The incidence of pica during pregnancy has been reported to range from 0% to 68% depending on the patient population. This study was designed to define characteristics and factors influencing the practice of pica in a rural obstetric population. Our study group was 125 consecutive pregnant women who were interviewed at their initial antenatal visit about attitudes and behavior regarding pica practices. The prevalence of anemia was determined. Chi-square and t tests were used when appropriate. A pica was found in 18 (14.4%) patients. There were no significant differences between patients with a pica and those with none with respect to age, race, weight, or anemia. Substances ingested included white and red dirt, ice, cornstarch, laundry starch, soap, ashes, chalk, paint, and burnt-matches. Characteristics of patients with pica included cravings (6 of 18 or 33.3%), pica before pregnancy (10 of 18 or 56.6%), childhood pica (6 of 18 or 33.3%), and the presence of other household members with pica (56.6%). Our study data suggest that pica is frequently associated with similar practices during childhood and nonpregnant states. These patients also may be at risk for lead toxicity or other environmental toxin exposures.