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

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!

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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).

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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.

Oster's book saved me from adhering to a bunch of unexplained, illogical rules during my first and second pregnancies. She advocates for moderation instead of restriction when making behavioral decisions and has the data to back it up. This is honestly the only book that has given me peace If mind during my pregnancies. I wish she would write another one about parenting!

This book came highly recommended from multiple friends who have had babies in the last couple of years. My husband and I both really enjoyed the read and the information. We may not be as gung-ho as the author about knowing EVERYTHING there is to know about pregnancy and babies, but the book is still really informative and funny, and as parents-to-be taking a more laid back approach, it’s been really helpful in encouraging us to have conversations we otherwise may not have had.

This book gave me peace of mind throughout my pregnancy. I read the information a trimester at a time and was relieved at all of the things I felt like I didn't have to stress about. While I didn't follow all of the recommendations she made (or implied), I felt much calmer knowing that eating sushi wasn't going to kill my baby and that taking a sip of my husband's wine isn't necessarily the end of the world. I would recommend this book to any pregnant woman prone to anxiety like I am.

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.