Sushi (Raw Fish)

Safety Status: Avoid Entirely

When it comes to raw fish sushi (including sashimi, nigiri, and rolls containing raw tuna, salmon, or yellowtail), standard clinical guidelines from the U.S. Food and Drug Administration (FDA) and the American College of Obstetricians and Gynecologists (ACOG) recommend avoiding them completely during pregnancy.

Raw or undercooked seafood carries a high risk of harboring foodborne pathogens, specifically:

• Listeria monocytogenes: A bacterium that can survive and multiply in refrigerated temperatures. Listeriosis, the infection it causes, can pass through the placenta and lead to miscarriage, stillbirth, or severe neonatal illness.
• Anisakis and other parasites: Small parasitic worms that infect raw fish. An infection (anisakiasis) causes severe vomiting, abdominal pain, and dehydration, which can restrict blood flow and oxygen to the baby.
• Vibrio bacteria: Vibrio vulnificus can cause severe gastrointestinal infection and blood poisoning.

Nutritional Benefits of Safe Alternatives

While raw fish is unsafe, seafood itself is exceptionally beneficial during pregnancy. Fish like salmon, sardines, and anchovies are excellent sources of Omega-3 fatty acids (DHA and EPA), which are crucial for the development of your baby’s brain, eyes, and nervous system. They also provide high-quality protein, vitamin D, and iron.

To enjoy these benefits safely, choose cooked or vegetarian sushi options instead. Fully cooked rolls provide the same nutritional benefits of cooked seafood without the bacterial risk. Excellent safe options include:

• California rolls (made with fully cooked imitation crab or real cooked crab).
• Shrimp tempura rolls (cooked fried shrimp).
• Eel (Unagi) rolls (cooked grilled freshwater eel).
• Vegetable rolls (cucumber, avocado, sweet potato, or asparagus).

Safe Preparation Tips

If you are dining at a sushi restaurant or making sushi at home, follow these safe preparation rules:

• Prevent Cross-Contamination: When ordering cooked sushi, explicitly ask the staff to ensure the chef uses clean cutting boards, knives, and prep surfaces. If the same tools are used for both raw and cooked fish, pathogens from raw fish can easily cross-contaminate your cooked roll.
• Check Ingredient Integrity: Ensure that the raw ingredients used in vegetable rolls, such as avocado or cucumber, are washed thoroughly under running water before slicing.
• Temperature Checks: If cooking seafood at home, ensure it reaches an internal temperature of 145°F (63°C) or is cooked until the flesh is opaque and flakes easily with a fork.