Expecting Better

THANK YOU! I love the way your mind works and this feels like an absolute must read for a couple wanting to be educated about the stats, risks, and reality of pregnancy. Great guide, and big anxiety reducer. I’ve gifted to two other expecting couples.

This approachable, entertaining, well-researched book provides clear and useful summaries of medical studies on a wide range of important pregnancy-related topics: the pros and cons of various pre-natal tests, epidurals, induction, doulas, and home birth; foods that are best to be avoided, and those that are less dangerous than conventional wisdom might have us presume. It is an excellent resource-- it's like a friendly encyclopedia of pregnancy- and childbirth- related medical research! The author emphasizes the fact that medical recommendations come from studies, not from thin air-- and that with a little guidance (which Oster provides), women and their partners can understand those studies, and how to interpret the results in the context of their own lives. Oster shares her own choices (with much self-deprecating humor), but makes it clear that this book is about providing information, not prescriptions. I greatly appreciated her discussions of the origins and evolution of different recommendations (eg. pre-natal testing after 35, bed rest, fetal heart monitoring during labor, episiotomies); it's really informative to see how best practices change from one generation to the next, and how sometimes practices lag behind research. The introduction is available online at the Huffington post; I'd suggest checking that out to get a feel for the book. It's a lot less controversial than many of the reviews below would have you believe. Edit: All the hoopla around the "pregnancy vices" chapter is overshadowing some of the other important contributions of this book. In the interest of helping you decide if the rest of the book is something you might find valuable: One of the main themes of this book is that if you want to act in the best interest of your child, you need to figure out what "best" is. Your doctor can guide you, but you can and should have responsibility and agency in these matters. To a lot of pregnant women, choices about alcohol, coffee, and food are easy-- err on the side of utmost caution. Yet one thing Oster highlights is that most pregnancy-related choices aren't so easily dealt with-- in part because the costs and benefits aren't always clear, and in part because even when they are, the alternatives *all* have costs and benefits worth weighing. Expectant parents have to make choices, choices that involve real tradeoffs for both baby and mother. Non-invasive prenatal screening, amnio, or CVS? Schedule the induction, or not? Epidural, or not? Home, or hospital? This book does fantastic job of presenting the most credible, up-to-date estimates of the costs and benefits associated with each of these choices, and pinpoints particular things about your situation that that might make you weigh the costs and benefits differently than your friend, your OB, or Emily herself. I think this is where the book excels, and really fills a void: chapters about topics that are less inherently buzz-worthy than booze, but perhaps even more difficult to navigate in a sea of murky data and misinformation. The prenatal testing chapter is particularly good.

As a woman in my mid-twenties and in the first trimester of my first pregnancy, I found this book refreshing! Up until purchasing Expecting Better, I found much of the literature on pregnancy and delivery definitely left something to be desired. It seems that many of the popular pregnancy books only offer blanket advice in a condescending tone; while also assuming that all woman, and therefore all pregnancies, are the same. Too often, advice is doled out to expectant mothers without explanation, and sometimes (it would seem) without foundation. In addition, I felt that many of the aforementioned books barely scratched the surface in some areas e.g., miscarriage, weight gain, and fetal testing. Expecting Better does a fantastic job of laying out the facts and letting the reader decide what is best for her and her baby. She also cites all of the studies that she pulled said facts from. I believe that I have benefited tremendously from reading it, and I would recommend it to others. That being said, the author has received quite a bit of static on some of her more "controversial" topics. Specifically, the topics of alcohol and coffee consumption during pregnancy. I personally was not offended, or put off in the slightest. To be fair, I am not a coffee drinker, and my alcohol consumption (when not pregnant) is typically somewhere around 1-2 beverages a couple times a month. Suffice it to say, these were not major concerns for me. I found the findings among various studies in these areas to be mildly interesting, and nothing more. Moving on to another complaint that comes up a lot in reader reviews of this book: bias. (Insert eye roll.) I would venture to say that MOST nonfiction works out there contain some level of bias. In most cases, (such as this one) the author is writing from personal experience. As stated above, not all women, or all pregnancies are identical- far from it! So, naturally, one may not identify (or agree) with certain aspects of the book, or with the opinion of the author. Expecting Better isn't meant to be a bible for expectant mothers, with all the so called "do's and don'ts" categorized into black and white, or right and wrong. I believe the author's goal was to seek out as much information as possible on the relevant topics, and inform the reader of her findings. My hat's off to her for all her research, much of which was done while pregnant herself. I only wish she had continued a little farther to explore other topics! I would be very interested in reading about studies regarding post partum depression, effects of formula vs breastfeeding, and vaccinations!

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.

This is written in a very entertaining easy to read fashion. I love all the data! I feel like the highlights were hit. Maybe not the most thorough but still comprehensive. I’d recommend

This was exactly the kind of book I needed. I have a biology degree, so I hate it when doctors talk to me like I don't know anything about how science or the human body works. Some doctors are better about that than others. Unfortunately my obgyn is one of the usual kinds that just gave me a list of drugs I'm allowed to take and foods I'm not allowed to eat with no explanation. My husband and I immediately started wondering how they arrived at this list. Are these drugs that have been proven to be safe, or ones that haven't been proven to not be safe? Are these foods especially dangerous during pregnancy, or just foods they think are unhealthy in general (my do-not-eat list even included pasta, refined sugar, fast food, etc.). So this book gives you the actual evidence for all these recommendations. I found the section on drugs especially interesting, because they're actually put into several categories based on how much evidence they have for their safety. Class A and B have evidence showing they are safe, Class C don't have much evidence one way or the other, Class D have evidence they are unsafe, but they treat a serious condition that is also unsafe for your pregnancy so it might be worth taking them if you have that condition, and Class X are drugs that are unsafe and not worth taking under any circumstances. And it turns out that some of the "forbidden foods" aren't any more dangerous to eat when you are pregnant than when you are not pregnant, while some of them really are more dangerous when pregnant. Maybe my doctor doesn't think that's an important distinction, but I do. The book didn't even mention pasta, but when I had morning sickness, starchy foods like pasta and bread were some of the few things I could easily eat, so I think my doctor just had pasta (and sweets, and fast food) on the list because eating too much might make me gain too much weight. I can't find anywhere else that says that pasta is especially dangerous to eat when you are pregnant, and then this book even goes on to say that gaining a little too much weight isn't that bad, so I'm still eating pasta. I am avoiding the foods that are on the list because they are more likely to contain bacteria that can make you sick, even though the book says Salmonella isn't any worse for you when you are pregnant than when you aren't (but Listeria and toxoplasmosis are). Salmonella poisoning is no fun, and I don't need that extra stress on top of being pregnant, so I'm avoiding those foods even though the book says I'd probably be OK if I ate them anyway. I also gave up alcohol completely, even though the book said an occasional drink is probably OK, but I just couldn't give up coffee, so I just cut back. 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 of understanding nuance and uncertainty. It's also reassuring to know that if you drank that one class of wine, ate a little blue cheese, took a Class C drug, or gained 5 pounds above the recommended amount, you probably haven't done serious harm to your fetus. Being pregnant is stressful enough already without having to add any unnecessary worry on top of that. After reading this book, I'm definitely ordering Cribsheet next, before the baby arrives.

My husband showed me an article on Emily Oster's book (published in the Wall Street Journal, August 9th) and once I read it, I could not wait to read her book. I am 12 weeks pregnant and could not understand the lack of data supporting all of the rules that pregnant women must adhere to. I saw 2 OB-GYN's and both doctors provided differing views, without providing sound data... was it just their opinion they were spouting off to me? That's what it seemed like to me. Women must make their own decisions, at the end of the day, and I am shocked with the negative reviews this book is receiving. This book is a MUST READ FOR ALL WOMEN!! The negativity is around drinking --- Emily Oster is NOT supporting drinking while being pregnant. This book provides multiple studies on women who drink and shows us that if you have a drink or two, you are NOT HURTING YOUR BABY. But if you don't agree with this philosophy, then don't drink and mind your own business! There are plenty of women around the world who drink while carrying a child. I highly doubt that the reviewers who are so concerned with FAS have actually read the book!! I loved the chapter on miscarrying since there is so much random information online. I too, like Emily's friend in the book, wondered the % of miscarrying at varying weeks. It is comforting to know that there are many reasons why women miscarry and you can't make a generalization as to your chances of miscarrying. Another chapter I appreciated was foods you really should avoid. Even though I'm pregnant, I don't want to feel like I can't live and enjoy food! Knowing the foods I must avoid brings me a peace of mind. In addition, I always wondered about listeria and did not believe it would be harmful to me or my baby. But Emily Oster opened my eyes to the seriousness of this bacteria. I am so thankful that this book came out during my 1st pregnancy. I felt very lost with all of the information that was provided to me and I kept wondering, "why is there such differing information out there?" This book is a god-send and every chapter is useful and to make it even better, she is HILARIOUS! This author is really funny and she adds personal touches throughout the book so you feel connected to her as well. You cannot disagree with data and please do not be influenced by the negative reviews. Please get this book and make your own decision. I am so thankful that I bought the book and I hope you enjoy it as much as I have!

I actually read this book (unlike a lot of the negative reviews on here) and feel that I must add my positive review to counteract the reviews on here that are unfair and uninformed. You don't have to like the book, but I think you should have to read it first before you comment. Anyway, back to the book. Her writing style is very easy to follow and kept me very engaged. She's you're go to nerdy girlfriend, here to fill in all of the mystery behind "thou shall not eat soft cheese" and other restrictions. I think what I loved about this book is simply that she's giving you to chance to make informed decisions about your child and your body. This is a woman who was very involved in her pregnancy and wanted real answers, not just commandments. I liked her summaries at the end of the chapters where she gives you her take-away from the information but she also trust you to be a thinking, independent adult and doesn't expect you to agree with her. She points to many instances when she gave this information to friends and one would use that information to take action A, while another friend, given the same information, was more comfortable with taking action B. I also liked that she shares and breakdowns for you the scientific studies that doctors have been using for years to back up their "You can't do..." statements. Some still hold water and some do not. This book is not an anti-doctor or big medicine book. She had her baby in a hospital and got the epidural. Go girl! This is a book about being informed. That study about mothers drinking and hurting their unborn babies? Yeah, they were also far more likely to use cocaine. There are more modern studies that give more accurate information. She also just happens to cover far less controversial issues if you're interested. Drinking coffee, when to cut the umbilical cord, why you don't need to freak out if you were drinking heavily the night the baby was conceived, etc (although I know some people will find every single one of these issues controversial, they just can't help themselves when it comes to trying to tell other women what they have to do to be a good mother. This woman-on-woman competitive mothering game is completely out of control). Overall, I think any to-be mother could benefit from reading this book. I know I came away with some things to really think about and I hope she writes more.