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With so many flavors and varieties, it’s no wonder that you’re craving sausage. But is it safe to eat during pregnancy? The quick answer is yes, you can enjoy sausage safely when you’re pregnant. That said, there are some food rules you’ll need to follow to ensure you and your baby don’t get sick.

Here are the types of sausages you can safely eat, notes for preparing them, and when you should call the doctor if you have concerns.

Before you sink your teeth into that tasty bratwurst, it’s important to know that there are four main types of sausage. All are made with ground meat that’s mixed with various seasonings, fat, salt, and possibly preservatives or fillers. The meat mixture is then stuffed into a convenient casing (often made from animal intestines) or sometimes pressed into patty form.

  • Fresh sausage is made from uncooked meat that’s either chopped, ground, or pureed. Examples include Italian sausage, Mexican chorizo, bratwurst, breakfast links, and sausage patties.
  • Pre-cooked sausage, as the name implies, is made from pureed meat that’s precooked either before or after stuffing into casings. Examples include hot dogs, bologna, frankfurters, mortadella, and some German-style “wursts” (but you should always double-check with your butcher).
  • Smoked sausage is another type of cooked sausage that’s smoked in either a smoker or smokehouse over a slow-burning fire. Examples include andouille and kielbasa.
  • Cured sausage is what you might often see on a charcuterie board. It’s made with fresh meat that’s salted and then left to air-dry for weeks or months. Examples include Spanish chorizo, coppa, and Genoa salami.

So, what’s safe?

Any type of sausage that is freshly cooked is safe to eat, provided that you eat it while it’s still hot and not after it’s been sitting out a while. You’ll need to pay attention to temperature, too, says the U.S. Department of Agriculture (USDA):

  • For sausage made with lamb, pork, beef, or veal, aim for an internal temperature of 160°F (71.1°C).
  • For varieties made with turkey or chicken, aim for a bit warmer — 165°F (73.8°C).

This means that your favorite fresh sausages (breakfast links, pork sausage, Italian sausage, some bratwurst and bockwurst, etc.) and cooked/smoked sausages (hot dogs, braunschweiger, cotto salami, Polish sausage, kielbasa, etc.) are likely safe provided you’ve followed these food safety guidelines.

Related: Safely handling meat, poultry, and fish

You may want to pass on cured sausages (also called cold cured meats), like salami, pepperoni, certain chorizos, and prosciutto. That is, of course, unless you cook them fully before eating. For example, you may be OK to eat pepperoni atop a pizza that has been baking at high heat in your oven.

The USDA notes that cured meats may harbor E. coli, which is a bacteria that can cause foodborne illness. While the use of salt, lactic acid, and other ingredients does often kill off bacteria, high-risk people (including pregnant people and children) are best off sticking to heat-treated meats.

With all types of sausage, the worry is eating undercooked or otherwise contaminated meat that can lead to foodborne illnesses. Even precooked meats, like hot dogs, can harbor bacteria like Listeria and shouldn’t be eaten without heating adequately.

Another concern with meat is with a parasite called Toxoplasma gondii that can cause an infection called toxoplasmosis.

About 50 percent of toxoplasmosis infections in the United States are caused by eating foods like undercooked meats. Pork, lamb, and venison are particularly high on the risk list, so take care with sausages made with these meats or avoid them altogether.

Cook all fresh sausage to an internal temperature of between 160°F (71.1°C) and 165°F (73.8°C), depending on the meat. When cooking pre-cooked sausages, aim to get them steaming hot or 165°F (73.8°C). You can purchase an inexpensive food thermometer online or at a big box store.

And, while tempting, never sneak a bite of sausage to sample before it’s fully cooked.

Cross-contamination is another concern. Before preparing other foods, always clean any cutting boards, countertops, utensils, knives, or other kitchen items that come in contact with raw meats. Simply washing well with dish soap and hot water — and then rinsing well — is sufficient.

While you’re at it, be sure to separate any raw meats from other ingredients in your refrigerator or when you’re prepping a meal. While it may seem like overkill, you may even want to make sure you keep them apart in the grocery cart as well.

All sausages (except cured varieties) can go bad without proper refrigeration even before opening. Here’s a guide for how long you can store in the fridge or freezer, depending on the type.

Type Before openingAfter openingFreezer
Fresh sausage (uncooked)1–2 days1–2 days1–2 months
Fresh sausage (previously cooked)n/a3–4 days2–3 months
Cooked sausage2 weeks7 days1–2 months
Cured sausage6 weeks in pantry; indefinitely in refrigerator3 weeks1–2 months

Last, but not least, always wash your hands thoroughly with warm soapy water after handling meat.

Related: Food safety during pregnancy

One link (70 grams) of a typical Italian sausage packs an impressive 14 grams of protein. However, it also contains 27 percent of the daily fat and 26 percent of the daily salt recommendations for the average adult. So, enjoy your favorite sausages in moderation along with plenty of fresh fruits, vegetables, whole grains, dairy, and other protein-rich foods.

And if heartburn is plaguing your pregnancy, you might want to skip on the sausage, hot dogs, pepperoni, and similar foods. These can be triggers for heartburn, which means they get your stomach acids brewing and cause that painful burning in your esophagus. Not fun at all.

If you’re looking for a substitute, you might even consider trying plant-based alternatives, like Beyond Sausage. It comes in three flavors — Original Bratwurst, Italian, and Sweet Italian — and boasts 16 grams of protein per link with less saturated fat than its animal counterparts.

Related: The ultimate guide to vegan meat substitutes

Feeling a little off? Stomach cramps, diarrhea, vomiting, and fever may be signs of exposure to bacteria, like E. coli or Listeria. Contact your doctor if you think you may have eaten contaminated foods.

Symptoms of toxoplasmosis include things like:

  • fever
  • headache
  • muscle pains
  • stiff neck
  • swollen glands

Some people may not notice any symptoms at all. Unfortunately, that doesn’t mean the infection can’t cross the placenta and reach your baby.

The Centers for Disease Control and Prevention estimate that between 300 and 4,000 babies are infected with toxoplasmosis each year in the United States. It can lead to a range of health issues for babies, including hearing loss, blindness, or intellectual delays. Some children may not develop these issues until years after they’re born.

If you notice symptoms or have concerns you may have eaten raw or undercooked sausage, speak with your doctor for next steps. Your health care provider may want to monitor you and your baby more closely to look for signs of infection or complications.

You can enjoy many of your favorite sausages throughout your pregnancy. Be sure to store your meat properly, prepare foods with clean utensils and on clean surfaces, and cook to appropriate temperatures to kill off potential bacteria and parasites.

When in doubt, consider skipping a dish if you can’t verify these steps were followed. It’s well worth the extra fuss to ensure you and your baby stay healthy.