Eating soil by pregnant women could harm babies: Midwives’ insight

The practice of soil consumption (geophagy) can be seen as a form of pica which is the craving and ingestion of non-nutritive substances. Several studies worldwide have revealed that pregnant women consume more soil than other groups for numerous motives. This practice is also commonly found among breastfeeding women, and rarely happens among non-pregnant women and men. The prevalence of geophagy among pregnant women in Africa has been reported to range from 28% to 84%. In Uganda, the prevalence of geophagy is estimated to be at around 50% among pregnant women.

Studies have shown that the etiology or cause and health consequences of geophagy are still poorly understood. This could be due to limited information in terms of literature and coverage of geophagy during Antenatal Care visits to health facilities. Pregnant women tend to consume a wide range of soils which include clay, ground soils, soils from walls of homes, termite mound soils among other sources of soil. Several studies indicate that eating soil may have a positive effect such as alleviating gastrointestinal or stomach upset like nausea and heartburn, detoxifying food, and therefore may be a protective behavior. Other studies show that geophagy may be due to hunger, or maybe psychological resulting to craving or it could be due to obsessive-compulsive spectrum disorder.

Furthermore, clay can be used as a traditional antidiarrheal pharmaceutical to treat acute gastro-enteritis. Geophagic soil can be a source for micronutrients, such as for iron deficiency. However, other studies suggest that the nutrient value of the soil is overestimated and that the consumption of soil rather exacerbates micro-nutrient deficiencies. 

Research further shows that various soils consumed by pregnant women contain chemicals such as arsenic, chromium, copper, iron, magnesium, zinc, cadium and mercury all in different quantities usually at higher levels exceeding risk levels designated by USA agency for toxic substance and disease registry.

Though soil consumption could provide the body with minerals such as iron, there are some problems that may arise from being a geophagist! For example, iron irritates the gut lining causing gastro-intestinal distress such as cramping and constipation, however excessive iron absorption is not possible since iron metabolites control iron absorption.                                                                                                                                                                              Arsenic, mercury, nickel and lead are sometimes referred to as toxic elements and have been linked to adverse reproductive outcomes, neurological disorders and impaired cognitive development in children. Furthermore, studies have shown that maternal arsenic exposure early in pregnancy is associated with low birth weight.  Studies report that exposure to cadium and lead are linked to many health outcomes including cognitive deficits and delayed developmental milestones in children.

With the many side effects that may arise due to a pregnant woman being a geophagist, we recommend that pregnant women should highly minimize consumption of soil.

The authors are; Musinguzi Mwesige Nelson; a BSc trained midwife working with Masaka Regional Referral Hospital and Lilian Nuwabaine Luyima; a BSc trained Nurse & MSN-Midwife & Women’s’ Health Specialist working with Aga Khan University as the Continuous Professional Development Coordinator