Ceviche, also known as cebiche, seviche or sebiche, is a popular seafood dish in many Latin American countries. It consists of fresh raw fish that is marinated in citrus juices, such as lemon or lime, and spiced with chili peppers, onions, salt and cilantro. The citric acid from the lime juice causes the proteins in the fish to become denatured, appearing to be cooked. However, since ceviche is not actually cooked with heat, there has been some controversy around whether it is safe to eat, especially for pregnant women who are advised to avoid raw fish due to the risk of foodborne illnesses. This article provides an extensive overview on the safety of eating cooked ceviche during pregnancy.
Is raw ceviche safe during pregnancy?
The current recommendation is that pregnant women should avoid eating raw or undercooked seafood due to the potential risk of foodborne illnesses. Raw seafood, especially raw shellfish, can contain several pathogens harmful to pregnant women and their developing babies, including:
- Salmonella
- Listeria monocytogenes
- Hepatitis A virus
- Norovirus
- Vibrio bacteria
These pathogens can cause symptoms like vomiting, diarrhea, abdominal cramps, fever, headaches, and in severe cases they may lead to severe illness that can have serious consequences for the pregnancy. Some of the potential risks associated with foodborne illness during pregnancy include:
- Preterm delivery
- Miscarriage
- Stillbirth
- Neural tube defects and other birth defects
- Dehydration and hospitalization of the mother
- Death of mother and/or baby in extreme cases
For these reasons, obstetricians and health organizations advise pregnant women to avoid eating raw or undercooked seafood, including raw ceviche. The ceviche needs to be fully cooked in order for it to be considered safe for consumption during pregnancy.
Is cooked ceviche considered safe?
Yes, ceviche that has been fully cooked or pasteurized is generally considered safe to eat during pregnancy. Here are some tips for ensuring the ceviche is safe:
- Only purchase ceviche from a reputable restaurant or seafood market that follows food safety guidelines.
- Make sure the ceviche has been prepared fresh and properly refrigerated until served.
- The seafood should be fully cooked by boiling, steaming or baking until it reaches an internal temperature of 145°F for at least 15 seconds.
- Ask if the ceviche has been pasteurized, which heats it to a high enough temperature to kill pathogens.
- Avoid eating ceviche stored at room temperature, such as ceviche sold by street vendors.
- When preparing ceviche at home, use freshly caught or very fresh raw seafood.
- Completely submerge the seafood in lime juice and stir occasionally for 5-10 minutes until it turns opaque and firms up.
- Stir in vegetables quickly and refrigerate until ready to eat.
- Consume the ceviche within a couple hours of preparation.
As long as these guidelines are followed, the ceviche should be safe for pregnant women to eat. The high acidity level in the lime juice, thorough cooking of the seafood and proper storage temperatures are key to preventing bacterial growth.
Which types of ceviche are considered safe?
These types of ceviche are generally safe for pregnant women when fully cooked:
- Fish ceviche made from halibut, sole, snapper, tilapia or other white fish
- Shrimp ceviche
- Scallop ceviche
- Cooked octopus or squid ceviche
- Imitation crab ceviche (made from cooked fish)
- Vegetarian ceviche made with cooked vegetables and tofu
However, it’s still important to confirm these ingredients have been fully cooked and properly stored.
Some higher risk options that are best avoided include:
- Raw oyster or clam ceviche
- Ceviche containing raw or undercooked shellfish
- Ceviche with raw eggs or raw seafood marinade
- Ceviche sold by street vendors without refrigeration
- Homemade ceviche using raw seafood and improper lime juice preparation
Pregnant women are better off avoiding these higher risk ceviches unless they can confirm the proper cooking and food safety precautions have been taken.
What foodborne illnesses are associated with ceviche?
There are four main foodborne illnesses that can be associated with raw, undercooked or contaminated ceviche:
Salmonella
- Bacteria commonly found in raw or undercooked seafood and eggs
- Causes diarrhea, vomiting, abdominal cramps, chills, fever, headaches
- Can be life-threatening in pregnant women, possibly leading to miscarriage
Listeria monocytogenes
- Bacteria found in unpasteurized dairy, soft cheeses, raw meats, raw seafood
- Causes fever, muscle aches, nausea, vomiting, diarrhea
- Can lead to miscarriage, stillbirth, preterm birth, or life-threatening sepsis
Vibrio bacteria
- Naturally occurs in coastal waters, flourishes in warm waters
- Species like V. parahaemolyticus found in raw shellfish
- Causes watery diarrhea, abdominal cramps, nausea, vomiting
- Rare cases can lead to septicemia
Hepatitis A virus
- Found in food or water contaminated by feces from someone with Hep A
- Causes fatigue, nausea, diarrhea, fever, yellowing of skin/eyes
- Increased risk of preterm delivery if contracted during third trimester
To avoid these illnesses, it’s critical that ceviche is fully cooked or pasteurized before eaten by pregnant women. Proper handwashing and sanitization during preparation is also key.
What are the nutritional benefits of ceviche for pregnant women?
Despite the food safety concerns around raw ceviche, cooked ceviche can actually be a very nutritious food choice during pregnancy. Here are some of the nutritional benefits:
- Lean source of protein – Fish and seafood provide high-quality protein needed for fetal growth and development.
- Rich in omega-3s – Seafood is an excellent source of omega-3 fatty acids like DHA, which are important for baby’s brain and eye development.
- Good vitamin and mineral profile – Ceviche provides vitamins like B-12, D, and K, plus minerals like selenium, zinc, iron, magnesium and phosphorus.
- Hydrating – The lime juice marinade helps replace fluids and prevent dehydration, which pregnant women are prone to.
- Refreshing – The tangy lime and spicy chili flavors make ceviche a light, appetizing and refreshing meal option during pregnancy.
As long as food safety guidelines are followed, ceviche can be a nutritious addition to a pregnant woman’s diet and provide benefits for both mother and baby. Expectant mothers should focus on fully cooked ceviche and avoid any raw or undercooked ingredients when preparing it at home.
Should I avoid all ceviche during pregnancy?
Most obstetricians recommend avoiding all raw ceviche during pregnancy due to the potential risks. However, fully cooked or pasteurized ceviche is generally considered safe for pregnant women to eat when prepared properly.
Here is a quick summary of which types of ceviche pregnant women should avoid versus which types are safe:
Avoid
- Raw, uncooked ceviche
- Undercooked ceviche
- Ceviche containing any raw or undercooked seafood
- Ceviche prepared or served improperly, such as at room temperature
- Ceviche with raw egg-based marinade
- Homemade ceviche not prepared correctly
- Ceviche from disreputable or unknown vendors
Safe
- Fully cooked ceviche from a reputable restaurant or seafood market
- Ceviche made from thoroughly cooked seafood that reaches 145°F
- Pasteurized ceviche
- Cooked imitation crab or cooked veggie ceviche
- Properly prepared homemade ceviche using cooked seafood
In general, pregnant women should not need to fully avoid ceviche – just be very cautious and selective about the source and preparation to minimize any food safety issues. When in doubt, it may be best to avoid ceviche altogether during pregnancy, but fully cooked ceviche can be a healthy addition in moderation.
Precautions for eating ceviche during pregnancy
If choosing to eat ceviche while pregnant, here are some important precautions to take:
- Only eat fully cooked, pasteurized ceviche from a trusted restaurant or seafood market.
- Do not eat ceviche sold by street vendors or made with raw seafood.
- When preparing homemade ceviche, use cooked seafood and freshly squeezed lime juice.
- Refrigerate ceviche immediately and eat within 2 hours of making.
- Avoid adding raw egg yolk or marinade to ceviche.
- Do not eat ceviche that has been sitting at room temperature for over 1 hour.
- Carefully inspect ceviche and look for any discoloration, sliminess or bad smells.
- If smelling ceviche served to you, if it smells bad, do not eat it.
- Avoid ceviche made with higher mercury fish like tilefish, swordfish, shark or king mackerel.
- Stick to a cooked seafood and veggie ceviche versus raw shellfish ceviche.
- When dining out, only order ceviche from restaurants you trust.
Being selective and smart about when and where you choose to eat ceviche can help mitigate the risks and allow pregnant women to enjoy this traditional dish safely. However, when in doubt, avoid ceviche altogether during pregnancy or opt for a cooked seafood alternative.
Conclusion
In summary, while raw ceviche is unsafe for pregnant women, fully cooked ceviche prepared properly can be a nutritious addition to the diet in moderation. Expectant mothers should exercise caution when choosing ceviche and avoid eating it from unknown vendors or street stalls. With adequate cooking of the seafood and proper preparation, storage and handling, ceviche made from fish, shrimp, scallops or imitation crab can provide healthy protein, omega-3s and other nutrients during pregnancy without the concerns about foodborne illnesses. Pregnant women should still take care when eating ceviche and follow safety precautions, but they do not necessarily need to avoid it completely as long as it is cooked thoroughly before consumed. The keys are confirming proper cooking, only choosing ceviche from reputable restaurants, and taking care to refrigerate it promptly and eat within a safe window of time after preparation. With these safeguards, pregnant women can prudently incorporate cooked ceviche into their diet and enjoy its refreshing flavors and nutritional benefits.
