Craving sushi and not sure if it is off the menu? The honest answer is that a lot of sushi is perfectly fine in pregnancy, and a little of it is best saved for later. The two things to think about are whether the fish is raw and how much mercury it has. Here is how to order with confidence.
- Cooked sushi (think cooked shrimp, eel, or a veggie roll) is generally considered fine.
- In the US, official guidance is to avoid raw and undercooked fish and shellfish during pregnancy.
- Choose low-mercury fish, and limit or skip high-mercury types.
- Cooked seafood is actually encouraged in pregnancy for its omega-3s, so you do not have to avoid fish overall.
The raw fish question
In plain English: 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.
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.
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.
Mercury matters separately from the raw question, because some fish carry more than others. Our guide to fish and mercury in pregnancy breaks down the best and worst choices.
A note on freshness
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.
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.
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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