My first baby was due in mid-September. Sometime in my final trimester, I became fixated on ice in a way that transcended any semblance of normal. I knew which gas stations had machines with the crushy stuff and how long I’d have to stash a plastic Aquafina bottle 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 enormously pregnant in the summer. I gave birth and didn’t think too much about ice pretty much the moment he popped out.
Six years later, I was pregnant again and in my third trimester. The obsession returned. Turns out, low iron really does seem to show itself in some wacky ways.
I’ve been thinking about all of this since stumbling on a Threads post from @courtnibreann that has since racked up 732K views. She asked followers to share their most “unrealistic” pregnancy cravings, opening with her own: she wanted salmon so badly she fantasized about catching it fresh from the river like a bear. Cue me getting lost in the replies for the better part of a half hour.
One woman craved ocean water so intensely that her fiancé suggested she put a Lay’s potato chip in her mouth and hold water in at the same time. Surprisingly, it worked. Another commenter went from committed vegan to eating red meat at least once a day throughout her entire pregnancy and never went back. Someone else admitted to craving cigarettes. Not to smoke them, that would be dangerous. Instead, she wanted to…eat them?! (8.5K likes on that one, no notes.) And then there’s the woman who, after years of infertility and IVF, found herself inexplicably eating lunchmeat, cheese, pickles, and chipotle aioli stacked on potato chips despite hating pickles. She joked to her husband that if she didn’t know better, she’d take a pregnancy test. She did. It was positive. She’s now 38 weeks.
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Since the thread went viral, I’ve kicked up 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, honestly, is both resourceful and a little haunting.
So what’s actually going on? I asked Dr. Prati Sharma, OB/GYN, REI, and Medical Advisor to Bird&Be, to help make sense of it.
It’s not just in your head (but it kind of is)
The physiology of pregnancy cravings is more layered than most people realize. “Hormonally, the rapid rise in hCG and progesterone during the first trimester directly alters taste and olfactory sensitivity, changing how the brain processes food,” Dr. Sharma explains. “The craving itself is not about needing that exact food, but instead, a signal of a nutritional demand that the brain translates into a very specific craving.”
In other words, your brain is not asking you to eat salmon out of a river. It’s asking for something that salmon contains — omega-3s, protein, iron — and packaging the request in the most irrational terms possible.
The aversions work a little differently. That former vegan who suddenly couldn’t stop eating red meat? Dr. Sharma says aversions during early pregnancy are partly evolutionary. “There’s an evolutionary theory that aversions are protective because they keep pregnant people away from foods with higher spoilage risk during a period of natural immune suppression.” The shift toward red meat, meanwhile, likely reflects increased iron and B12 demand that plant-based dietary sources struggle to meet during pregnancy.
When your body is actually sending a signal
The ocean water craving is one of the more satisfying examples of a craving with a clear physiological explanation. “During pregnancy, blood volume expands significantly, and the kidneys work differently to retain fluid,” Dr. Sharma says. “This shifts the sodium balance, causing some people to experience drops that trigger intense salt cravings. The saltiness of the ocean water is likely what she was craving and the chip provided the sodium her body was signaling it needed.”
As for the ice obsession I carried through two pregnancies and blamed entirely on August heat, that’s a well-documented phenomenon called pagophagia, and it’s one of the more common presentations of pica during pregnancy. Pica — the persistent craving for non-food items — affects about 28% of pregnant people worldwide, according to Dr. Sharma, and it’s more common than most people talk about. It can show up as cravings for ice, dirt, clay, chalk, or laundry starch, and it’s typically linked to iron, calcium, or zinc deficiencies.
Which brings me back to my ice situation. I craved it obsessively through two pregnancies, both times in the third trimester, and both times I was running low on iron. I didn’t connect those dots until much later. The crackers-and-chalk-videos approach my friend’s friend used was, in retrospect, her body doing the same thing — trying to satisfy something real through a safer proxy.
When to actually call your doctor
Dr. Sharma’s general guidance is to lean into food cravings as long as they’re safe. “Eat the french fries or the veggie sushi rolls as much as you want 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 is no risk and your overall diet is balanced with daily prenatal vitamins, I say go ahead.”
The calculus shifts once cravings move into non-food territory. “Once cravings cross from food to non-food, it’s time to talk to your provider,” Dr. Sharma says. “Cravings for non-food items almost always signal an underlying deficiency that requires further screening.” She also flags that if a craving feels distressing or compulsive, it may be connected to perinatal mental health. In this case, a provider who knows your history is the right person to help sort out the root cause.
The cigarette craving from the thread — the one where the person wanted to eat them, not smoke them — is exactly the kind of thing Dr. Sharma would want patients to bring up. Not for judgment but for information.
A few other signals worth noting according to Dr. Sharma: intense salt cravings can reflect sodium imbalance or, less commonly, adrenal insufficiency. Sugar cravings that feel compulsive and come with increased thirst or frequent urination might be worth flagging to your provider, especially if you haven’t had a gestational diabetes screening yet. None of these cravings are diagnostic on their own, but they’re worth mentioning.
The foods that are actually off-limits
For the raw salmon devotees in the Threads comments, Dr. Sharma recommends steering clear of raw fish and anything high in mercury during pregnancy, as well as undercooked meats and deli meat (listeria risk, unless it’s been heated through). Her approach with patients isn’t just to list prohibitions but to find safer alternatives. If your body is calling for something specific, there’s usually a way to honor the underlying need without the risk.
Prenatal vitamins with adequate iron absorption are also worth revisiting if you’re experiencing intense or unusual cravings. Dr. Sharma specifically flags iron formulation as an area where not all prenatals are equal, and it’s worth asking your provider whether what you’re taking is actually meeting your needs.
In the meantime, the Threads comment section will remain a love letter to the strangeness of the pregnant body — 732K views and counting. The salmon-from-the-river woman is still out there, still craving, still envious of bears. Same, honestly.
