Pica | Unusual pregnancy cravings explained

The desire to eat substances like soil or soap is called Pica, and can be a strong and persistent craving for some pregnant women. By Francoise Gallet


“Pica is craving and purposefully consuming non-food items,” explains obstetrician and gynaecologist, Priya Soma-Pillay. This unusual pregnancy craving is commonly undisclosed to health practitioners. “It’s often the partner or family member who brings it up,” explains obstetrician and gynaecologist, Uviwe Petse.

Most common types of Pica

The most common types of Pica in pregnancy, says Soma-Pillay, are geophagy (earth), amylophagy (raw starch) and pagophagy (ice). Other items that pregnant women may consume include pencil erasers, wood chips, chalk, tissue, charcoal, ash or flecks of paint.

Dangers of Pica

The medical consequences of Pica for mother and foetus vary with the nature and amount of the substance ingested.

Effects on the mother could include:
  • Dental injury
  • Constipation
  • Intestinal obstruction
  • Parasitic infections
  • Interference with absorption of minerals
  • Poisoning
  • Hypocalcaemia
  • Increased risk of post-partum bleeding.

Possible effects on the foetus include:
  • Premature birth
  • Low birth weight
  • Exposure to chemicals like lead and pesticides.

What causes Pica?

Despite its ancient history in medical texts, Young notes that Hippocrates (460-377 BCE) was responsible for the first written record of Pica – doctors are yet to nail down an exact cause.

Petse outlines some theories:

Nutritional deficiency:

It’s commonly postulated that mineral deficiency in pregnancy could set about a craving for substances that contain the mineral. However, research to support this theory is inconclusive.

In particular, with respect to geophagia, the questions largely still in play are whether low-iron status induces craving for soil or whether eating soil leads to low iron levels.

“One possible explanation is that when there are a lot of non-food substances in the gut, the gut, in turn, becomes less efficient in extracting nutrients from the food,” explains Professor Angela Mathee, director of the Environment & Health Research Unit at the Medical Research Council (MRC).


The cornerstone of any treatment programme is to stop the behaviour by educating the pregnant mother about the dangers and ensuring emotional support for any psychological stress. As the condition often presents as iron-deficiency anaemia, Soma-Pillay explains that treatment will usually attempt to identify any vitamin or mineral deficiency and treat this.

Cultural factors

Cultural factors certainly play a role, says Petse. “Pica is accepted in some cultures as a way of increasing spirituality and treating morning sickness like nausea.”

Mathee also points out that cultural heritage is a strong influencing factor. “Some women are taught by their elders and believe it to be in the interest of the health of their babies.”




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