You thought your pre-pregnancy sushi cravings were bad, but now that you’re in the family way and pining for it, you’re wondering if you’ll survive another day without a big plate of spicy tuna rolls. But can pregnant women eat sushi, or are you doomed to only dream about it for the next thirty-odd weeks?

The final verdict is still out on whether sushi is safe for pregnant women. Some experts say yea, some say nay. Here, we’ll hear out both sides and offer some advice for staying safe while enjoying those delectable, wasabi-laced rolls.

can pregnant women eat sushi

The Case Against Eating Sushi While Pregnant

The 2015 – 2020 Dietary Guidelines for Americans and the Food and Drug Administration recommend that pregnant women avoid eating any kind of meat, including fish, that’s not cooked to safe internal temperatures known to destroy any microbes that might be present. For fish and shellfish, that internal temperature is 145 degrees.

When you’re pregnant, your immune system is suppressed so that your body doesn’t attack the new organism growing inside it. This makes it more difficult to fight food-borne illnesses like Listeriosis, E. coli, and salmonella. These can be severe (and severely miserable,) and in some rare cases, a dangerous blood infection could occur, putting your and your baby’s lives at risk.

But it’s not just parasites and pathogens that concern some medical experts. It’s also the high levels of mercury found in some seafood. Elevated mercury levels can cause damage to the lungs, kidneys, brain, and nerves, and it can lead to brain damage and vision and hearing problems for babies exposed to it in the womb.

That spicy tuna roll? It’s got one of the highest mercury levels of them all, along with shark, swordfish, and king mackerel, and you should avoid these fish, cooked or uncooked, during your pregnancy. But other fish, including crab, shrimp, and salmon, have lower mercury levels, and these are considered the best choices for seafood during pregnancy. As long as you don’t eat more than three four-ounce servings per week, low-mercury fish provide you and your developing baby with essential nutrients.

The Case For Eating Sushi While Pregnant

If you’re looking for an affirmative answer to the question, can pregnant women eat sushi?, look no further. Some experts, including Dr. Amos Grunebaum, the Director of Obstetrics and Chief of Labor and Delivery at Cornell Medical Center, say eating sushi during pregnancy is just fine as long as it’s a low-mercury fish. And in fact, raw fish is an age-old staple for a healthy prenatal diet in Japan.

An article published in the journal Canadian Family Physician points out that while seafood-related pathogens in pregnancy haven’t been well-studied, when they do occur, infections are generally limited to gastrointestinal symptoms that are treated by preventing dehydration or administering pregnancy-safe antibiotics. Furthermore, the article stresses that most parasites found in seafood don’t cause illness in humans, and as long as the raw fish comes from a reputable establishment, pregnant women needn’t avoid eating it.

Can Pregnant Women Eat Sushi?

Sushi naysayers make a good case about mercury and food-borne illnesses when recommending that pregnant women eschew sushi altogether. But the pro-sushi camp also makes some good points about the low risk of illness in reputable sushi establishments and the lack of evidence showing that raw fish is dangerous for pregnant women.

The bottom line is that you should discuss your sushi craving with your doctor. If she gives the go-ahead, choose low-mercury fish for your sushi fix, and opt for the most reputable restaurant you can find. If your doctor puts the nix on your fix, enjoy a 145-degree serving of farm-raised salmon to tide you over until after Baby comes.