Ceviche should be avoided during pregnancy. While citrus juice denatures fish protein (making it appear cooked), it does not kill parasites or all harmful bacteria. Only heat kills these pathogens reliably.
An "Avoid Completely" rating means major health authorities (FDA, ACOG, CDC, and/or USDA) advise against this food during pregnancy due to a specific, well-documented risk — not a minor precaution or a matter of personal preference. Foods in this category typically carry either no safe preparation method (as with alcohol) or a meaningfully elevated risk of foodborne illness or fetal harm even with careful handling. If you’re unsure whether a past exposure is a concern, your provider is the best resource for guidance specific to your situation.