Last week, I wrote an entry about things that bugged me from my pregnancy during residency. One thing that ended up being a bit of a topic of debate in the comments was the issue of radiation during pregnancy. Basically (in case you didn't read the original post), when I was in my second trimester, an attending asked me to hold a patient's head while they were getting spine X-rays, then seemed shocked when I was reluctant to do so.
I certainly didn't expect all the readers to be on my side, and I wasn't disappointed. A couple of people commented that they didn't understand the big deal, since I would be covered by lead. One person went so far as to say that she would never ever consider covering for a pregnant women who wanted to avoid radiation.
I don't think I'm a weirdo for worrying about radiation during pregnancy. Most attendings never asked me to do such a thing. When we were taking an X-ray at the patient's bedside, they immediately stepped in and ordered me out of the room. On another occasion, when I wasn't pregnant, I went down to hold a patient's head, and the radiology tech grilled me about whether or not I was pregnant, even going so far as to ask if I was on birth control. Another resident in my program had her schedule for the year arranged so she could avoid a radiation-intense rotation during her pregnancy, and I don't think anyone questioned this.
Of course, there isn't a lot of conclusive research about radiation exposure during pregnancy, since it's not like they're going to be doing any double-blinded randomized controlled trials any time soon. An X-ray, I've read, provides about as much exposure as a cross-country plane flight. I spent a minute doing a PubMed search before writing this and it seemed like the only thing they knew for sure is that radiation during pregnancy causes a lot of anxiety in mothers-to-be.
I think it's an important topic for women in medicine though. After all, a lot of fields do have radiation exposure. And a lot of us get pregnant. A friend of mine is currently pregnant and working as a Pain physician, performing injections under fluoroscopy. I know she wanted to get pregnant and deliver prior to that job in order to avoid the radiation exposure, but things didn't work out that way. Sometimes you can't avoid radiation during pregnancy. But if you can, should you make an effort to try?
At the risk of causing an argument in the comments, which y'all know I really hate, I'd like to ask the readers what their feelings are about radiation exposure during pregnancy. Do you think the anxiety is unwarranted? If you were pregnant, would you have held that patient's head during that X-ray (and the 3-4 other times it came up during my pregnancy)? Would you work as a Pain physician doing injections daily with an X-ray machine? Would you agree (or better yet, volunteer) to help a pregnant co-resident who wanted to avoid radiation exposure?