My first baby was born in mid-September. At some point in my last trimester, I became fixated on the ice in a way that went beyond what seemed normal. I knew which gas stations had machines with the crushed stuff and how long I would have to keep a plastic bottle of Aquafina in the fridge to get that perfect layer of crust. Despite the extreme nature of my obsession, I wrote it off as a symptom of being too pregnant over the summer. I gave birth and didn’t think much of the ice the moment it left.
Six years later, I was pregnant again and in my third trimester. The obsession is back. It turns out that low iron really does seem to show up in some weird ways.
I’ve been thinking about all of this since I stumbled a Threads post by @courtnibreann which has since amassed 732,000 views. She asked followers to share their most “unrealistic” pregnancy wishes, opening up about her own: she wanted salmon so bad she fantasized about catching it fresh from the river like a bear. Get me lost in the answers for the better part of half an hour.
One woman craved ocean water so badly that her fiance suggested she put a Lay’s potato chip in her mouth while holding water inside. Surprisingly, it worked. Another commenter went from a committed vegan to eating red meat at least once a day throughout her pregnancy and never going back. Another admitted to craving cigarettes. Not to smoke them would be dangerous. Instead, he wanted to… eat them?! (8.5k likes on this one, no notes.) And then there’s the woman who, after years of infertility and IVF, found herself inexplicably eating lunch meat, cheese, pickles and chipotle aioli piled high on chips even though she hated pickles. She joked to her husband that if she didn’t know better, she would take a pregnancy test. He did it. It was positive. She is now 38 weeks.
Since the thread went viral, I’ve started the pregnancy craving conversation with countless friends. One woman told me about a friend who confessed to eating crackers while watching videos of people eating chalk so she could safely satisfy her compulsions. Which, frankly, is both resourceful and a little haunted.
So what’s really going on? I asked Dr Prati SharmaOB/GYN, REI, and Medical Advisor to Bird&Beto understand it.
It’s not just in your head (but it kind of is)
The physiology of wanting to get pregnant is more multi-layered than most people realize. “Hormonally, the rapid rise in hCG and progesterone during the first trimester directly alters taste and olfactory sensitivity, changing the way the brain processes food,” explains Dr. “The craving itself is not about needing that particular food, but rather a signal of a nutritional requirement that the brain translates into a very specific craving.”
In other words, your brain isn’t asking you to eat salmon out of the river. It’s asking for something that salmon contains – omega-3s, protein, iron – and packaging the request in the most absurd terms possible.
Aversions work a little differently. That ex-vegan who suddenly couldn’t stop eating red meat? Dr. Sharma says that early pregnancy aversions are partly evolutionary. “There is an evolutionary theory that aversions are protective because they keep pregnant women away from foods with a higher risk of spoilage during a period of natural immune suppression.” The shift toward red meat, meanwhile, likely reflects the increased demand for iron and B12 that plant-based dietary sources struggle to meet during pregnancy.
When your body actually sends a signal
The longing for water in the ocean is one of the most satisfying examples of longing with a clear physiological explanation. “During pregnancy, blood volume expands significantly and the kidneys work differently to retain fluid,” says Dr. Sharma. “This changes the sodium balance, causing some people to experience drops that cause intense salt cravings. The saltiness of the ocean water is likely what she was craving, and the chip provided the sodium her body signaled she needed.”
As for the ice obsession I had in two pregnancies and blamed entirely on the August heat, this is a well-documented phenomenon called ice eating and is one of the more common occurrences of pica during pregnancy. Pica—the persistent craving for non-food items—affects about 28 percent of pregnant women worldwide, according to Dr. Sharma, and is more common than most people let on. It can appear as a craving for ice, dirt, clay, chalk or laundry starch and is usually associated with iron, calcium or zinc deficiency.
Which brings me back to my ice state. I craved it obsessively in two pregnancies, both times in the third trimester, and both times I was iron deficient. I didn’t connect those dots until much later. My friend’s cracker and chalk approach was, in hindsight, her body was doing the same thing – trying to satisfy something real through a safer proxy.
When to really call your doctor
The general guidance of Dr. Sarma is to yield to the desire for food, as long as they are safe. “Eat all the fries or veggie sushi rolls if that’s what you’re craving,” she says. “Your body is working incredibly hard, so most cravings are to be expected. As long as there’s no risk and your overall diet is balanced with daily prenatal vitamins, I say go for it.”
The calculus shifts once the craving moves into non-food territory. “Once cravings switch from food to non-food, it’s time to talk to your provider,” says Dr. Sharma. “Cravings for non-food items almost always signal an underlying deficiency that requires further investigation.” She also points out that if a craving feels painful or compulsive, it may be linked to perinatal mental health. In this case, a provider who knows your history is the right person to help resolve the root cause.
Cigarette cravings from the thread — the kind where the person wants to eat them, not smoke them — is exactly the kind of thing Dr. Sharma would like patients to report. Not for judgment but for information.
Some other signs worth noting according to Dr. Sharma: intense salt cravings may reflect sodium imbalance or, less commonly, adrenal insufficiency. Sugar cravings that feel compulsive and are accompanied by increased thirst or frequent urination may be worth mentioning to your provider, especially if you haven’t yet been screened for gestational diabetes. None of these desires are diagnostic in themselves, but are worth mentioning.
Foods that are actually off limits
For the raw salmon devotees in the Threads comments, Dr. Sharma recommends avoiding raw fish and anything high in mercury during pregnancy, as well as uncooked meats and cured meats (risk of listeria unless heated). Her approach with patients is not just to list prohibitions but to find safer alternatives. If your body is asking for something specific, there is usually a way to meet the underlying need without the risk.
Prenatal vitamins with adequate iron absorption are also worth reconsidering if you experience severe or unusual cravings. Dr. Sharma specifically points to iron composition as an area where not all prenatals are equal, and it’s worth asking your provider if what you’re taking is really meeting your needs.
Meanwhile, the Threads comment section will remain a love letter to the weird state of the pregnant body — 732,000 views and counting. The salmon woman from the river is still out there, still yearning, still jealous of the bears. Same, honestly.
