Can You Eat Sushi While Pregnant?

Is sushi safe to eat during pregnancy?

It depends on the type of sushi. Cooked sushi is safe during pregnancy when from reputable restaurants. Raw sushi (with raw fish or seafood) should be avoided during pregnancy due to risks of foodborne illness from Listeria monocytogenes, parasites (including Anisakis worms), and bacteria like Salmonella. Pregnant women are about 10 times more susceptible to listeriosis than non-pregnant adults, and infection can cause miscarriage, stillbirth, premature delivery, or severe newborn illness even at low exposure levels. The risk from raw seafood, even sushi-grade fish, is not zero. The FDA and ACOG both recommend pregnant women avoid raw fish during pregnancy. Cooked sushi options provide a way to enjoy this cuisine safely.

What sushi can you eat during pregnancy?

Several cooked sushi options are safe during pregnancy: California rolls (made with cooked imitation crab/surimi and avocado); tempura rolls (with deep-fried shrimp or vegetables); BBQ eel rolls/unagi (eel is always cooked before serving); Philadelphia rolls (with cream cheese and cooked salmon or just smoked salmon, though smoked salmon is debated); spicy California rolls (cooked imitation crab with spicy mayo); Dragon rolls (with cooked eel and avocado); shrimp tempura rolls; cooked salmon rolls; egg/tamago rolls (cooked egg omelet); vegetable rolls (avocado, cucumber, asparagus, pickled radish). Confirm with the restaurant that ingredients are fully cooked. Smoked salmon is a gray area; refrigerated smoked salmon carries listeria risk, but if heated through (in baked roll) it's fine.

What sushi should you avoid during pregnancy?

Avoid all sushi containing raw fish or seafood: raw tuna (maguro, ahi), raw salmon (sake), raw yellowtail (hamachi), raw shrimp (ebi nigiri without cooking), raw mackerel (saba), raw uni (sea urchin), raw fish roe (ikura, masago, tobiko - cooked fish roe is debated, often safer than raw fish), raw octopus, raw squid, sashimi, poke bowls, spicy tuna rolls (raw tuna), rainbow rolls (typically include raw fish), and any nigiri sushi with raw fish on top. Also avoid: ceviche-style sushi, sushi from buffets (food has been sitting at room temperature), sushi from grocery stores or convenience stores that may have been improperly stored, and homemade sushi unless you're certain ingredients are sushi-grade and properly handled. Mercury concerns also apply: avoid bigeye tuna sushi specifically (very high mercury), even if cooked.

How can you order sushi safely during pregnancy?

Choose reputable sushi restaurants with high turnover (ingredients are fresher). Tell the server you're pregnant and want only cooked options; most restaurants are accommodating. Ask specifically about ingredients: 'Is this raw or cooked?' or 'Is the salmon in this roll cooked or raw?' Order rolls with clearly cooked ingredients (BBQ eel, shrimp tempura, cooked imitation crab). Vegetable rolls and tamago (cooked egg) are always safe. Hand rolls and nigiri are riskier because preparation is more variable; rolls are generally a safer choice. Avoid sashimi entirely. Soy sauce, wasabi, pickled ginger are all safe. Watch out for unagi sauce containing mirin (small amount of alcohol, but typically considered safe in cooking). Consider warming or microwaving sushi if uncertain about cooking; some pregnant women heat sushi until just warm to ensure any harmful bacteria are destroyed.