The table has ordered, the boat is on its way, and you are still holding the menu doing arithmetic. Nobody wants to be the person asking the waiter three questions. A lot of a sushi menu is fine in pregnancy and a little of it is better saved for later, and sorting one from the other comes down to two questions rather than one. Which two they are, what that leaves you ordering, and what to do if you already ate the salmon nigiri last Tuesday are all below.
The raw fish question
The concern with raw fish is foodborne illness, including listeria and parasites, which pregnancy makes you more vulnerable to. In the United States, the FDA and most providers advise avoiding raw or undercooked fish and shellfish while pregnant. Cooking kills the organisms of concern, which is why cooked rolls get the green light.
Listeria is the same bacteria behind the advice on deli meat and on soft cheese. It is one worry turning up in three different aisles, and the answer is a version of the same thing every time: heat it, or check the label.
Why the advice differs by country
It is worth knowing that guidance differs by country. Some places, including parts of the UK and Japan, take a more relaxed view of fresh, properly handled raw fish in pregnancy. If you are following US guidance, the simple rule is to keep it cooked. Reading a friendlier rule from somewhere else does not mean you have been worrying over nothing, and following the cautious one does not make you the anxious friend either.
Sushi that is generally fine
- Fully cooked rolls: cooked shrimp, eel (unagi), shrimp tempura.
- California roll made with cooked or imitation crab.
- Vegetable rolls (cucumber, avocado, sweet potato).
- Cooked egg (tamago) nigiri.
What to skip or save for later
- Raw fish nigiri and sashimi (tuna, salmon, yellowtail, and similar) if you are following US guidance.
- High-mercury fish even when cooked, such as bigeye tuna, swordfish, shark, and king mackerel.
- Raw shellfish like oysters and raw scallops.
The mercury half of the question
Mercury matters separately from the raw question, because some fish carry more than others. That is the second of the two questions, and it is the one that keeps mattering long after the sushi craving passes, since it applies to the fish you cook at home too. Our guide to fish and mercury in pregnancy breaks down the best and worst choices.
Where you order matters too
Whatever you order, choose a clean, busy, reputable restaurant with good turnover, and trust your senses. If something smells or looks off, skip it. Good handling matters as much as the menu.
A sushi table also tends to set two other pregnancy questions down in front of you. The green tea counts toward your caffeine for the day, which is easy to forget when it arrives free and keeps being topped up. The sake is the one thing on the table that guidance is unanimous about, and our page on alcohol in pregnancy sets out what that is built on.
When to call your provider
If you ate raw fish and then developed fever, chills, diarrhea, vomiting, or body aches, contact your provider, since listeria and other foodborne illnesses can take time to appear and are worth checking in pregnancy. For everyday menu questions, your provider can tell you what fits your situation.
Some of you are planning dinner and some of you already ate the salmon. For the second group, the paragraph above is the whole of it. For the first, a table of cooked rolls is a real dinner and not a consolation prize, and the comment box below is a good place to say which one you ended up ordering.
Medical Disclaimer: This article is for general educational purposes only and is not medical advice, and it does not replace guidance from your doctor or midwife. Always confirm what is right for you with a qualified professional. If you think you may be experiencing a medical emergency, contact your local emergency services right away.
Sources
- US Food and Drug Administration (FDA) and EPA. “Advice About Eating Fish.” 2024.
- American College of Obstetricians and Gynecologists (ACOG). Guidance on food safety in pregnancy.
- National Health Service (NHS). “Foods to avoid in pregnancy.” 2024.
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