You may have heard that you should be careful with cat litter and raw meat during pregnancy. The reason is toxoplasmosis — an infection that is usually completely harmless for adults, but which can harm the fetus if you are infected for the first time during pregnancy.

Here you will learn what toxoplasmosis actually is, how you can protect yourself, and what happens if you become infected.

What is toxoplasmosis?

Toxoplasmosis is caused by the parasite Toxoplasma gondii. It is found in raw meat, unwashed vegetables, and in the feces of infected cats. Most people who are infected notice little or nothing — perhaps a slight fever and swollen lymph nodes for a few weeks.

What makes toxoplasmosis particularly relevant for pregnant women is that the parasite can be transmitted to the fetus through the placenta if you are infected for the first time while pregnant. If you have been infected previously, you have antibodies that protect the fetus.

According to the WHO, the vast majority of fertile women worldwide are susceptible to infection. Infection during pregnancy is uncommon, but the consequences can be serious.

How is it transmitted?

Toxoplasmosis can be transmitted to humans in several ways:

Through food

Raw or undercooked meat — the most common source of infection
Unwashed vegetables and fruit — can be contaminated with the parasite's oocysts from soil
Unpasteurized milk — rare but possible source of infection

Through contact with cats

Cat feces — infected cats shed oocysts in their feces for 1–3 weeks after infection
Gardening — soil contaminated by cat feces

You cannot be infected by petting your cat. The risk of infection is linked to contact with cat feces. Cats that live exclusively indoors and eat dry food have a very low risk of being infected.

Transmission to the fetus

The risk of the parasite being passed to the fetus varies throughout pregnancy:

First trimester — under 5–10 percent transmission risk, but the greatest risk of serious harm
Second trimester — approximately 30 percent transmission risk
Third trimester — 70–80 percent transmission risk, but lower risk of serious harm

In other words: the earlier in pregnancy you are infected, the lower the chance of the fetus being infected. But if it does happen, the potential for harm is greatest early in pregnancy.

Possible consequences for the baby

If the fetus is infected, the consequences can vary:

Eye infection (chorioretinitis) — inflammation of the retina that can affect vision
Brain damage — in severe cases, with risk of intellectual disability
Hearing loss — may develop over time
Miscarriage — the risk increases with infection early in pregnancy

According to health authorities, approximately 90 out of 100 infected newborns appear completely healthy at birth. But many can develop health problems months or years later. That is why infected children are monitored over time to detect any delayed complications.

A confirmed infection in the mother does not necessarily mean the fetus is infected. Further investigation with amniocentesis after week 15 can clarify this. Talk to your doctor about the next steps.

Prevention — how to protect yourself

Health authorities provide clear guidance for pregnant women to avoid toxoplasmosis. There is no vaccine, so prevention is about good food and hand hygiene.

Food safety

Cook meat thoroughly — use a meat thermometer and ensure the core temperature reaches at least 67°C (153°F)
Avoid raw meat — this includes steak tartare, carpaccio, and rare beef
Wash fruit and vegetables thoroughly — peel them when possible
Wash all utensils that have been in contact with raw meat thoroughly with soap and hot water
Freezing kills the parasite — minimum 48 hours at -20°C (-4°F)

Cats and gardening

Have someone else change the cat litter — ideally daily, since oocysts take 1–5 days to become infectious
Wear gloves in the garden — soil can be contaminated by cat feces
Wash your hands thoroughly after gardening or contact with soil
Do not get a new cat while pregnant
Avoid physical contact with stray cats

You do not need to rehome your cat because you are pregnant. As long as someone else handles the litter box and you wash your hands well after contact with the cat, the risk is very low. The parasite has never been found in breast milk, so you can safely breastfeed.

Screening and diagnosis

Routine screening for toxoplasmosis in pregnant women is not recommended in most countries. The reason is that infection is uncommon, and screening can lead to unnecessary worry and invasive tests.

A blood test is recommended however if you:

Have symptoms consistent with toxoplasmosis (fever, swollen lymph nodes)
Have been exposed to a confirmed or possible source of infection
Are worried that you may have been infected

The blood test measures antibodies (IgG and IgM) against Toxoplasma. The results are interpreted by a doctor and can provide information about whether you have been recently infected, previously infected, or never infected.

If the blood tests suggest a new infection, you will be referred to a fetal medicine unit for further investigation. An amniocentesis after week 15 can determine whether the fetus is infected.

Treatment when infection is confirmed

Treatment depends on whether only the mother is infected, or whether the fetus is also affected.

When the mother is infected but the fetus probably is not

Spiramycin is recommended to reduce the chance of the parasite being transmitted to the fetus. Treatment is started with confirmed or likely new infection.

When fetal infection is confirmed

With a positive PCR in amniotic fluid, combination treatment is started with:

Pyrimethamine — inhibits parasite growth
Sulfadiazine — works together with pyrimethamine
Folinic acid (calcium folinate) — counteracts side effects of pyrimethamine

Treatment continues until delivery. After birth, treatment of the child often continues through the first year of life.

Prenatal treatment has been shown to reduce the risk of serious long-term complications in infected fetuses. Early diagnosis and treatment leads to better outcomes.

What happens after birth?

If you have been diagnosed with toxoplasmosis during pregnancy, your doctor will take blood tests from the baby after birth to check whether it is infected. Infected children are monitored with regular check-ups to detect any eye infections, hearing loss, or developmental delays.

The good news is that a woman who is infected in one pregnancy is normally immune in subsequent pregnancies. This means that future pregnancies are safe with regard to toxoplasmosis.

Frequently asked questions

Do I need to get rid of my cat when pregnant?

No. You can keep your cat. Have someone else empty the litter box, wash your hands after contact, and avoid coming into contact with cat feces. Indoor cats that eat dry food have a very low risk of infection.

Can toxoplasmosis be detected on ultrasound?

Ultrasound can in some cases reveal changes in the fetus that may be caused by toxoplasmosis, such as calcifications in the brain or an enlarged head. But ultrasound cannot rule out infection — that requires blood tests and possibly amniocentesis.

Is cured or deli meat safe during pregnancy?

Cured meats such as salami and prosciutto can contain Toxoplasma cysts if the meat has not been sufficiently cooked. When in doubt, heat deli meats until steaming before eating.

What if I was infected before I became pregnant?

In that case, you have antibodies that protect the fetus, and you do not need to worry. Blood tests can confirm this.

Summary

Toxoplasmosis during pregnancy is uncommon, but it is worth taking precautions. With good food and hand hygiene, you can reduce the risk significantly. And if you do become infected, there is effective treatment that improves the prospects for the baby.

If you are unsure about anything, bring it up with your midwife or doctor at your next prenatal appointment. There are no stupid questions when it comes to the safety of you and your baby.

Sources: WHO — Toxoplasmosis, CDC — Toxoplasmosis in Pregnancy, AAP Guidelines on Prenatal Infectious Disease

Last updated: March 2026

Toxoplasmosis During Pregnancy: How to Protect Yourself and Your Baby