title: Interpreting habits in a new place: Migrants' descriptions of geophagia during pregnancy.
abstract: Previous studies of soil eating, or geophagia, among pregnant women in sub-Saharan Africa indicate the practice is widespread. Various explanations have been explored to explain the global phenomenon of soil eating, with the most compelling explanation focused on clay's ability to prevent or treat intestinal infection. The urban South African context for clay eating is not well understood. This paper explores clay consumption amongst pregnant migrants who are nationals of countries where clay consumption may be common.
  
  
  
  I conducted in-depth interviews with a purposively selected group of Somali, Congolese, and Zimbabwean women (n = 23). Interviews included questions broadly related to maternal and infant nutrition. In addition, I conducted nine focus group discussions (n = 48) with adult Somali, Congolese (DRC), and Zimbabwean men (N = 3) and women (N = 6), segregated by country of origin and gender. This paper focuses specifically on responses related to geophagia.
  
  
  
  While Somali women did not report consuming clay or charcoal, Congolese and Zimbabwean participants self-reported commonly consuming clay during pregnancy, and at times also when not pregnant. Despite having heard public health messaging that discouraged the practice, participants largely did not describe this consumption in terms of health, but rather in terms of craving and habit. Participants described continued consumption of clay in South Africa, and the only reason for ceasing consumption was in cases of severe constipation.
  
  
  
  The widespread consumption of clay soil by Congolese and Zimbabwean women during pregnancy may be a mechanism through which identity was reasserted and reproduced in a foreign country. Participants' emphasis on clay consumption seemed related to the absence or expense of other craved foods, and perhaps also to feelings of loss in Cape Town.
authors.affiliation: Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Faculty of Health Sciences, Anzio Road, Cape Town, 7925, South Africa. Electronic address: hunterjo@gmail.com.
authors.forename: Jo
authors.initials: J
authors.lastname: Hunter-Adams
mesh_terms: D000538:Aluminum Silicates / Q000008:administration & dosage; D000077215:Clay; D066249:Craving; D015023:Democratic Republic of the Congo; D004032:Diet / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006184:Habits; D006801:Humans; D008297:Male; D010842:Pica / Q000523:psychology*; D011247:Pregnancy / Q000523:psychology; D011634:Public Health; D012987:Soil; D012998:Somalia; D013019:South Africa; D014171:Transients and Migrants; D015030:Zimbabwe
chemical_list: D000538:Aluminum Silicates; D012987:Soil; D000077215:Clay
keywords: Food habits; Geophagia; Migrant diets; Pregnancy diet