Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong - and What You Really Need to Know [NOOK Book]


“Gives moms-to-be a big helping of peace of mind!” —Harvey Karp M.D., bestselling author of The Happiest Baby on the Block

Pregnancy—unquestionably one of the most pro­found, meaningful experiences of adulthood—can reduce otherwise ...
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Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong - and What You Really Need to Know

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“Gives moms-to-be a big helping of peace of mind!” —Harvey Karp M.D., bestselling author of The Happiest Baby on the Block

Pregnancy—unquestionably one of the most pro­found, meaningful experiences of adulthood—can reduce otherwise intelligent women to, well, babies. Pregnant women are told to avoid cold cuts, sushi, alcohol, and coffee without ever being told why these are forbidden. Rules for prenatal testing are similarly unexplained. Moms-to-be desperately want a resource that empowers them to make their own right choices.

When award-winning economist Emily Oster was a mom-to-be herself, she evaluated the data behind the accepted rules of pregnancy, and discovered that most are often misguided and some are just flat-out wrong. Debunking myths and explaining everything from the real effects of caffeine to the surprising dangers of gardening, Expecting Bettering is the book for every pregnant woman who wants to enjoy a healthy and relaxed pregnancy—and the occasional glass of wine.
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  • Expecting Better
    Expecting Better  

Editorial Reviews

From Barnes & Noble

Dr. Emily Oster is an award-winning social scientist, but she is also a mother. When she became pregnant, she listened to the same litany of prohibitions and restrictive instructions that every expectant mother hears: No caffeine, alcohol, and sushi; narrow prescriptions for bed rest, induction, weight gain and fetal testing. As a trained, independent-thinking economist, she began testing these ironclad guidelines and, sometimes to her own surprise, discovered that they were sometimes downright wrong and almost always oversimplified. This groundbreaking book is bound to generate both interest and controversy.

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Product Details

  • ISBN-13: 9781101617939
  • Publisher: Penguin Group (USA)
  • Publication date: 8/20/2013
  • Sold by: Penguin Group
  • Format: eBook
  • Pages: 336
  • Sales rank: 57,254
  • File size: 2 MB

Meet the Author

Emily Oster, the daughter of two economists and the wife of a third, is an associate professor of economics at the University of Chicago Booth School. She lives with her husband and daughter in Chicago.
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Interviews & Essays


Author of the new book

EXPECTING BETTER: Why the Conventional Pregnancy Wisdom is Wrong—and What You Really Need to Know

Making the right decisions during pregnancy and birth isn't easy. Like many pregnant women I wanted to be sure I was doing the right thing, but I struggled to get good information about what that was. My doctor had a lot of rules about what I could and couldn't do, but rarely was able to back those rules up with any evidence. In the end, I found I had to use my training in economics and statistics to sort through the data and find the real facts. Because you can't make a good decision with bad information.

When I got the real facts I found that sometimes I agreed with my doctor's rules and recommendations, but not always. By getting the real facts - going back to the original medical studies and learning what the data really has to tell us - I was able to be more confident in my choices. And when friends came to ask about their own pregnancies, the data was able to help them be more confident, too.

How does an economist come to write a book about pregnancy?

Economics is basically about making decisions based on all the available data. So I was shocked when I became pregnant and was basically given a list of rules that appeared to be based on vague or conflicting evidence. It all felt incredibly oppressive. I ended up spending my evenings trawling through the medical literature in a bid to make more informed choices. This book was an attempt to look at all the evidence in a more analytical way.

So how is your book different from all the other pregnancy bibles out there?

You won't find any Dos or Don'ts in my book, for starters. I've read a lot of books that say don't touch caffeine during pregnancy, for example, and others that say a cup of coffee a day is fine, but I never found a book that explained the facts behind the recommendations. This book aims to bring women the facts so they can make their own judgment calls.

How much do you think the medical establishment is to blame for the fear culture surrounding pregnancy and birth?

There is a tendency to baby pregnant women. We're not trained in medicine, so it's hard to make certain decisions, but actually we just need the facts, not patronizing lectures. More doctors need to focus on the stuff that really matters. For example, there's a list of hundreds of foods for women to steer clear of during pregnancy, to the extent that even just eating becomes fraught. But actually from studying the research, I found that only six foods are really off limits. WHAT ARE THESE? Sushi and raw eggs are no more of a risk when you're pregnant than when you're not.

Any more myths you'd like to debunk?

Bed rest is prescribed for around 20% of expectant mothers in the US, for all types of complications. And yet there is zero evidence that this is helpful for anything. In fact, all the studies point to the contrary - staying in bed for weeks on end can lead to muscle wasting and increase risk of blood clots. The whole caffeine thing is interesting, too. I love coffee, so I looked into it thoroughly and actually all evidence supports having up to two cups a day, and much of it supports up to three or four cups.

Your book also concludes a glass of alcohol a day is fine in the second and third trimesters. Aren't you worried some women will take this as a green light to overdo it?

It's incredibly patronizing to assume that if you tell women it's OK to have a glass of wine every day they'll go crazy and have six margaritas. I think we can trust expectant mothers to use the same common sense they employed before they were pregnant. Blanket policies that make everything off limits are far more dangerous in my opinion; if you tell women don't drink, don't smoke, don't have coffee, don't do anything, they're more likely to think, ?well I won't drink alcohol, but I'll smoke. I have to do something.' Actually the only real don't is cigarettes. But then they're a total no no when you're not pregnant, too.

Why do you think pregnancy has become such a source of anxiety?

There's definitely more fear surrounding birth now thanks to the wealth of conflicting data, and hysterical reporting. A lot of it also stems from that whole competitive parenting thing that seems to have backed up into pregnancy. Parents so desperately want to get it right that they end up obsessing over every detail. But it's important to relax a little and enjoy your pregnancy. Although obviously it took a lot of me obsessing over countless medical studies to come to this conclusion!

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Customer Reviews

Average Rating 3.5
( 10 )
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Sort by: Showing 1 – 9 of 10 Customer Reviews
  • Anonymous

    Posted August 26, 2013

    Let's just say I've read a few pregnancy books before, and I rea

    Let's just say I've read a few pregnancy books before, and I really can not say this loudly enough: This is the BEST one that I have read so far. Sure, Emily Oster is an economist and yeah, that means that she didn't go to medical school. But! She's clearly incredibly intelligent and she's a mom, so she's been there, and she doesn't tell you what to do. She simply goes over the research behind the recommendations she heard from her doctors and gives you the information you need to make an informed choice. That's what economists do these days (forget about Wall Street - that's a different type of economics). They pull information from random bits of data and put it together to try to make sense of this crazy world. They know what types of research are reliable and which ones should be taken with a grain (or ten) of salt. And man, the world of pregnant ladies sure could use a lot less crazy! Emily Oster tackles an incredibly emotionally charged subject with wit and charm, and manages to tell a great story in the meantime. I might not do all the things that the data indicates is okay to do while pregnant, but armed with Expecting Better, I sure can make an informed choice about the things that are important to me.

    And a side note about all the negative reviews here - as has been said before, many of them did not read the book and are merely writing reviews about what they've seen in the media or on certain websites. If you actually read the book, you'll find that the stance on alcohol while pregnant is very clear and supported by solid research. She also explains the difference between saying 'no amount of alcohol has been proven safe' and the idea that a glass or two of wine during your pregnancy is not going to be harmful. Want to know what she said? Buy a copy of the book and read it yourself! You won't be sorry!

    6 out of 8 people found this review helpful.

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  • Anonymous

    Posted August 20, 2013

    This writer you has grossly neglected her responsibility to rese

    This writer you has grossly neglected her responsibility to research and confirm the validity of her sources and there has been widespread international concern expressed about the study in the UK that she specifically references. The study stopped following children at age 5 when behavioral and learning disabilities have not had a chance to be identified. Alcohol is a teratogen. We have used it as a sterilizing agent for centuries precisely because it is so good at killing cells. Whatever is currently developing in the baby when alcohol is consumed prenatally (and postnatally, if breastfeeding) can be affected. Recent genetic and epigenetic studies are just beginning to understand why some individual cells may be affected and others not, why some babies are more affected and others less. So, while it is theoretically possible drinking a certain amount won’t cause severe intellectual disability, or neuro-behavioral issues in one woman’s baby the very same amount or less might in another’s. There is no way to know at this point if a woman has “good” genetics or “bad” genetics. Perhaps someday there will be tests to determine the genetic fragility of the cell wall in all areas that are growing in a baby and to determine a truly safe amount for a specific woman to consume …..but for now there is no safe kind of alcohol, no safe time during pregnancy for alcohol, and no safe amount of alcohol. The author, publisher and booksellers carrying this book should all be ashamed for being so totally reckless and irresponsible in promoting alcohol consumption by pregnant women.

    5 out of 12 people found this review helpful.

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  • Anonymous

    Posted October 3, 2013

    As a physician, I can tell you that the curriculum in most medic

    As a physician, I can tell you that the curriculum in most medical schools does not have the ability to give students a comprehensive background in statistics simply because there is not the time alotted. The ability to understand and decipher statistics is integral to one's ability to evaluate the scientific literature and I can tell you that most MD's have a poor understanding. So my first point is that our MD's do not have the extensive backround in statistics. Familiarity with the science of healtcare does not allow you to evaluate the quality or validity of studies.  Secondly,our current healthcare system relies on multiple patient visits  to generate the revenue needed to support the average OB. Your OB does not have the time to sift through all of the new studies to decide if his or her recommendations for behavior during pregnancy are backed by the literature. Generally, recommendations are made based on history and overall concensus from the ACOG, which like any such entity takes a long time to make any changes. Case in point is the American Heart Association which only recently changed his recommendation regarding prophylaxis despite over 10 years of research showing the prior recommendation was not justified by the literature. Thirdly, an OB has to carry some of the most expensive malpractice insurance in all of healthcare. In the US, we are particularly litigious and MD's rightfully want to avoid being sued. Therefore the recommendations err very far to the overly cautious . The risk to a pregnant woman and her fetus is actually greater from a motor vehicle accident than many of the standard list of "no's" during pregnancy. Finally, to the point about there being no randomized controlled clinical trials looking at safety levels of some things well, think about it. One, studies like that really aren't done anymore without informed consent and certainly, we are not willing to risk injury to a research subject. The same is true in all aspects of medicine, not just obstetrics. Two, there would never be funding for a study like that. There isn't money in it. The money is in new drugs that pharmaceutical companies can increase their profits with. In short, this was an AWESOME book and is truthfully how we should be looking at life. Evaluate the evidence, make the call. 

    4 out of 5 people found this review helpful.

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  • Anonymous

    Posted August 20, 2013

    Emily Oster has no medical training or expertise and is unqualif

    Emily Oster has no medical training or expertise and is unqualified to write a book which provides advice and guidance about alcohol use and pregnancy.She cherry picks studies and ignores the research showing light drinking to be associated with miscarriage, stillbirth, preterm delivery, spontaneous abortion, and sudden infant death syndrome (SIDS).If Emily Oster wants to tolerate the risk of alcohol on her own baby, that’s her choice, but she has no right to advise pregnant women to expose their unborn baby to even a small amount of a substance that can cause brain damage.She is clearly less concerned with protecting the health of newborns than she is with protecting expectant mothers from health messages she deems bothersome.Sadly, Oster’s statements will likely influence some pregnant women to drink alcohol, who then could tragically give birth to offspring with lifelong brain damage from the effects of prenatal exposure to alcohol, including Fetal Alcohol Syndrome.Emily Oster thinks that the way to relieve women of the worry and guilt from having a few drinks during pregnancy is to tell them: Don’t worry, it’s fine. Enjoy a glass of wine.  In fact, the best way to relieve women of this worry is to encourage pregnant women to avoid alcohol, including wine, and therefore have no reason to worry whatsoever.Liberation for expectant mothers doesn’t come from drinking wine while pregnant.  Liberation comes from never having to worry that you might have done something to harm your child by drinking alcohol.Emily Oster claims that her 2-year old daughter is perfectly healthy, yet the full impact of the alcohol exposure on her child will not be evident until the adolescent years.What Oster calls the “pregnancy police” are in fact public health professionals, doctors, OB-GYNs, and researchers, dedicated to improving the health outcomes of women and their children.  NOFAS, and the overwhelming majority of people actively promoting the message that no amount of alcohol is safe during pregnancy, purposely avoid scare tactics so as not to alarm women who may have had a drink before they knew they were pregnant.

    4 out of 11 people found this review helpful.

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  • Anonymous

    Posted August 20, 2013

    Ms Oster has created a well written and readable book that does

    Ms Oster has created a well written and readable book that does a reasonable job of critiquing available research on various pregnancy risks. What she has not done however is discuss WHY there are no definitive studies available on these topics. Think about that for a moment. Not one single longitudinal study done delivering calibrated doses of alcohol to pregnant woman en measuring the impact against a non-drinking control group. Why? Because there are no scientists or medical professionals willing to take that risk with unborn children. Anyone reading this book would be wise to cast a very critical eye on the conclusions and recommendations it gives.

    4 out of 7 people found this review helpful.

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  • Anonymous

    Posted September 10, 2013

    As a Registered Dietitian, I applaud Ms. Oster's efforts to shar

    As a Registered Dietitian, I applaud Ms. Oster's efforts to share the science supporting the numerous benefits of eating seafood during pregnancy. The omega-3s in seafood are essential for optimal baby brain and eye development. Her advice for pregnant women to eat more fish is spot on: "The worst thing you can take from mercury advice is the idea that you should avoid fish. Fish are great! People who eat a lot of fish have smarter kids on average, even with the greater mercury exposure."

    Her advice for pregnant women to limit canned tuna, however, is flat-out wrong. As a RD who consults with the National Fisheries Institute, I have extensively reviewed the science around mercury and seafood, particularly canned tuna. The USDA's Dietary Guidelines for Americans include canned tuna as a fish that is low in mercury. According to the FDA, there are only four fish that pregnant women need to avoid: shark, swordfish, king mackerel and tilefish. All other commercially-caught fish (including canned tuna) and shellfish can--and should--be enjoyed during pregnancy.

    Despite the Dietary Guidelines recommendation that pregnant women should eat at least 8 ounces and up to 12 ounces of seafood every week, the average pregnant woman in the U.S. consumes less than 2 ounces of seafood per week. This dangerously low amount of seafood puts pregnant women at risk for omega-3 deficiency, which could greatly impact their child's cognitive outcomes.

    Misguided dietary advice and nuanced nutrition messages leave pregnant women confused. I know this first-hand, both as a mother of two young children (who was frustrated during both pregnancies by confusing tuna advice) and as a consulting RD (who helps individuals sort out real science from nutrition myths).

    While the author's intent to encourage pregnant women to increase seafood consumption was positive, Ms. Oster missed the boat on helping these women make informed decisions about fish. Exhaustive research shows that expecting moms can safely and confidently enjoy canned light and white albacore (up to 6 ounces each week) tuna, both of which are an affordable and convenient way to help pregnant women meet their protein and omega-3 nutrient needs. - Rima Kleiner, MS, RD

    1 out of 2 people found this review helpful.

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    Posted March 18, 2014

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    Posted June 17, 2014

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    Posted November 27, 2013

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