early development, as soon as six weeks into pregnancy. [4] With this information, Ismail and other believers of the Ramzi theory hypothesize that there are early indicators of sex that we may be able to identify prior to the visible development of external genitalia. [2-3] Using the findings from the ultrasound study, the researchers found that a large majority of male fetuses had a placenta on the right side of the uterus around six weeks of pregnancy, and the majority of female fetuses had a placenta on the left side of the uterus around week six. [2-3] Thus predicting the early location of the placenta may be able to predict sex. 

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Scientific Scrutiny and Expert Opinions

While the initial study done by Saam Ramzi Ismail showed promising results, the study was not peer-reviewed. According to an interview, Dr. Ismail is not a medical doctor but does hold a PhD in Public Health and a master’s degree in medical ultrasounds. [5] Additionally, multiple studies that attempted to recreate the initial research have been unable to confirm any association between placental location and fetal sex. [2] 

Proven Ways to Determine a Baby's Sex

While wives' tales and scientific theories can be a fun way to predict or guess your baby’s sex, proven methods like ultrasounds and genetic testing are far more likely to give you an accurate result. 

20-Week Ultrasound

If someone does want to know their baby’s sex, the best path forward is to speak with their healthcare provider. In many cases, parents will learn the sex of their baby around 20 weeks of pregnancy with the help of an ultrasound, commonly known as an “anatomy scan”. [6] During this visit, the provider will check on the physical development of the baby and look for any signs of abnormalities. The provider will also take measurements and make sure the fetus is growing at an appropriate rate. [6] The fetus should be developed enough at this point that the provider will be able to make out the external genitalia from an ultrasound scan. [6] This is when you may learn if your baby is a boy or a girl! 

Fetal Testing

Other methods of determining a child’s sex include noninvasive prenatal testing (NIPT), chorionic villus sampling (CVS), or amniocentesis. NIPT, sometimes referred to as NIPS, is a prenatal testing method that requires drawing blood from a pregnant person. [7] Using this blood, providers can analyze the risk of genetic abnormalities and disorders. CVS involves removing a sample of tissue from the placenta that can be tested for chromosomal abnormalities and genetic problems. [8] CVS and NIPT can be done in the first trimester, usually around weeks 10-12 of pregnancy. [7-8] Amniocentesis is a procedure that involves removing some of the amniotic fluid surrounding a fetus in order to be tested or treated. [9] Amniocentesis can provide useful information about genetic defects, lung development, infections, and more. [9] This test is often done between weeks 14 and 20 of pregnancy. 

Because these tests involve inspecting genetic material, they can also tell you what the sex of your baby is. There are risks and costs associated with these tests and screening options, so be sure to speak with a provider before moving forward. Support a healthy pregnancy with our women’s prenatal vitamin >>

Other Theories and Wives Tales

In addition to the Ramzi theory, some theories and wives’ tales focused on determining fetal sex include:

• Nub theory [10]: A method of sex prediction that involves examining the angle of the “nub”, a shortened name for the genital tubercle, which is the early development of the genitals in fetuses. Supposedly, a nub that is turned upwards a certain amount may indicate a boy, while a nub turned downwards may indicate a girl. 
• Craving sweet vs salty: a craving for sweets supposedly indicates a girl, while craving salty snacks indicates a boy. Read more about pregnancy cravings here → 
• Dry vs soft hands: Soft hands = a girl, dry hands = a boy
• Carrying low vs high
• Severe morning sickness with girls vs minor morning sickness with boys
• The pendulum test: holding a necklace or a chain with a ring over the belly to see if the ring swings back and forth or in a circle

There are countless other theories surrounding pregnancy and sex prediction, but few have any scientific pull. These theories can be fun to try out early on in pregnancy, but it’s best to not take them as fact or base any important decisions on the results. Speak to your healthcare provider if you have questions or concerns about your pregnancy. 

Natalist's Approach to Pregnancy and Parenthood

To summarize, the Ramzi theory is one of many unproven claims about predicting the sex of a baby. It can be a fun and harmless way to guess your baby’s sex, but shouldn’t be taken as fact. If you are looking for a proven method to identify your child’s sex, speak to a healthcare provider about your next ultrasound, or your options for genetic testing. Whether you’re currently pregnant or planning to become pregnant, it’s important to have access to products and information that you can trust. Natalist was founded by moms and doctors who know all about the ups and downs of TTC, pregnancy, and postpartum life. Hear from reproductive health experts on the Natalist blog, or shop a wide variety of products from our ovulation test kit or early pregnancy tests strips to postnatal vitamins.

References:

1. Pregnancy week by week. Mayo Clinic. December 3 2022. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/placenta/art-20044425
2. Nwadike, Valinda. Villines, Zawn. What is the Ramzi theory? Medical News Today. September 2022. https://www.medicalnewstoday.com/articles/ramzi-theory
3. The Relationship Between Placental Location and Fetal Gender (Ramzi’s Method). Contemporary OBGYN. June 14 2011. https://www.contemporaryobgyn.net/view/relationship-between-placental-location-and-fetal-gender-ramzis-method
4. Rey R, Josso N, Racine C. Sexual Differentiation. [Updated 2020 May 27]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279001/
5. Dr. Saad Ramzi Ismail Responds to My Article on the “Ramzi Theory” Bottlesoup. March 2014. https://bottlesoup.com/2014/03/06/dr-saad-ramzi-ismail-responds-to-my-article-on-the-ramzi-theory/
6. 20-Week Ultrasound (Anatomy Scan). Cleveland Clinic. April 2022. https://my.clevelandclinic.org/health/diagnostics/22644-20-week-ultrasound
7. What is noninvasive prenatal testing (NIPT) and what disorders can it screen for? Medline Plus. National Library of Medicine. Accessed December 2023. https://medlineplus.gov/genetics/understanding/testing/nipt/
8. Chorionic Villus Sampling (CVS). Johns Hopkins Medicine. Accessed December 2023. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/chorionic-villus-sampling-cvs
9. Amniocentesis. Mayo Clinic. October 2022. https://www.mayoclinic.org/tests-procedures/amniocentesis/about/pac-20392914
10. Najdi N, Safi F, Hashemi-Dizaji S, Sahraian G, Jand Y. First trimester determination of fetal gender by ultrasonographic measurement of anogenital distance: A cross-sectional study. Int J Reprod Biomed. 2019;17(1):51-56. Published 2019 Mar 3. doi:10.18502/ijrm.v17i1.3820

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University.  She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.