Often I get asked about radiation in pregnancy- specifically, how much is too much? Mothers are concerned, naturally, that the numerous sonograms they get during pregnancy coupled with the amount of radiation that’s in their natural environment puts both Mom and baby at risk. I applaud Moms for being alert to just how much radiation they may be exposed to, including necessary medical screening or surveillance and then things like microwaves or the scanner at airports. Fortunately, according to governmental and scientific sources, the amounts of radiation pregnant women are exposed to is, thankfully, minimal. Let me break it down for you from the medical or obstetrical side, so you can better understand the difference.
Ionizing and Non-Ionizing Radiation
There are two kinds of radiation: ionizing and non-ionizing. Ionization is one of the principle ways that radiation, such as charged particles and X-rays, transfers its energy to matter. Think about ionizing radiation as similar, or in line with, the types of radiation we give patients to treat cancer: we want the radiation we provide them to enter the diseased cells or tissues and cause changes in the structure of those cells, so they die off or not reproduce.
Conversely, non-ionizing radiation does not carry enough energy to break molecular bonds and ionize atoms. Basically, non-ionizing radiation just “passes through” the cells or tissues but is too weak to cause any cellular or tissue changes. The radiation we use for sonograms that are done during pregnancy is non-ionizing; the radiation is the weaker kind and therefore does not harm fetal or maternal cells or tissues (hence why we can safely recommend and use sonography throughout pregnancy).
Getting X-Rays When You’re Pregnant
Pregnant women are often leery of any X-rays during pregnancy. Truth be told, an improper dose of radiation can destroy how new cells are changing and growing in utero. However, in modern times, there are numerous safeguards in place to protect unnecessary exposure to a growing fetus. The science surrounding radiology have made significant advances to protect patients, especially pregnant women. We have all seen the sign: “If you are pregnant or think you might be pregnant, please inform the technician”. These signs are boldly placed in multiple areas wherever radiation is present, so women can have ample opportunity to alert staff in doctor’s offices, clinics, or diagnostic centers that they are pregnant, may be pregnant, or considering becoming pregnant.
Additionally, most radiologic technologists, therapists, or physicians practice rigorous shielding techniques for all patients, including the use of lead aprons or neck collars, so scattered radiation does not affect other body parts unnecessarily. More importantly, practitioners working within radiology have rigorous education, training and stringent safety standards to uphold for licensure that demonstrate a focus, and primary emphasis, on safety. In fact, most organizations have medical physicists or health physicists whose primary responsibility is to monitor the amount of radiation used during diagnostic testing or that staff or patients may be exposed to in the environment.
Should pregnant women get X-rays?
That answer depends on the situation. There are certain cases where X-rays, or CT Scans, are necessary to make a diagnosis. The risks and benefits of these tests, however, are weighed and considered extensively by both the practitioner ordering the diagnostic test and the radiologist overseeing and interpreting the test. Generally, X-rays of the arms, legs, teeth, chest, and head are considered safe because the lowest dose of non-ionizing radiation is used, with appropriate shielding, to complete the test. CT scans use more radiation, so the need to use them is discussed on a case-by-case basis. MRI, in contrast, does not use radiation, so when needed, it is safe to use.
The days of using X-rays randomly during pregnancy are over. However, when needed, X-rays and some radiologic diagnostic testing is safe and poses minimal to no threat to the mother or her growing baby. Fortunately, the practitioners and technologists who administer, work with, or interpret X-rays or radiologic tests are, quite frankly, militant when it comes to safety and using the least amount of radiation possible or necessary to complete a test. Pregnant women should absolutely question the need for any X-rays or diagnostic work up with their practitioner, but also feel secure that, if necessary, when X-rays or radiologic tests are conducted strict safety standards are upheld.
The Food and Drug Administration has a concise webpage that can provide guidance and answers to questions regarding X-rays or radiologic testing.