If you've caught yourself eyeing the dirt in a houseplant and wondering if you've completely lost it, you're not alone. It's called pica, and it shows up in pregnancy more often than people talk about.
What is pica?
Pica is a persistent urge to eat non-food items – things with no nutritional value – for a month or more. (If you're old enough to say "pass me that bucket of sand," you're also old enough to know better. That's the developmental part doctors mean when they define it.)
In pregnancy, the cravings can include:
- Dirt, clay, or sand
- Chalk or plaster
- Burnt matches or charcoal
- Cornstarch or baking soda
- Soap or toothpaste
- Coffee grounds
- Cigarette ashes
A quick note on ice: craving ice (it even has its own name – pagophagia) is technically a form of pica too, but it's far more common and far lower-risk than the rest of this list. Wanting to crunch ice all day isn't usually a red flag on its own, though it's still worth mentioning at your next appointment.
Why does this happen?
The leading theory ties pica to iron deficiency and your body reaching for something, anything, to fill a nutritional gap. Zinc deficiency has also been linked to it. And sometimes pica shows up with no detectable deficiency at all, which can be frustrating if your bloodwork comes back "normal" but the cravings haven't gone anywhere.
It's also a bit of a chicken-or-egg situation: some researchers think the deficiency causes the pica, while others think eating things like dirt or clay actually blocks iron absorption and causes the deficiency in the first place.
Pica also isn't evenly distributed. Research has found women with anemia are noticeably more likely to develop pica than women without it, and rates run higher among certain groups, including Black women, possibly tied to a mix of biology, access to care, and nutrition. If you're in a higher-risk group, it's worth being a little more proactive about getting your levels checked.
Thankfully, for most women, pica fades after delivery as nutrient levels and pregnancy-related demands normalize. This isn't usually a forever thing.
Is it dangerous?
It can be. Some of the things people crave are genuinely toxic, and beyond that, pica carries real risks, including exposure to parasites or soil contaminants, heavy metal exposure (especially from old paint chips or certain clays), intestinal blockages, and crowding out the actual nutrients you and the baby need.
Call your doctor right away if:
- You've already eaten something toxic, lead-containing, or sharp
- You're worried about parasite exposure from soil or unwashed substances
- You're eating non-food items frequently enough that it's replacing real meals
What should you do about it?
If you're noticing these cravings:
- Get your iron (and possibly zinc) levels checked. Ask your provider for bloodwork – this is the most useful first step.
- Don't act on cravings involving anything toxic or parasite-prone. Soil and similar substances are a hard no.
- Keep eating real food. Don't let the cravings crowd out the basics like protein, veggies, the usual.
- Tell someone. Having a partner or friend who knows what's going on and can gently redirect you in the moment helps more than you'd think.
There's no magic cure, but chewing gum is the most commonly suggested distraction technique. It's not a perfect substitute, but it gives your mouth something to do.
For more on iron deficiency in pregnancy specifically, check out Iron-Deficient Anemia and the Lucky Iron Fish. ACOG's guidance on anemia in pregnancy also touches on pica as one of the symptoms worth flagging to your provider, if you want to dig into the clinical side.
Did you crave anything weird during pregnancy? Tell me in the comments.
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