Can I eat King mackerel?

King mackerel should be avoided during pregnancy. Very high mercury — one of four fish FDA says to avoid in pregnancy. The primary risks are: Very high mercury levels, Neurological harm to fetus. These pose real dangers to both mother and baby. Safe alternatives include: Atlantic mackerel, Salmon, Sardines. This guidance is based on FDA recommendations for pregnant women.

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.

The FDA and EPA's joint fish advisory recommends pregnant women eat 2-3 servings (about 8-12 oz total) of low-mercury seafood per week — options like salmon, shrimp, pollock, catfish, and canned light tuna. Higher-mercury fish such as shark, swordfish, king mackerel, tilefish, and bigeye tuna should be avoided, since methylmercury can affect fetal brain development. Separately from mercury, raw or undercooked seafood (sushi, raw oysters, ceviche) carries a risk of Listeria, parasites, and other foodborne bacteria, so seafood should generally be cooked to an internal temperature of 145°F. Fish also provides omega-3 fatty acids (DHA and EPA) that support fetal brain and eye development, which is part of why the FDA/EPA advisory recommends regular low-mercury fish intake rather than avoiding fish altogether.

The risk this food carries isn’t limited to a specific trimester — the guidance to avoid it applies from conception through delivery. If you ate this before realizing you were pregnant, a single past exposure is a common concern; mention it to your provider at your next appointment rather than worrying it caused harm, since isolated exposure is generally lower-risk than regular consumption. If you experience symptoms like fever, vomiting, or unusual cramping after eating this food, contact your provider promptly rather than waiting to see if it resolves.

Beyond food-specific guidance, a few baseline food-handling habits reduce risk across everything you eat during pregnancy. These come from general FDA and USDA food-safety guidance rather than being specific to any one food, and they apply the same way in every trimester: