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Are X-rays of any kind bad to get while pregnant? I’m asking because my twin and I are both pregnant (she’s further along), and she is absolutely refusing to get even dental X-rays because of the radiation. I’m wondering if that’s too cautious. What if we break a bone or something? Are there varying degrees of radiation that we need to worry about?
—At Odds With My Sis
This is a good question, and one where I think it’s not surprising you see some disagreement, since the data is a little nuanced.
At high doses, radiation can cause pregnancy loss (especially in the first two weeks of pregnancy) and fetal abnormalities (particularly when there is exposure in the first trimester). However, the dose really matters. Our evidence on these negative effects generally comes from people who were exposed during the bombing of Hiroshima or after the Chernobyl disaster. These doses are many orders of magnitude higher than what you would get in any X-rays, dental or otherwise.
The CDC considers radiation doses above 150 mGy to be the minimum level at which there might be fetal harm. A chest X-ray delivers about 0.002 mGy to the fetus — that’s the standard unit for radiation dose. A dental X-ray is in the same ballpark, often even less, because the beam isn’t anywhere near your abdomen. What this means is that exposure levels from a chest X-ray are about 75,000 times less than this minimum possible harm dose.
Because of this wide gap between the harmful dose and what you’d get in an imaging scan, X-rays during pregnancy are generally considered safe. However, because of an abundance of caution (and, sometimes, concerns about being sued), doctors and dentists tend to be slightly more cautious about imaging during pregnancy. For example, a dentist might feel comfortable using an X-ray when addressing a painful tooth, but push off routine X-rays until post-pregnancy. But the reality is that this is likely over-cautious.
By extension, if there is a clear need for an X-ray (a broken bone or other significant health concern), you should definitely have this done. In that case, the benefit clearly outweighs any possible risk.
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Does “chest xray” include mammogram? My midwife said generally doctors recommend ultrasound as the first line of breast cancer screening when pregnant and mammogram if the ultrasound shows anything of concern. But a radiologist pressured me to get a mammogram as well, even though the ultrasound didn’t show anything indicating cancer. She was extremely dismissive of my concerns about radiation exposure to the fetus.