Is an X-Ray Safe During Pregnancy?

Is an X-Ray Safe During Pregnancy?

Short answer: For almost every X-ray, yes. A chest, arm, leg, hand, foot, dental, or head X-ray delivers a fetal dose of well under 0.01 mGy — thousands of times below the 50 mGy level at which any harm to a developing baby has been shown. Abdominal, pelvic, and lower-spine X-rays put the baby in or near the beam and carry a higher (but still low) dose, so those are the ones your doctor weighs more carefully and often replaces with ultrasound or MRI.

If you are pregnant and have a suspected fracture, a bad cough, or a dental problem, being told you need an X-ray can feel alarming. The reassurance here is in the numbers, and they are very good. Here is how the radiologists at Advanced Medical Imaging in Seminole, FL think about X-rays in pregnancy.

The Threshold: 50 mGy to the Fetus

Fetal radiation risk is measured in milligray (mGy). Based on decades of data, the American College of Obstetricians and Gynecologists (ACOG) and the American College of Radiology (ACR) agree that no increase in miscarriage, birth defects, growth restriction, or intellectual disability has been demonstrated below 50 mGy of fetal dose. Most analyses place the real threshold closer to 100 mGy.

For context, every pregnancy receives roughly 0.5–1 mGy of natural background radiation over nine months. The question for any X-ray is simply: how does its fetal dose compare to that?

Fetal Dose by X-Ray Type

Typical fetal doses from a single plain-film X-ray, per ACR and ACOG reference values:

• Extremity (hand, wrist, elbow, foot, ankle, knee): less than 0.001 mGy — effectively zero
• Dental X-rays (bitewing, panoramic): less than 0.001 mGy
• Chest X-ray (2 views): 0.0005–0.01 mGy
• Cervical spine or skull: less than 0.01 mGy
• Thoracic spine: about 0.003 mGy
• Abdomen (single view): 0.1–3 mGy
• Lumbar spine (2–3 views): 1–10 mGy
• Pelvis or hip: 1–4 mGy

Even the highest-dose plain X-ray on that list — a full lumbar spine series — stays 5 to 50 times below the 50 mGy threshold. A single chest X-ray delivers less fetal radiation than a cross-country flight.

Why Location Matters More Than Anything

The fetus receives meaningful dose only when it sits in the direct X-ray beam. For an X-ray of your wrist, chest, or jaw, the beam never crosses the uterus; the only exposure is a minuscule amount of internal scatter. That is why extremity, chest, and dental films are considered safe in every trimester without hesitation.

Abdominal, pelvic, hip, and lumbar-spine X-rays are different because the uterus is in or beside the imaged area. They are still well below harm levels, but they are the exams where your doctor will ask two questions first: Is this X-ray really needed now? and Can ultrasound or MRI answer it instead?

What Changed With Lead Shielding

For decades, pregnant patients were draped with a lead apron over the abdomen. In 2019 the American Association of Physicists in Medicine (AAPM) recommended ending routine fetal shielding, and the ACR and many state radiation programs have followed. The reasons: a lead apron over the belly does nothing for an X-ray of the hand or chest (the beam is not there), and when the abdomen is being imaged, the apron can hide anatomy or trick the machine's automatic exposure control into raising the dose. Some facilities still offer an apron for patient comfort, but its absence is not a safety lapse — it reflects current best practice.

Common Situations

Suspected fracture after a fall. Extremity X-rays are the right first test and are safe at any stage of pregnancy. Waiting risks a malunion; the X-ray risks essentially nothing.

Cough, shortness of breath, or possible pneumonia. A two-view chest X-ray is standard in pregnancy and delivers a negligible fetal dose. If a blood clot in the lung is suspected, the next step is usually a CT scan — see Can You Have a CT Scan While Pregnant?

Dental pain or infection. Dental X-rays are safe in pregnancy per ACOG and the American Dental Association. Untreated dental infection is a real pregnancy risk; a bitewing film is not.

Low back or pelvic pain. This is where the calculus shifts. Most pregnancy-related back pain needs no imaging at all. If imaging is needed, MRI — which uses no radiation — is generally preferred over a lumbar-spine X-ray series. Read Is MRI Safe During Pregnancy?

Kidney stones or abdominal pain. Ultrasound is the first-line test. X-ray is rarely helpful here in pregnancy.

"I Had an X-Ray Before I Knew I Was Pregnant"

This is one of the most common calls we get, and the answer is almost always reassuring. A chest, dental, or extremity X-ray in early pregnancy delivers far too little dose to affect the embryo. Even an abdominal or pelvic film taken before a positive test falls well under the threshold. Radiation exposure below 50 mGy is not a medical reason to consider ending a pregnancy, per ACOG. If you want the exact number for your case, a medical physicist can calculate the fetal dose from the exam records — ask your imaging center.

How AMI Handles X-Rays for Pregnant Patients

• We ask every patient of childbearing age about possible pregnancy before any X-ray.
• For extremity, chest, and dental-adjacent studies, we proceed with standard digital X-ray technique, which already uses a fraction of the dose of older film systems.
• For abdominal, pelvic, or lumbar requests, our radiologist reviews the order first and will suggest ultrasound, Open MRI, or 3T MRI when one of those can answer the question without radiation.
• We collimate tightly to the area of interest and use the lowest technique that still gives your doctor a clear image.
• Self-pay patients can request imaging without an outside referral, and pricing is published — X-rays are $50 per body part.

What to Tell Us When You Schedule

1. That you are pregnant or may be, and how many weeks along.
2. Which body part your doctor wants imaged and why — this tells us whether a radiation-free alternative makes sense.
3. Any prior imaging for the same problem so nothing is repeated.

The Bottom Line

An X-ray of the chest, arms, legs, head, or teeth is safe during pregnancy in every trimester — the fetal dose is a tiny fraction of the level linked to harm, and skipping a needed diagnosis is the greater risk. Abdominal, pelvic, and lower-spine X-rays are still far below harm thresholds but are the ones worth a second look, and ultrasound or MRI frequently does the job instead. Schedule online or call (727) 398-5999 and let us know you are pregnant — we will plan the exam around it.

Sources: - ACOG Committee Opinion No. 723 — Guidelines for Diagnostic Imaging During Pregnancy and Lactation - ACR–SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation - AAPM Position Statement on the Use of Patient Gonadal and Fetal Shielding (2019)