The CDC recommends that pregnant women avoid eating deli meat unless it has been reheated to an internal temperature of 165°F (steaming hot). This applies to all cold cuts, whether sliced at a deli counter or pre-packaged, and the guidance holds even when there are no active outbreaks. The concern is a bacterium called Listeria, which is rare but disproportionately dangerous during pregnancy.
Why Deli Meat Is Risky During Pregnancy
Listeria is a type of bacteria that can survive and even grow at refrigerator temperatures, which makes deli meats a perfect environment for contamination. Most healthy adults who encounter Listeria fight it off with mild symptoms or none at all. Pregnancy changes the equation. Your immune system shifts during pregnancy to protect the fetus, and that shift leaves you more vulnerable to certain infections.
What makes Listeria especially concerning is its ability to cross the placenta. The bacterium uses specific surface proteins to attach to and invade the placental tissue, gaining direct access to the fetus. Once inside the placenta, the infection triggers an intense inflammatory response: immune cells flood the area and can disrupt the delicate balance that keeps the pregnancy stable. This can lead to miscarriage, stillbirth, or premature delivery. In newborns, listeriosis can cause life-threatening bloodstream infections or meningitis.
How Real Is the Risk?
Listeria outbreaks linked to deli meat are not hypothetical. In a 2024 outbreak traced to meats sliced at deli counters, 61 people across 19 states became infected. Of those, 60 were hospitalized and 10 died. Among people interviewed during the investigation, 94% reported eating deli meats before getting sick, and 96% of those had eaten meats sliced at a deli counter rather than pre-packaged options. Deli-counter slicing creates more opportunities for cross-contamination from shared equipment.
Pregnant women make up a small fraction of the general population but account for a disproportionate share of listeriosis cases. The infection itself is uncommon, so the odds of any single sandwich causing harm are low. But the consequences when it does happen are severe enough that major health organizations treat deli meat as a food to avoid entirely during pregnancy.
Heating Makes It Safe
If you’re craving a sandwich, you don’t have to go without for nine months. Heating deli meat to 165°F kills Listeria reliably. You can microwave slices until they’re steaming, toast them in a panini press, or heat them in a skillet. The key is that the meat needs to be genuinely hot throughout, not just warm. If steam is visibly rising from the surface, you’re in the right range. You can let it cool before eating if you prefer it that way.
A food thermometer removes guesswork, but the visual cue of steam rising from the meat is a reliable backup. You can’t see, smell, or taste Listeria on contaminated food, so “it looks fine” is never a safe test.
Dry-Cured and Fermented Meats Carry Risk Too
Hard salami, pepperoni, and other dry-cured or fermented sausages are sometimes assumed to be safer because of their lower moisture content and the preservatives used in curing. The CDC classifies them alongside regular deli meat as a riskier choice for pregnant women when eaten unheated. The same 165°F rule applies. If you want pepperoni on a pizza that’s been baked at high heat, that’s a safer choice. Cold pepperoni straight from the package is not.
Nitrates Are a Separate Concern
Beyond Listeria, processed meats contain nitrates and nitrites, preservatives that give deli meat its pink color and extend shelf life. Pregnancy creates a high oxygen demand state, and your blood volume increases by 40 to 50%, peaking around week 30. This expansion makes you more susceptible to the effects of nitrites, which can interfere with your red blood cells’ ability to carry oxygen. The sensitivity is highest near the 30th week of pregnancy, when the natural oxidative stress of pregnancy also peaks.
This doesn’t mean a single sandwich will cause harm, but it’s another reason processed meats are generally a less ideal protein source during pregnancy. Freshly cooked chicken, turkey, or roast beef that you prepare at home gives you the same protein without the preservative exposure or the Listeria risk.
What Listeriosis Looks Like
If you’ve already eaten cold deli meat during pregnancy, don’t panic. Most exposures don’t result in infection. But know what to watch for, because listeriosis symptoms can appear up to two months after eating contaminated food. That long incubation period means you might not connect a fever in October to a sandwich you had in August.
Early symptoms mimic the flu: fever, chills, muscle aches, diarrhea, or an upset stomach. More serious signs include a stiff neck, headache, confusion, or loss of balance. If you develop any of these symptoms and you’ve eaten deli meat recently (or even weeks ago), let your doctor know specifically that you’re concerned about Listeria. Early treatment with antibiotics can protect the pregnancy.
Practical Choices That Lower Your Risk
- Heat all deli meat to 165°F before eating, regardless of brand or where it was sliced.
- Choose freshly cooked meats you prepare at home over pre-sliced options from a deli counter, where shared slicers increase contamination risk.
- Skip cold sandwiches at restaurants unless you can confirm the meat was heated. Most sub shops serve deli meat cold by default.
- Check your refrigerator temperature. Listeria grows slowly even at proper fridge temps (40°F or below), but a warmer fridge accelerates it.
- Eat deli meat quickly. If you do buy it, use it within three to four days rather than letting it sit in the fridge for a week.