Yes, many Japanese women continue eating sushi and sashimi during pregnancy. Unlike Western countries, where health authorities typically advise pregnant women to avoid raw fish entirely, Japan takes a different approach: rather than banning it, Japanese guidelines focus on limiting mercury exposure from specific high-mercury species while encouraging fish as an important part of a healthy pregnancy diet.
This difference surprises many people, but it reflects Japan’s deep cultural relationship with seafood, its rigorous fish-handling standards, and a medical perspective that weighs the nutritional benefits of fish against the risks.
What Japanese Health Officials Actually Recommend
Japan’s Ministry of Health, Labour and Welfare (MHLW) does not tell pregnant women to stop eating raw fish. Its official guidance is focused almost entirely on mercury, not on the rawness of the fish itself. The ministry explicitly states that its advice “is intended not to ask the pregnant women to avoid fish and shellfish that contain high levels of mercury, but to advise them to refrain from a large consumption particularly of fish and shellfish that are higher in mercury and to benefit from them by reducing the risk from mercury.”
The guidelines even use sushi and sashimi as a standard serving unit (one piece equals about 15 grams), which tells you something important: the government assumes pregnant women are eating sushi and builds its recommendations around that reality rather than against it.
The specific mercury restrictions target a handful of species. Swordfish and alfonsino are limited to two servings per week (60 to 80 grams per serving). Certain shark species and whale meat are limited to once a week or less. Bottlenose dolphin meat gets the strictest limit at once every two months. For the vast majority of fish used in everyday sushi, including salmon, shrimp, squid, and most tuna varieties, the ministry says there is no evidence of adverse health effects for pregnant women at normal consumption levels.
Why Japan’s Approach Differs From Western Guidelines
In the United States, the United Kingdom, and most of Europe, official guidelines tell pregnant women to avoid all raw or undercooked fish due to risks from bacteria (like Listeria) and parasites (like Anisakis). Japan doesn’t ignore these risks, but it manages them differently, primarily through strict food safety infrastructure rather than blanket avoidance.
Japan’s Ministry of Health recommends freezing fish at minus 20°C for at least 24 hours to kill Anisakis parasites. Research from Japan’s Food Safety Commission has shown that rapid freezing to a core temperature of minus 35°C is even more effective. These freezing protocols are standard practice in Japan’s commercial sushi supply chain, where fish quality and safety are regulated at a level that most other countries simply don’t match. Sushi restaurants in Japan operate under strict hygiene and handling standards that have been refined over generations.
There’s also a practical cultural dimension. Fish is central to the Japanese diet in a way it isn’t in most Western countries. Asking Japanese women to avoid all raw fish for nine months would be a far more disruptive dietary restriction than it would be in, say, the Midwestern United States. Japanese health authorities have weighed that cultural context alongside the evidence and concluded that moderate, informed consumption is a reasonable approach.
The Nutritional Case for Eating Fish During Pregnancy
Japanese guidelines actively encourage fish consumption during pregnancy rather than merely tolerating it. Fish provides high-quality protein, omega-3 fatty acids (which support fetal brain development), and vitamin D. Research on Japanese pregnancies has linked maternal fish consumption to benefits including a lower risk of preterm birth. The MHLW emphasizes that “fish is valuable for human health in general and the advice should be correctly understood so that fish consumption will not decrease.”
This framing is strikingly different from the cautionary tone of most Western pregnancy guides. Japanese authorities worry not just about women eating too much of the wrong fish, but about women being so afraid of mercury that they cut out fish altogether and miss its benefits. Their guidelines are designed to keep pregnant women eating fish confidently, just with some awareness of which species to limit.
Which Sushi Is Considered Safe
Most of the sushi and sashimi you’d find at an average Japanese restaurant falls well within what the guidelines consider safe for pregnant women. Salmon, sea bream, flounder, shrimp, scallops, squid, and octopus are all low-mercury options. Even standard tuna (like yellowfin or skipjack, commonly used in sushi) is not flagged in the Japanese guidelines as a concern for pregnant women at normal portions.
The species to watch are the large predatory fish that accumulate mercury through the food chain: swordfish, certain sharks, and alfonsino. Bigeye tuna, which is larger and longer-lived than the tuna typically served at conveyor-belt sushi restaurants, carries somewhat higher mercury levels and is worth eating in moderation. In practice, these species make up a small fraction of what most people order when they eat sushi.
What This Means If You’re Pregnant Outside Japan
Knowing that Japanese women eat sushi during pregnancy doesn’t automatically mean it’s equally safe everywhere. Japan’s food safety infrastructure for raw fish is unusually rigorous. The freezing protocols, supply chain standards, and restaurant inspection systems are built around a culture that consumes enormous quantities of raw seafood and has strong economic and public health incentives to keep it safe.
If you’re pregnant and eating sushi outside Japan, the quality and safety of raw fish varies much more widely. A high-end sushi restaurant sourcing fish from reputable suppliers and following proper freezing protocols is a very different risk profile from a gas station sushi tray. Your local food safety guidelines exist partly because that consistency can’t be guaranteed across all outlets.
The mercury advice, however, applies universally. Regardless of where you live, the species that accumulate high mercury levels are the same. Limiting large predatory fish like swordfish and shark while eating a variety of lower-mercury seafood is sound guidance whether the fish is raw or cooked.