When Cravings Get Quirky: A Midwife’s Guide to Pica and Pregnancy

Pickles at midnight? A sudden dislike of your morning coffee? Cravings and aversions are some of the most talked-about parts of pregnancy. For many women, they’re harmless, even a bit amusing. But sometimes, cravings get a little quirky.

As a midwife, I often hear women laugh about their unusual food preferences, but I also hear quieter admissions: “I can’t stop chewing ice” or “I find myself wanting to eat dirt or chalk.” These non-food cravings are known as pica, and they’re important to talk about.

In this blog, we’ll explore what’s normal when it comes to pregnancy cravings, why aversions happen, and when unusual cravings may be your body’s way of asking for extra care.

What’s Normal: Food Cravings and Aversions

Cravings and aversions are very common in pregnancy. They’re often strongest in the first trimester but can appear anytime. Hormones heighten your senses of taste and smell, which may explain why your usual morning coffee suddenly makes you gag, or why you must have citrus fruit right now.

Common cravings include:

• Carbs (bread, pasta, cereal)

• Dairy (milk, cheese, yoghurt)

• Chocolate or sweets

• Salty snacks

• Fresh fruit

Common aversions include:

• Coffee or tea

• Strong-smelling foods like garlic or fish

• Greasy or spicy foods

Most of the time, these changes are simply your body adjusting and are nothing to worry about.

When Cravings Get Quirky: What Is Pica?

Pica is the name given to persistent cravings for non-food substances, such as:

• Ice

• Dirt or clay

• Paper

• Chalk

• Soap or laundry starch

Unlike a craving for chips or fruit, pica can be a red flag. Research suggests it’s sometimes linked to nutrient deficiencies, especially iron deficiency anaemia【NHMRC, 2020; RANZCOG, 2021】.

Why Does Pica Happen?

The exact cause isn’t fully understood, but possible explanations include:

• Nutrient deficiencies (most often iron or zinc)

• Cultural practices or beliefs

• Stress or psychological factors

What’s important to know is that pica isn’t your fault, and you’re not alone. It’s a well-recognised condition that your midwife or doctor will take seriously.

Is Pica Dangerous?

It can be. Eating non-food substances may:

• Interfere with nutrient absorption (making anaemia worse)

• Introduce toxins (like lead or parasites in soil)

• Damage teeth or the digestive tract

This is why speaking up is so important, even if it feels embarrassing to mention.

What To Do If You Experience Pica

• Tell your care provider. Midwives and doctors hear this more often than you think.

• Request a blood test. Checking iron and other nutrients is often the first step.

• Don’t ignore it. Unusual cravings are your body’s way of asking for attention.

If iron deficiency is found, supplements or dietary adjustments can often make the cravings fade.

Coping With Everyday Cravings and Aversions

For the more typical food-related cravings and aversions, these tips may help:

• Keep snacks handy for sudden cravings.

• Pair less healthy cravings with nutrient-rich foods (e.g., chocolate with a handful of nuts).

• Explore substitutes if aversions cut out major food groups (e.g., beans or lentils if meat is off-putting).

Final Thoughts

Pregnancy cravings are a normal, even entertaining, part of the journey. But if cravings start to feel unusual or involve non-food items, that’s a sign to reach out for support. Remember, asking for help doesn’t mean something is wrong with you. It means you’re caring for yourself and your baby.

Disclaimer

This article is for general education only and does not replace personalised medical advice. If you experience unusual cravings, especially pica, please speak with your midwife, doctor, or healthcare provider for assessment and support.