Pregnancy is an exciting time, and many expecting parents start thinking carefully about how their choices may affect their baby. Food questions often come up early, especially when it comes to foods you may have enjoyed before pregnancy.

Sushi is one of the most common concerns. While many people are told to avoid sushi altogether during pregnancy, the answer is not always black and white. Some types of fish and preparation methods are safer than others. Below, we break down what to know so you can make informed choices with confidence.⁷

The Cons of Eating Sushi While Pregnant

Raw or undercooked fish can carry risks during pregnancy, which is why certain types of sushi are discouraged.^1,7,8

While sushi and other raw fish dishes have become more mainstream, many expectant mothers are still unsure why caution is advised during pregnancy.^1,7,8 This uncertainty can be confusing and frustrating. Eating sushi is not as taboo as it once was, but there are still important pros and cons to understand. Let’s take a closer look at the reasons it may not be recommended:

1. Most Sushi Is Raw

One vital reason is that most sushi is uncooked fish. According to the American College of Obstetricians and Gynecologists (ACOG), raw fish or seafood is more likely to contain parasites and bacteria (including Listeria) that could harm you and your baby.^7,8 Even the best sushi restaurant could unintentionally subject its customers to foodborne illnesses.⁸ This is a gamble most pregnant women aren’t willing to take.

Related: Foods to Avoid During Pregnancy

2. There Can Be High Levels of Mercury

A good reason to be cautious about eating sushi while pregnant is the presence of mercury, particularly when the fish is uncooked.¹ Mercury is a toxic metal that can cause severe birth defects, including brain damage, blindness, and deafness.^9,10 Some examples of fish to avoid (even in a cooked roll) due to high levels of mercury include ahi (or yellowfin tuna), swordfish, blue marlin, yellowtail, sea bass, and mackerel.¹

3. Fish May Have Anisakis and Other Parasitic Worms

Occasionally, fish such as salmon may contain small parasitic worms like anisakis.^2,3 The worm usually dies at high temperatures.¹¹ However, eating the good stuff raw or undercooked means you might risk exposing yourself and your baby to the worms. Infection with these worms results in a condition known as “anisakidosis.” Symptoms of anisakidosis include:^2,6

• Severe abdominal pain
• Nausea and vomiting
• Diarrhea

Eating fish contaminated with anisakis can also cause an allergic reaction.⁴ Freezing raw wild fish kills any worms that may be present, makes it safer to eat, and is generally a good idea to help combat other bacteria.^3,4,12 Anisakidosis has also been found in individuals who consume raw or marinated anchovies.⁴ Anchovies are traditionally processed and preserved in salt and brine, which doesn’t always destroy the worms.

Related: Safe Fish During Pregnancy: Good and Bad Seafood Options

The Pros of Eating Sushi While Pregnant

When properly cooked and chosen carefully, some fish can still be part of a healthy pregnancy diet.⁵

Beyond avoiding raw options, many cooked fish offer meaningful nutritional benefits during pregnancy. Cooked, low-mercury fish are an excellent source of healthy fats and omega-3 fatty acids that support fetal development.⁵ A 12-ounce portion of well-cooked fish can be a valuable part of a balanced pregnancy diet.⁵ Salmon, in particular, is often recommended, as long as it is fully cooked by baking, grilling, or broiling.^14,15

The Verdict: Is Sushi Safe To Eat During Pregnancy?

A proper diet for an expectant mother should include foods that your trusted medical professional agrees upon and approves. Generally, you’re encouraged and allowed to consume well-prepared and well-cooked fish and shellfish while pregnant.⁵ These creatures from the big blue sea provide many excellent health benefits — not to mention they’re delicious!¹⁵ But remember, you should avoid any raw or undercooked fish during pregnancy, according to ACOG.⁷

Different Types of Sushi

When you’re at a restaurant, it’s important to be aware of the ingredients in the dish you’re ordering. Sushi restaurants are often great at explaining the different kinds of sushi in their menus. But here’s a quick guide if you cannot decode the lingo:

• Nigiri: This is a type of sushi, typically featuring fish, served on top of sushi rice. It’s often raw and made with shellfish, fish, and other such toppings.¹⁸
• Sashimi: This refers to fish or shellfish served as a standalone dish with no accompanying rice. It’s often raw.¹⁶
• Maki: Maki is a type of sushi consisting of rice and filling wrapped in seaweed.¹⁷ It’s a popular sushi staple, and it’s not always raw, so be sure to read the description of each sushi dish available.
• Temaki: Also known as a “handroll,” these messy cones of fish, rice, and other ingredients are occasionally raw, so be sure to double-check the menu when ordering.¹³

Related: Pregnancy Diet: What To Eat for a Healthy Pregnancy

What To Order: Sushi Menus for Pregnant Women

All those variations of sushi listed above sound delicious, right? For the most part, though, you’d be safer ordering tempura or another form of cooked fish when having seafood. Opt for shrimp tempura or a similar cooked roll when out for Japanese cuisine with friends or family. In most cases, sushi restaurants also serve chicken, beef, or pork in teriyaki or hibachi style. Choose one of these with all the delicious veggies and rice your heart desires! Not only is it yummy, but you’ll feel confident knowing you’ve done something positive for your baby and tummy.

While sushi can be tricky during pregnancy, understanding which types of fish are safe and how they are prepared can help you make confident choices. When in doubt, opt for fully cooked options and follow guidance from your care provider so you can enjoy meals that support both you and your baby.^5,7