Clay ingestion (mis)perceptions during pregnancy among African women in London: maternal health implications

Introduction: Clay ingestion (CI) during pregnancy has implications for maternal and child health. Within the biomedical discourse, CI has been associated with potential exposure to toxic metals, parasitic infection, and adverse maternal and foetal outcomes. Despite repeated warnings against CI during pregnancy and breastfeeding by the Food Standards Agency, evidence points to an ongoing practice outside of the biomedical discourse. In addition, there is limited research exploring how African women living in London understand and interpret CI during pregnancy, including perceived potential harms. Against this background, this study aimed to explore how African migrant women living in London interpreted, explained, and negotiated CI during pregnancy through lived experiences. Materials and methods: This study used an interpretative phenomenological analysis (IPA) to explore how African women living in London understood, explained, and negotiated clay ingestion during pregnancy. In-depth interviews were conducted with 30 women, followed by a focus group discussion with seven participants. Participants were recruited using purposive sampling, snowball sampling and quota sampling. The analysis generated several themes; this article focuses on the emergent theme of (mis)perceptions. Results: Analysis generated the theme of (mis)perceptions, showing how women interpreted CI through lay explanations shaped by lived experience, cultural knowledge, beliefs, social norms, sensory assessment, and interpretations of bodily signs and experiences. Clay was often viewed as safe, beneficial, or manageable when sourced from familiar or visibly clean places, was consumed in moderation, or had not previously caused observable harm. Drawing from socially shared explanations and reflecting on embodied and experiential reasoning, participants described a range of perceptions regarding potential harm of CI such as ‘sucking blood’, developing gallstones and appendicitis, and nose and ear blockages perceived to affect the foetus if clay was ingested ‘excessively’. Perceptions of newborns being coated in clay at birth were also reported, though considered harmless. CI was also perceived safer than products such as chocolates and alcohol. Conclusions: Women’s perceptions of CI potential harms during pregnancy were shaped by socially shared knowledge, lived experiences, source familiarity, sensory assessment, and the absence of observable harm. These perceptions differed from biomedical and regulatory understandings of safety and risk. Antenatal and public health services should therefore use culturally sensitive and non-judgemental communication that acknowledges women’s explanatory models while providing clear, accessible information about the potential risks and uncertainties associated with CI during pregnancy to support informed decision-making by expectant mothers.