It is not recommended to eat raw sushi while pregnant due to the increased risks of exposure to parasites, bacteria (like Listeria, which can survive refrigeration), and high levels of mercury in certain fish. These foodborne illnesses can pose serious health risks to both the mother and the developing baby, including miscarriage, stillbirth, or premature delivery.
Risks of Eating Raw-Fish Sushi During Pregnancy
Raw fish can harbor parasites and bacteria that can weaken a pregnant person's already more-vulnerable immune system and make you more susceptible to infections, says Mariam Aboulela, MD, an ob-gyn with Memorial Hermann Health System in Houston.
You can safely eat the following types of sushi while pregnant:
- Avoid high-mercury fish - Avoid raw shellfish - Choose reliable sources, that you trust were stored and cooked/prepared properly The good thing about sushi is that there are many kinds; cooked rolls and rolls with just veggies (avoiding sprouts) are safe.
The raw fish in sushi should be safe in pregnancy as long as it has been frozen before the sushi was made. Raw fish that has not been frozen may contain small parasites (worms) which can make you sick. For this reason you should avoid store bought sushi and not use any raw meat or seafood if you make your own sushi.
Although pregnant women are at increased risk from Listeria infection, it's important to remember that the risk of listeriosis in Australia is low, and that there are simple steps you can take to avoid infection while still eating a balanced, healthy diet.
Popular Cooked Sushi Varieties
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You can choose from several categories of sushi made without raw ingredients. These include cooked seafood, egg based preparations, vegetarian and vegan styles and rolls influenced by Western ingredients and preparation methods.
During the first trimester, avoid alcohol, smoking, and drugs, limit caffeine, and steer clear of foods like high-mercury fish (shark, swordfish, marlin), raw/undercooked meats, eggs, seafood (sushi, smoked salmon), unpasteurized dairy, and soft cheeses, plus activities like cleaning litter boxes (toxoplasmosis risk) or using saunas/hot tubs (overheating), to protect the vulnerable developing baby from infections, toxins, and overheating.
When cooked, both crab and imitation crab are safe to eat during pregnancy. Practicing careful food preparation and always cooking seafood thoroughly are other ways people can protect themselves and the growing fetus from food poisoning dangers.
There's a small risk of getting toxoplasmosis if you eat raw and undercooked meat, which can cause miscarriage. Cured meats are not cooked, so they may have parasites in them that cause toxoplasmosis. Liver and liver products have lots of vitamin A in them. This can be harmful to an unborn baby.
You should avoid all raw or undercooked fish when you're pregnant, though many types of fish are safe to eat when fully cooked. Raw fish, including sushi and sashimi, are more likely to contain parasites or bacteria than fully cooked fish. Read Nutrition During Pregnancy and Listeria and Pregnancy to learn more.
It's recommended that if you're pregnant or planning to become pregnant you should not drink alcohol. This will keep any risk to your baby to a minimum. Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink, the greater the risk.
Seafood used in making sushi should be labeled as sushi grade seafood. Fish that's consumed raw in sushi must be frozen to -20°C (-4°F) for 7 days or -35°C (-31°F) for 15 hours. This process will destroy any parasite in the fish making it safer to consume but there's still risk.
Sushi always includes vinegared rice, while sashimi is purely raw fish or seafood served without rice. Sushi can feature both raw and cooked ingredients, but sashimi is exclusively raw.
The fish-killing method also helps preserve the freshness and safety of the fish. When they are frozen with extreme temperatures up to -40°C, it causes their pathogenic cells (which makes it rot/goes bad) to explode and die. Aside from fish, Japanese people love eating raw eggs.
During pregnancy, avoid raw/undercooked meats, seafood (like sushi, smoked fish), and eggs to prevent bacteria; limit high-mercury fish (shark, marlin); skip soft cheeses, deli meats, pâté, and unpasteurized dairy due to Listeria risk; avoid unwashed produce and sprouts; and cut out alcohol, while moderating caffeine, to protect your baby from infections, bacteria, mercury, and other harmful effects.
Sushi is generally safe to eat during pregnancy—but stick with sushi that includes vegetables and cooked seafood. As with cooked fish, pregnant women should avoid sushi that contains shark, swordfish, king mackerel, tilefish, bigeye tuna, marlin and orange roughy.
Eating sushi during pregnancy does not expose to the risk of toxoplasmosis. The reason is simple: the Toxoplasma gondiithe parasite responsible for this infection, is not present in fish. However, it is other foods that pose a risk, such as raw or undercooked meat.
Sushi can be cooked or raw, depending on the ingredients used. For instance, rolls can feature cooked ingredients such as shrimp tempura, grilled eel, or tamagoyaki (Japanese omelet). Sashimi, on the other hand, is always raw. Its purpose is to highlight the freshness and quality of the seafood.
Craving sushi anyway? Try rolls made with cooked fish or veggies instead of raw fish. Some safe sushi options include: Shrimp tempura rolls (made with cooked shrimp)
Many sushi varieties use cooked seafood, vegetables, or other ingredients like tofu and eggs. Options like tempura rolls, veggie rolls, and eel rolls provide delicious alternatives without raw fish.