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

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

by Emily Oster
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Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong - and What You Really Need to Know by Emily Oster

What to Expect When You're Expecting meets Freakonomics: an award-winning economist disproves standard recommendations about pregnancy to empower women while they're expecting

Pregnancy—unquestionably one of the most pro­found, meaningful experiences of adulthood—can reduce otherwise intelligent women to, well, babies. We’re told to avoid cold cuts, sushi, alcohol, and coffee, but aren’t told why these are forbidden. Rules for prenatal testing are hard and fast—and unexplained. Are these recommendations even correct? Are all of them right for every mom-to-be? In Expecting Better, award-winning economist Emily Oster proves that pregnancy rules are often misguided and sometimes flat-out wrong.
A mom-to-be herself, Oster debunks the myths of pregnancy using her particular mode of critical thinking: economics, the study of how we get what we want. Oster knows that the value of anything—a home, an amniocentesis—is in the eyes of the informed beholder, and like any compli­cated endeavor, pregnancy is not a one-size-fits-all affair. And yet medicine often treats it as such. Are doctors working from bad data? Are well-meaning friends and family perpetuating false myths and raising unfounded concerns? Oster’s answer is yes, and often.
Pregnant women face an endless stream of decisions, from the casual (Can I eat this?) to the frightening (Is it worth risking a miscarriage to test for genetic defects?). Expecting Better presents the hard facts and real-world advice you’ll never get at the doctor’s office or in the existing literature. Oster’s revelatory work identifies everything from the real effects of caffeine and tobacco to the surprising dangers of gardening.
Any expectant mother knows that the health of her baby is paramount, but she will be less anxious and better able to enjoy a healthy pregnancy if she is informed . . . and can have the occasional glass of wine.
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Numbers are not subject to someone else’s interpretation—math doesn’t lie. Expectant economist Emily Oster set out to inform parents-to-be about the truth of pregnancy using the most up-to-date data so that they can make the best decisions for their pregnancies. The results she found were often very surprising…
·        It’s fine to have the occasional glass of wine – even one every day – in the second and third trimesters.
·        There is nothing to fear from sushi, but do stay away from raw milk cheese.
·        Sardines and herring are the fish of choice to give your child those few extra IQ points.
·        There is no evidence that bed rest is helpful in preventing or treating any complications of pregnancy.
·        Many unnecessary labor inductions could be avoided by simply staying hydrated.
·        Epidurals are great for pain relief and fine for your baby, but they do carry some risks for mom.
·        Limiting women to ice chips during labor is an antiquated practice; you should at least be able to sneak in some Gatorade.
·        You shouldn’t worry about dyeing your hair or cleaning the cat’s litter box, but gardening while pregnant can actually be risky.
·        Hot tubs, hot baths, hot yoga: avoid (at least during the first trimester).
·        You should be more worried about gaining too little weight during pregnancy than gaining too much.
·        Most exercise during pregnancy is fine (no rock climbing!), but there isn’t much evidence that it has benefits.  Except for exercising your pelvic floor with Kegels: that you should be doing.
·        Your eggs do not have a 35-year-old sell-by date: plenty of women get pregnant after 35 and there is no sudden drop in fertility on your birthday.
·        Miscarriage risks from tests like the CVS and Amniocentesis are far lower than cited by most doctors.
·        Pregnancy nausea may be unpleasant, but it’s a good sign: women who are sick are less likely to miscarry.

Product Details

ISBN-13: 9781594204753
Publisher: Penguin Publishing Group
Publication date: 08/20/2013
Pages: 336
Product dimensions: 5.70(w) x 9.10(h) x 1.20(d)

About the Author

Emily Oster is an associate professor of economics at the University of Chicago Booth School of Business. She was a speaker at the 2007 TED conference and her work has been featured in The New York Times, The Wall Street Journal, Forbes, and Esquire. Oster is married to economist Jesse Shapiro and is the also the daughter of two economists. She has one child, Penelope.

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Expecting Better: Why the Conventional Pregnancy Wisdom is Wrong - and What You Really Need to Know 3.4 out of 5 based on 0 ratings. 12 reviews.
Anonymous More than 1 year ago
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. 
Anonymous More than 1 year ago
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!
katsuratree More than 1 year ago
My only craving so far has been to have access to the evidence behind all recommendations surrounding pregnancy; to be able to make my own educated decisions based on reality, not old tales and infantilizing scare tactics. This book is the answer to my rational quest and the antidote to my allergy to paternalism - I only wish I'd found it sooner!
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jessicaabruno More than 1 year ago
http://well.blogs.nytimes.com/2013/08/19/pregnant-and-disputing-the-doctor/?smid=pl-share Heres another article (Pregnant, and Disputing the Doctor: After having a child, Emily Oster wrote “Expecting Better,” a book that challenges the conventional wisdom on pregnancy) that I have found awhile back. I mean the day it came it out. I'm currently in the midst of reading this particular book. Its not like what the reviewer thinks it is. Well, at least not in the intro and 1st part of it, but the rest of it. But at the same time I have found that it was lacking certain areas. Like beyond basic conception, elective c-sections, freestanding birth centers, parenting, and maybe others. In which I highly the other book that I'm in the midst of reading Parenting Without Borders: Surprising Lessons Parents Around the World Can Teach Us, Christine Gross-Loh. Again, this is like a book that I have read earlier this summer, The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell You, and How Put Your Pregnancy, Childbirth, and Baby Before Their Bottom Line, Jennifer Margulis. At the same time have mentioned as well. In which both of these books and their authors like another book that I have read Homeward Bound: Why Women are Embracing the New Domesticity, Emily Matchar. Have also mentioned this book. Think thats it for now. Thank you, again, in advance.
Anonymous More than 1 year ago
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.
Anonymous More than 1 year ago
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
Anonymous More than 1 year ago
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.
Anonymous More than 1 year ago
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.