The curious case of pregnancy cravings
While nausea, exhaustion and back pain are some of the common symptoms of pregnancy, many expecting mothers can also harbor conditions commonly known as food craving or, in other cases, food aversion. Even though it is hard to pin down the root causes, many believe that hormonal changes are to blame. The conventional wisdom in Ethiopia is to let a woman sate her cravings for fear that representational birthmarks may appear on the body of the newborn. Same is true in Malta; whereas among the Hmong, it is to guarantee that the baby will not be born with a deformity. Tibebeselassie Tigabu delves into the topic in this issue of The Reporter.
Many of the old neighborhoods in Addis such as Shiro Meda are renowned for having a vibrant community life. If one takes a casual walk around the area, among the usual sights one would come across are drying laundry hanging by a roadside and streets teeming with pedestrians and vehicles.
The various activities on the streets and in the small kiosks, punctured fences and all, lend the place vitality.
These spaces, owing to their varying sizes and locations, accommodate from the smallest outdoor activities such as manual coffee grinding to erecting a tent for a wedding or a funeral. These communal spaces are also a safe haven for children to dribble their footballs, jump rope relay, play hide-and-seek and engage in other activities.
While the children are playing football, a kid, about seven, sitting nonchalantly on a stone, not minding his tears or the mucus from his nose, is biting on his mango.
Just a short distance from the boy stands a pregnant woman, Askale, gazing in the boy's direction for a while before snatching the mango from his hand, and taking a mouthful instantly.
Yeshi Belay, a friend of Askale’s, remembers the scene vividly and says that the kid started crying right away. The kid’s frantic sobbing did not, however, make Askale relent, according to Yeshi. She rather kept on munching on the fruit with a hearty appetite. Askale’s audacious action drew a small crowd of neighbors who were amused by the situation. “They thought she was crazy but I had to explain that she is pregnant and that it is just a food craving,” Yeshi recalled.
Some of the people did not quite understand what was going on, but according to Yeshi, many of the women were sympathetic to Askale, and even offered to bring her a ‘clean’ mango. Yeshi, a mother of five, further noted, “Of course, she does not want a ‘clean’ mango. A pregnancy craving does not give time,”
It is not only Askale, but many pregnant women also experience an intense desire to consume a specific type of food. There are many stories of pregnant women having a breakdown because they could not get an item of food they are craving.
It is not hunger per se; rather an impulsive need for some food items and, in some cases, for non-nutritive ones.
There are cases of pregnant women consuming mud (commonly known as walka chika), clay, toothpaste, kerosene, painted plaster, charcoal, burnt match sticks, petroleum, soap and unsanitary foods.
Some of the cravings can be for sweets, salty foods or spicy ones. There are more bizarre stories of cravings by pregnant women.
One is a craving for eclectic leftover food items that beggars carry in their bags. Kidist Lemma, 45, and a mother of three, went through one of the strangest food craving episodes. It all started in a church when she was in her fifth month of pregnancy. It was Saint Mary’s Day, and a woman was handing out alms to beggars and Kidist had this uncontrollable craving for the food.
“It was not even the food the woman was handing out that I wanted to eat; rather the food that a needy one was keeping in a plastic bag," Kidist said.
Kidist was ashamed of asking the woman for alms, or approaching the beggar for a share of his food. “I went home and I actually cried because I thought this could not happen to anyone else,” Kidist added.
Though Kidist assumes it is unusual, it is actually a very common phenomenon. She has also heard about other cravings such as for alcohol or for tasteless food items. One incident she recounts happened when she was young. A pregnant woman came to visit her mother. She and her sister were preparing tella (traditional ale). One of the ingredients for the brew was yetela kita (a flatbread baked at high temperature), solely used as an ingredient for tella. The woman was craving the flatbread but Kidist and her sister did not know what her desire was. Her mother was not at home and the visiting woman left abruptly. Later on, when Kidist’s mother went to visit her, the woman started to cry and complained that her daughters refused to give her “yetela kita” to sate her pregnancy cravings.
The mother invited back the pregnant woman home and offered her the flatbread that unfortunately had been mixed with other ingredients. According to Kidist, the pregnant woman did not hesitate to eat the mixed ingredient that was very bitter. Growing up, she also heard stories of pregnant women craving for such food items as sauteed onions, dulet (traditional tripe) raw meat, honey and injera straight from the hearth. Her experience of craving for this eclectic leftover food is, according to her, “unsanitary” and “unimaginable”. Later on, the craving was intolerable and Kidist was crying for many nights and then decided to eat the eclectic leftovers. After that, she heard similar stories of cravings for eclectic leftover food beggars are handed out as alms. A friend told her the husband of a pregnant woman she knew was going all over Addis every night for almost two weeks asking beggars for their food, and sometimes offering to buy it from them. For Kidist, this is one of the most memorable cravings she ever had.
In addition to this, the other food items were roasted chickpea and nifro (boiled wheat) which, according to followers of the Ethiopian Orthodox Church, is eaten on a special occasion. On her recent-most pregnancy, all she was craving was yedigis migib (food prepared for holidays, weddings and funerals). Along with her friend and her sister, she even crashed a wedding party and asked to be served. "Many people understand this and on a couple of occasions, we were well-entertained at wedding parties,” Kidist said.
Some of the cravings can be harmful for the unborn baby, such as Sofia Hussein’s mother craving for tella. According to Sofia, her mother sipped many glasses of tella during her pregnancy. “Everyone in the family, including my father, understood her cravings. So we sometimes bought her tella during her pregnancy,” Sofia said. In addition to tella, she was craving for sugar cane.
Mesfin Demeke also shares his experience of how his wife craved for soda, especially Coca Cola in her first pregnancy. In the second pregnancy, Mesfin recalled that all she wanted to have was a bucket of ice.
Whether it is harmful or not, many people give pregnant women something to sate their cravings. In many Ethiopian cultures, pregnant women are encouraged to satisfy their cravings for specific foods, lest their unborn child will bear a representational birthmark, commonly known as shita.
Some mothers The Reporter talked to say that they did not have any food craving, rather an aversion. Instead of wanting to eat a certain food, they were actually repulsed by the food item -- especially foods with strong smells like onions, garlic and eggs.
In some pregnancies, they crave food they used to regard as distasteful. One of them is Alem Gebre, 32, who gave birth recently to her first child. Before her pregnancy, she used to hate any type of sweet, even did not consume sugar, but during her pregnancy, all she wanted to eat was sweet. She thus consumed a lot of chocolate, ice cream, cake, honey, and even sugar. Her situation baffled her and when she told her doctor what she was going through, he told her that it was caused by hormonal changes in her body.
Yirgu Gebrehiwot (MD), a gynecologist and obstetrician at the Addis Ababa University College of Health Sciences, said the exact cause for food craving and aversion is not clear. One of the probable causes could be that the hormones produced and excreted by the placenta can have a huge impact on taste and smell. According to Yirgu, certain cravings are understandable. For example, craving a large amount of ice and non-edible substances such as mud, clay, soap, toothpaste and kerosene (a condition called pica) is linked to an iron deficiency. In such instances, it is actually possible to cure the craving, noted Yirgu. A craving for non-nutritive things, according to Yirgu, is very harmful to both the mother and the unborn baby. Eating non-edible substances may interfere with nutrient absorption and can potentially cause a deficiency.
Pica cravings are also a concern because non-edible items may contain toxic or parasitic elements. In some cases, the mother will develop an infection or a disease such as appendicitis.
Even with edible items, Yirgu advises pregnant women to watch what they consume. "Since pregnancy is a time to be extra cautious, one has to refrain from consuming a lot of sugar, alcohol, cigarettes, among other things," Yirgu advised.
Consuming sugar can be dangerous since pregnant mothers can potentially develop gestational diabetes, which can lead to a rise in blood sugar levels. Gestational diabetes normally abates once the baby is born.
Accordingly, Yirgu recommends that even though pregnancy cravings can be intense and overwhelming, one need to refrain from consuming a lot of sugar since this can develop into full-blown diabetes.