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Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong-and What You Really Need to Know Hardcover – August 20, 2013

by Emily Oster (Author)
4.6 4.6 out of 5 stars 10,804 ratings
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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.
 
* * *
 
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.

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  1. Book 1 of 4
    The ParentData
  2. Print length
    336 pages
  3. Language
    English
  4. Publisher
    Penguin Press
  5. Publication date
    August 20, 2013
  6. Dimensions
    6.3 x 1.1 x 9.3 inches
  7. ISBN-10
    1594204756
  8. ISBN-13
    978-1594204753
  9. See all details
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Customer reviews

4.6 out of 5 stars
10,804 global ratings

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Customers say

Customers find the book informative and well-organized. They appreciate the clear explanations and humor that make it an easy, pleasant read. The book provides reliable data to help readers make informed decisions. Customers find the writing style refreshing and reassuring, keeping them engaged throughout. The organization is structured and methodical, with summaries and bullet points at the end of each section. Overall, customers find the book helpful in preparing for pregnancy and postpartum.

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Select to learn more
Information qualityReadabilityHumorData qualityRefreshingOrganizationBiasPreachiness
571 customers mention "Information quality"520 positive51 negative

Customers appreciate the book's information quality. They find it informative, providing a thorough review of the data and personal anecdotes. The author helps readers make their own decisions with her analysis and thorough research. Overall, they consider it a valuable resource for anyone who is pregnant or trying to become pregnant.

"...Kudos to the author for the work it took to write such an informative book while making the read so pleasant, easy, and funny!" Read more

"...I read, not because it tells you what to do, but because it calmly presents the data on every major decision you'll need to make during pregnancy,..." Read more

"...this books really helps with worries you might have about different things you can do during pregnancy" Read more

"...Her analysis is thorough even as she keeps her writing accessible, humorous, and sympathetic...." Read more

413 customers mention "Readability"404 positive9 negative

Customers find the book easy to read and informative. They appreciate the clear explanations of topics and studies. The writing style is friendly and accessible, keeping readers engaged. Overall, customers find the book helpful and well-researched.

"...work it took to write such an informative book while making the read so pleasant, easy, and funny!" Read more

"...This book was hands down the most useful pregnancy book I read, not because it tells you what to do, but because it calmly presents the data on..." Read more

"...Her analysis is thorough even as she keeps her writing accessible, humorous, and sympathetic...." Read more

"...As others have said, this book is great if you want to make your own informed decisions, instead of being treated like you are stupid and incapable..." Read more

74 customers mention "Humor"63 positive11 negative

Customers find the book humorous and easy to read. They appreciate the author's witty writing style and anecdotes that make reading enjoyable. The book has a conversational tone and is approachable.

"...such an informative book while making the read so pleasant, easy, and funny!" Read more

"...Her analysis is thorough even as she keeps her writing accessible, humorous, and sympathetic...." Read more

"I regularly enjoy Emily Oster's informative, witty, and incisive columns on fivethirtyeight.com, so when I heard she'd written a book on pregnancy,..." Read more

"This approachable, entertaining, well-researched book provides clear and useful summaries of medical studies on a wide range of important pregnancy-..." Read more

48 customers mention "Data quality"40 positive8 negative

Customers appreciate the book's data quality. They find it helpful for making informed decisions and providing a good basic overview of the information. The book provides charts and data to back up claims, with a focus on analysis and explanation of strengths and weaknesses.

"...Despite it being very technical and data-driven, the author kept me engaged the entire time—to the point I didn't even want to skip the "boring"..." Read more

"...that it's mind-boggling, this book had so many sources and so much data to back up claims that I'd be willing to start with the data in this book..." Read more

"...Fantastic read. Seriously gave us peace of mind and REAL DATA to backup on decisions. This is why we have analysts and economists...." Read more

"...It does that deep research for us. It provides the data. It explains things clearly and practically.It helps us make informed decisions!" Read more

21 customers mention "Refreshing"21 positive0 negative

Customers find the book refreshing and informative. They say it helps ease their minds and prepare for pre- and post-natal motherhood. The book is easy to follow and keeps them engaged.

"...I found this book's approach refreshing and illuminating, and I will recommend it to my pregnant friends...." Read more

"...Her writing style is very easy to follow and kept me very engaged...." Read more

"...Very interesting...." Read more

"...It really helped to put my mind at ease about so many small decisions you have to make! I’ll be using it as a guide for labor for sure!" Read more

17 customers mention "Organization"14 positive3 negative

Customers appreciate the book's organization. They find the summaries and bullet points at the end of each section helpful. The chapters are structured and methodical, providing a good balance between information and conciseness. Readers appreciate the handy charts and research supporting the content. Overall, the book provides useful guidance and supports it with supportive studies.

"...Chapters are the perfect mix of informative and concise.Highly recommended" Read more

"...She presents the data in very easy to understand terms and has summary bullet points for those who want to see her assessments and conclusions in..." Read more

"...This book is great. It's well organized, so if you want to skip around, you can absolutely do that...." Read more

"...and it's well organized, concise, and touches on all the major topics.This book would have saved me HUNDREDS of hours of googling...." Read more

27 customers mention "Bias"9 positive18 negative

Customers have different views on the book's bias. Some find it informative and non-judgmental, providing study-based facts. Others feel that the conclusions and facts are wrong, misleading, or contradictory.

"This book is most limited by the lack of clear evidence, unfortunately. I am a practicing (non-OB) physician and a mother of a toddler...." Read more

"...I also love about how she reports researching findings is the nonjudgmental approach in which she delivers the information...." Read more

"...This entire chapter was purely opinion and had zero fact or evidence backing that would actually be relevant to those reading it..." Read more

"...You’re better off asking your OB directly. Stay away from this pile of biased garbage." Read more

16 customers mention "Preachiness"9 positive7 negative

Customers have different views on the book's preachiness. Some find it respectful and non-condescending, while others mention some of the information is misleading and false.

"...There’s no preaching, no lecturing, no “pregnancy rules” you must follow just so, which is not to say that the author advocates for winging it...." Read more

"...That being said, the author still has published some false statements, and ultimately is pro-hospital and anti-natural childbirth/homebirth/etc...." Read more

"...in plain English and not in a preachy way. It is not a medical textbook...." Read more

"...I think the idea here is good but some of the info is offensive since pregnant women come in all shapes, sizes, ages and I worry that some people..." Read more

Favorite pregnancy book!!
5 out of 5 stars
Favorite pregnancy book!!
I feel like this photo is a perfect description of how much I loved this book. As a first time mom, I wanted to know everything I could about pregnancy and just overall- becoming a mother. I wanted to know the studies, the opinions and the critiques of pregnancy and this book gave me that. I love that it’s honest and it’s real, it’s not based solely off of doctors opinions but as a mother’s personal opinions as well. It was comforting to me and I read this book 4 times during my pregnancy- it became a comfort thing for me. I definitely would recommend this to any pregnant woman or woman trying to conceive!!
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Top reviews from the United States

  • Amazon Customer
    5.0 out of 5 stars The Only Pregnancy Book You’ll Need
    Reviewed in the United States on December 12, 2024
    Verified Purchase
    I returned What to Expect When You’re Expecting as soon as I opened it. This book though, I read cover to cover within a day of getting it and my pregnancy anxiety vanished. I finished this book feeling like an informed and highly educated mom. Kudos to the author for the work it took to write such an informative book while making the read so pleasant, easy, and funny!
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  • AU-AU
    5.0 out of 5 stars My #1 go-to pregnancy book! Does not treat you like an idiot.
    Reviewed in the United States on July 11, 2014
    Verified Purchase
    It's a pity this book got caught up in a kerfluffle about alcohol, when that is about 1% of the books actual content (I've put *exactly* what the author says about it at the bottom of the review for all those negative reviewers who couldn't be bothered reading the actual book!).

    This book was hands down the most useful pregnancy book I read, not because it tells you what to do, but because it calmly presents the data on every major decision you'll need to make during pregnancy, and then encourages you to form your *own* opinions based on it, instead of treating you like an idiot who can't be trusted to understand anything other than black-and-white 'rules'. As the author says:

    "I teach my students that making good decisions requires two things. First, the right data. Second, the way to weigh the plusses and minuses of the decision *to you personally*...So naturally, when I did get pregnant I thought this is how pregnancy decision making would work too. Take something like amniocentesis. I thought my doctor would outline the plusses and minuses...She'd give me the data I needed. She'd then sit back, and my husband and I would discuss it and we'd come to a decision that worked for us. This is not what it was like *at all*".

    Every pregnant woman knows this feeling.

    This book has the missing data that thinking parents need to help them make many of those decisions, including:
    - What *really* happens to your odds of conception after 35?
    - What is the evidence that having a cup of coffee will harm your baby? or 2 cups? 3 cups? Why is there so much conflicting advice on this?
    - Same for alcohol, by trimester
    - What is the likelihood of miscarriage each week? (I found this super reassuring)
    - What is the statistical likelihood of issues arising from eating deli meats, eggs, fish, shellfish, soft cheeses, and sushi? How do you weigh up the omega 3 vs mercury risk for fish?
    - What % of women are still experiencing morning sickness each week? Are your morning sickness symptoms 'worse' than the average woman and how risky are the drugs for it?
    - What should you know before you make a decision to get antenatal testing for downs syndrome? Does amniocentesis really have a 1 in 200 risk of miscarriage? Is CVS more or less risky than amnio? (We ended up having the non-invasive test, while getting our results the doctor told us 'you seem really well informed on this!'. Thanks Emily :-)
    - Is emptying the cat litter box as dangerous as gardening?
    - Exactly how much airplane travel is risky?
    - What are the real risks (and benefits!) of gaining more weight than the recommended amount?
    - Is there anything that will help you correctly guess the gender?
    - What's the evidence on whether Kegels help?
    - How can I understand the data on which drugs are safe during pregnancy?
    - What is your chance of a pre-term birth, week by week? And what % of pre-term babies at each week will survive? (also reassuring)
    - For full term babies, what is the chance of the baby arriving each week, if it didn't come last week? Are there any studies than show symptoms the baby might come soon? Is there anything safe you can do to bring on labor if you are overdue?
    - What are the risks and benefits of induction? Do you really need to be induced for 'low amniotic fluid'?
    - How long does the average labor really take?
    - What, statistically, are the pros and cons of a c-section or an epidural? What about cord-clamping, homebirth, doulas, types of fetal monitoring, episiotomy, and cord blood storage?
    - An example of an evidence-based birth plan is included, but emphasis given to choosing what works for you.

    So, in summary, the data need to make your own important decisions along the way. Recommended read!

    --------
    Appendix: *Exactly* what this book says about alcohol during pregnancy:

    "There is no question that very heavy drinking during pregnancy is bad for your baby. Women who report binge drinking during pregnancy are more likely to have children with serious cognitive defects. In one Australian study, women who binged in the second and third trimester were 15 to 20% more likely to have children with language delays than women who didn't drink. This is repeated again and again in other studies. Binge drinking in the first trimester can cause physical deformities and in later trimesters, cognitive problems.

    If you are binge drinking, stop.

    However, this does not directly imply that light or occasional drinking is a problem. When I looked at the data, I found no credible evidence that low levels of drinking (a standard glass of wine or so a day) have any impact on your baby's cognitive development"

    (The author then goes on to review a number of studies in more detail, including an analysis of whether those studies correctly separated causation from correlation).

    ------------
    I did not read that as a licence to go drinking while pregnant. In fact, I read it and chose not to drink anyway (I was too morning sick to want anything to do with alcohol!). And I respected the author for giving me the evidence, and not blindly repeating something others had said.

    Here's to being treated with respect when you are pregnant, not like an idiot.
    1,514 people found this helpful
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  • Gloria
    5.0 out of 5 stars a great and easy read!
    Reviewed in the United States on December 9, 2024
    Verified Purchase
    it was great to read the research that was done on myths during pregnancy. this books really helps with worries you might have about different things you can do during pregnancy
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  • Caroline Niziol
    4.0 out of 5 stars Fact-based book for empowered pregnancy choices
    Reviewed in the United States on August 21, 2013
    Verified Purchase
    If you asked me a couple of weeks ago if I was interested in reading Yet Another Pregnancy Book, I would have laughed. Hardly! I read a couple early on, then turned to the almighty Google when I had questions or curiosities. Then about a week ago, my mom clipped an excerpt from the Wall Street Journal called "Take Back Your Pregnancy." Well, I took the bait. Emily Oster's article intrigued me. Definitely one for any subsequent pregnancy, I thought!

    Then the furor struck on the Interwebs. Because Oster draws the conclusion from a variety of studies and data that it's fine to indulge in the occasional alcoholic beverage during pregnancy, she has been excoriated in a variety of articles and in the responding comments. Current Amazon.com reviews are skewed by those who take issue with an economist (not a medical doctor) who will, in their minds, increase the number of children born with FASD (Fetal Alcohol Spectrum Disorder). Several comments made nasty remarks about the author's 2-year-old daughter, Penelope, implying that it was only a matter of time before she would begin to fail IQ tests and demonstrate signs of FASD herself.

    Was Oster truly that horrible and conniving? Did she write her book to cause birth defects and emotional trauma? I had to know the truth, and while 40 weeks and two days pregnant, I picked up Expecting Better and read it carefully.

    Spoiler alert: it's really not that bad. I love authors who examine evidence, explain scientific studies and methodology, and draw logical conclusions about the data. Oster isn't an ob/gyn, but she's a well-trained economist whose job is interpreting data. Her analysis is thorough even as she keeps her writing accessible, humorous, and sympathetic. As she points out in the introduction, advice about pregnancy tends to be either black and white--don't have any drinks, ever--or vague--drink coffee in moderation. Instead of relying on the hearsay, she reviews the actual data and comes to her own conclusions. Oster doesn't demand that women drink during pregnancy despite their own reservations. Not at all! She just presents the evidence that light drinking has been shown to be not harmful, and lets the reader make her own choice.

    The knee-jerk reactions to the book and Oster's approach are misguided because they don't realize that telling women what to do during pregnancy is exactly the opposite of Oster's intentions. Rather, she wants all the data laid out so women can make informed decisions during pregnancy based on their own assessment and comfort levels with varying amounts of risk. That is far more empowering and practical than a notarized list of what to do and not do. She gives examples in the text, citing instances where her review of the data prompted her to chose one path and a friend reviewing the same data to chose another path. That is fine. The goal is seeking knowledge to inform personal decisions.

    Pregnancy in the U.S. is fraught with judgment from family, friends, and total strangers that add extra stress in an already anxious time. Expecting Better steps back from the hysteria and offers women up-to-date, relevant information about the choices they will need to make during pregnancy. I'll definitely be recommending this one to pregnant friends in the future.
    682 people found this helpful
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  • Madelynn Hawkins
    5.0 out of 5 stars Favorite pregnancy book!!
    Reviewed in the United States on December 7, 2024
    Verified Purchase
    I feel like this photo is a perfect description of how much I loved this book. As a first time mom, I wanted to know everything I could about pregnancy and just overall- becoming a mother. I wanted to know the studies, the opinions and the critiques of pregnancy and this book gave me that. I love that it’s honest and it’s real, it’s not based solely off of doctors opinions but as a mother’s personal opinions as well. It was comforting to me and I read this book 4 times during my pregnancy- it became a comfort thing for me. I definitely would recommend this to any pregnant woman or woman trying to conceive!!
    Customer image
    Madelynn Hawkins
    5.0 out of 5 stars Favorite pregnancy book!!
    Reviewed in the United States on December 7, 2024
    I feel like this photo is a perfect description of how much I loved this book. As a first time mom, I wanted to know everything I could about pregnancy and just overall- becoming a mother. I wanted to know the studies, the opinions and the critiques of pregnancy and this book gave me that. I love that it’s honest and it’s real, it’s not based solely off of doctors opinions but as a mother’s personal opinions as well. It was comforting to me and I read this book 4 times during my pregnancy- it became a comfort thing for me. I definitely would recommend this to any pregnant woman or woman trying to conceive!!
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    Customer image
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  • Pen Name
    5.0 out of 5 stars LOVED it
    Reviewed in the United States on December 16, 2024
    Verified Purchase
    I don't write reviews often, but this book justifies one. It's informative, really digs in to the science without a lot of jargon, and helps you make your own decisions instead of trying to rely on competing information from well-meaning friends, family members, and strangers. Do yourself a favor and READ THIS BOOK. It's an absolute game changer!
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Top reviews from other countries

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  • Beatriz Amaro
    5.0 out of 5 stars La mejor guía
    Reviewed in Mexico on September 1, 2024
    Verified Purchase
    Uno de los mejores libros de embarazo, ya que te da todos los argumentos para que tú tomes decisiones en tu embarazo basadas en miles de estudios realizados en todo el mundo.
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  • A
    5.0 out of 5 stars Really good book!
    Reviewed in the United Kingdom on November 26, 2024
    Verified Purchase
    Interesting book for new moms or mom's to be, pretty detailed and also shares the scientific information and research about the body.
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  • Lindsay L
    5.0 out of 5 stars Must-read even before conception, highly recommend
    Reviewed in Canada on June 19, 2021
    Verified Purchase
    Every woman should be given a chance to read this book - the author explains that every pregnancy is different and different women faced with the same information may make a different choice which is right for them. Oster debunks various pregnancy myths in a way that is informative and not alarmist. She does give you her opinion but also arms you with the information you need to form your own. You do need to have some interest in the research and data but she brings everything together in a way that is relatively easy to understand. I would say about half the book deals with conception and the first trimester so it makes for an excellent read even pre-conception. I feel much less freaked out having read it, which is no small feat. Highly recommend.
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  • Anestis
    5.0 out of 5 stars A must
    Reviewed in the Netherlands on May 30, 2023
    Verified Purchase
    Puts things into perspective and helps with ease your mind into your first pregnancy. A good data driven approach that I really appreciated !
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  • Casilda Perez
    5.0 out of 5 stars Buen libro
    Reviewed in Spain on May 15, 2023
    Verified Purchase
    Es el único libro que me he leído para embarazadas porque está completamente basado en datos. Esta bien para desmentir algunos mitos y ayudarte con consejos importantes
    Report