Are X-Rays Harmful During Pregnancy?

A digital tablet with a patients x-rays.
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The vast majority of pregnant women will not even think about having an X-ray in pregnancy, particularly as we are able to use ultrasound to see the baby. But there are occasions where an X-ray during pregnancy might be considered.

X-Rays Needed During Pregnancy

A couple of scenarios which might include X-ray consideration include X-ray imaging before you knew you were pregnant and X-ray imaging during pregnancy but when the benefit outweighs the risk.

The two biggest issues when considering X-ray imaging in pregnancy are the location of the imaging (proper shielding of the abdomen when possible) and the length of gestation.

It's also important to note that most women aren't getting X-rays all the time. Pregnant women with other children may find themselves with a child in need of an X-ray and have to find someone to stay with their child during the actual X-ray. Emergency dental X-rays, X-rays for trauma or broken bones are other common times when X-ray imaging comes into question in pregnancy.

X-Ray Dosing and Risks

The risks of an X-ray in pregnancy vary with the weeks of gestation and the dose, which is measured in rads or milligrays (mGy). The vast majority of plain X-rays, like the kind you'd have for a broken bone or at the dentist's office, have low doses of radiation.

According to the American College of Radiology (ACR), if you should have an X-ray just prior to conception, there is no risk to you or the soon-to-be-baby. If you were to have an X-ray in week three or four, the risks are probably zero at less than 10 rads. Greater than 10 rads indicates a possible miscarriage.

In weeks five through 10, but between 5-10 rads they say, "Potential effects are scientifically uncertain and probably too subtle to be clinically detectable." Over 10 rads and the chances of malformations increase with the dose.

In weeks 11 through 17, at the 5-10 rad dose, "Potential effects are scientifically uncertain and probably too subtle to be clinically detectable." Though ACR notes that you can have IQ damage over the 10 rad mark, increasing with exposure.

Once you hit weeks 18-27, you don't see issues with X-rays until you hit the greater than 10 rad dose, "IQ deficits not detectable at diagnostic doses." After week 28, the risks are the same for the baby as the mother. Doses less than 5 rad are always considered to cause no issues at any point in pregnancy.

Questions to Ask Before You Get an X-Ray

  • Is there another test that might help you, without an X-ray?
  • What happens if we don't do the X-ray?
  • Can the X-ray wait for a period of time? (Say until after week 20 or until the baby is born.)

A Word From Verywell

If you need an X-ray, at any point in pregnancy, it is probably safe for you to have one. Be sure to take proper shielding precautions and let the X-ray tech know that you are pregnant, even if you think it is obvious. If you work with X-ray or other radiological imaging, be sure to alert your supervisor as soon as possible.

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Article Sources
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  1. U.S. Food and Drug Administration. X-rays, pregnancy, and you. Updated December 9, 2017.

  2. American College of Radiology. ACR-SPR practice parameter for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. Updated 2018.