Are x-rays during pregnancy safe?

Are x-rays during pregnancy safe for the unborn baby?

The simple answer is yes. During pregnancy, a person must address their overall health alongside prenatal care. The term, “x-ray” often triggers concern about potential harm to the unborn baby. X-rays send electromagnetic radiation through the body to create an image, also known as a radiograph (1). However, research shows that people who are pregnant do not need to avoid x-rays, as the risk to the fetus is minimal to none.  In fact, avoiding a necessary x-ray may cause more harm to the pregnant person than the small risk posed by radiation exposure (2).

To understand why x-rays are generally considered safe during pregnancy, it is helpful to know how they work. A technician takes an x-ray by operating a machine that sends electromagnetic radiation through the body. As this radiation passes through internal structures it is absorbed in varying amounts which creates an image on the x-ray detector (3). Patients cannot feel or see the radiation during the exam (1). Healthcare providers may order x-rays to diagnose bone fractures, tumors, lung infections, foreign objects, dental issues, or other injuries (3,4). When x-rays are medically necessary, physicians follow the same principle used for the general population: keep radiation exposure “as low as reasonably achievable” (5). This means performing x-rays only when necessary and capturing the fewest images needed for diagnosis. In most imaging studies, pregnant individuals do not need to worry about radiation’s effects on the fetus. According to the American College of Radiology, “no single diagnostic x-ray procedure has enough radiation to threaten the well-being of a developing baby” (6).

While x-rays are generally safe, the stage of pregnancy can influence the level of risk to the fetus (7). The risks of radiation are most significant while organs are forming (known as organogenesis). This takes place during the first trimester or the first 8-15 weeks post-conception (8). The risk decreases in the second trimester and continues to decline in the third (8). In addition to organ formation, the central nervous system (CNS) is most sensitive to radiation during the first 25 weeks of pregnancy. Radiation sensitivity peaks between weeks 8 and 15, lessens during weeks 16 to 25, and becomes minimal after 25 weeks (8). Because of these developmental sensitivities, physicians may explore alternative imaging options depending on how far along the pregnancy is. However, if an x-ray is the best tool for diagnosis, the pregnant person can rest assured that a single x-ray produces radiation in such small amounts that it is unlikely to harm the growing fetus (9).

Another factor that affects radiation exposure is the location of the imaging. Since the uterus and fetus are located in the pelvis, any imaging near that area results in more direct exposure (5). A lumbar spine radiograph, for example, produces the highest radiation levels. However, the exposure still remains well below the established safety limit (5). Other x-rays that might expose the fetus to more radiation include those of the abdomen, stomach, pelvis, lower back, and kidneys (2). In contrast, x-rays of the arms, legs, head, teeth, or chest do not directly expose the fetus because these body parts lie farther from the pelvis (2).

Despite the low risk, pregnant individuals can take precautions to reduce potential exposure. First, they should inform their provider of their pregnancy so the provider can consider safer alternatives, such as ultrasound or MRI. Second, the pregnant person should wear a lead apron to block the abdomen from radiation. Third, if the x-ray is not urgent, waiting until after delivery may be an option (6).  

In conclusion, x-rays are considered safe for the unborn baby when medically necessary. They play an important role in protecting the health of the person who is pregnant. The risk of not receiving a diagnosis outweighs the minimal radiation exposure. The risk to the fetus is greatest during the first trimester and decreases as the pregnancy progresses. While x-rays targeting areas near the fetus involve slightly more radiation, these levels still fall below safety thresholds. Pregnant individuals can reduce risk by exploring alternative imaging and shielding. Ultimately, maintaining the health of the pregnant person supports the well-being of the developing baby, and x-rays, when needed, help achieve that goal.

References:

1.     Cleveland Clinic. X-ray. Updated February 14, 2023. Accessed June 3, 2025. https://my.clevelandclinic.org/health/diagnostics/21818-x-ray

2.     U.S. Food and Drug Administration. X-rays, pregnancy and you. Accessed June 2, 2025. https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/x-rays-pregnancy-and-you.

3.     National Institute of Biomedical Imaging and Bioengineering. X-rays. National Institutes of Health. Updated June 2022. Accessed June 2, 2025. https://www.nibib.nih.gov/science-education/science-topics/x-rays

4.     Centers for Disease Control and Prevention. Facts about X-Rays. Updated February 20, 2024. Accessed June 2, 2025. https://www.cdc.gov/radiation-health/data-research/facts-stats/x-rays.html

5.     Yoon I, Slesinger TL. Radiation exposure in pregnancy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2025. Updated May 1, 2023. Accessed June 2, 2025. https://www.ncbi.nlm.nih.gov/books/NBK551690/

6.     Stanford Medicine Children's Health. Should pregnant women worry about x-rays? Accessed June 2, 2025. https://www.stanfordchildrens.org/en/topic/default?id=should-pregnant-women-worry-about-x-rays-197-28587.

7.     Mayo Clinic. X-ray during pregnancy: Is it safe? Accessed June 3, 2025. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/x-ray-during-pregnancy/faq-20058264.

8.     International Atomic Energy Agency. Pregnant women. Accessed June 3, 2025. https://www.iaea.org/resources/rpop/health-professionals/radiology/pregnant-women.

9.     American Academy of Orthopaedic Surgeons. Pregnancy and X-ray safety. OrthoInfo. Published January 2020. Accessed June 2, 2025. https://orthoinfo.aaos.org/en/treatment/pregnancy-and-x-ray-safety/.

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