Friday, September 20, 2013

Book Review: Expecting Better by Emily Oster

Title: Expecting Better
Author: Emily Oster
Publisher: Penguin Press
Publication Date: August 20, 2013
Source: copy received from the publisher via NetGalley for an honest review

Plot Summary from Goodreads:

Pregnancy is full of rules. Pregnant women are often treated as if they were children, given long lists of items to avoid—alcohol, caffeine, sushi— without any real explanation from their doctors about why. They hear frightening and contradictory myths about everything from weight gain to sleeping on your back to bed rest from friends and  pregnancy books. Award-winning economist Emily Oster believes there is a better way. In Expecting Better, Oster shows that the information given to pregnant women is sometimes wrong and almost always oversimplified, and she debunks a host of standard recommendations on everything from drinking to fetal testing.

When Oster was expecting her first child, she felt powerless to make the right decisions for her pregnancy. How doctors think and what patients need are two very different things. So Oster drew on her own experience and went in search of the real facts about pregnancy using an economist’s tools. Economics is not just a study of finance. It’s the science of determining value and making informed decisions. To make a good decision, you need to understand the information available to you and to know what it means to you as an individual.

Take alcohol. We all know that Americans are cautious about drinking during pregnancy. Official recommendations call for abstinence. But Oster argues that the medical research doesn’t support this; the vast majority of studies show no impact from an occasional drink. The few studies that do condemn light drinking are deeply flawed, including one in which the light drinkers were also heavy cocaine users.

Expecting Better overturns standard recommendations for alcohol, caffeine, sushi, bed rest, and induction while putting in context the blanket guidelines for fetal testing, weight gain, risks of pregnancy over the age of thirty-five, and nausea, among others.

Oster offers the real-world advice one would never get at the doctor’s office. Knowing that the health of your baby is paramount, readers can know more and worry less. Having the numbers is a tremendous relief—and so is the occasional glass of wine.

This groundbreaking guidebook is as fascinating as it is practical.

My Review:

Apologies in advance for the limited potential audience for this review book, readers.  However, when I first heard about this new release from Emily Oster (mostly through countless emails/texts from my friends that said "This is YOUR pregnancy book!"), I knew I had to read it ASAP.

Pregnant ladies, throw away your copy of What to Expect When You're Expecting, because Expecting Better is...better.

When I was pregnant with Small Fry, I often found myself frustrated with the advice in traditional pregnancy books.  WTEWYE, in my opinion, is basically a user's manual for everything that can potentially go wrong in your pregnancy--and often with no true indication of how likely/unlikely that is.  Others are somewhat better (my personal favorite was Your Pregnancy Week By Week), but still included annoyingly specific pregnancy diets (does anyone actually follow those?) and week-by-week ranges for how much weight you should have gained (spoiler alert: I was always (ALWAYS) heavier than the recommended range...woo, ego boost!).

Doctor's advice can help to counter the confusing info in these books, but is often just as difficult to interpret.  I remember asking my OB if I needed to avoid hot dogs due to listeria risk during pregnancy.  Her answer: "Well, in all my time as an OB, I've only seen one woman get listeria during pregnancy, so I think you are fine to eat them."  This cleared up nothing for me.  How long has she been practicing?  (Am I her 10th patient and that one listeria case happened last week?)  Did that one patient get listeria from hot dogs, or from something else?  I ended up avoiding them completely, much to my ballpark-frank-loving dissatisfaction.

Okay, so given all that, let's talk about Expecting Better.  If you want to really know the whys for all those pregnancy rules, this is YOUR pregnancy book.  Emily Oster is an economist, and approached her pregnancy with an economist's view of the rules.  So if her doctor told her that she couldn't drink alcohol--she wanted to know why.  She went into all the medical studies surrounding the topic, gathered the findings, and helpfully compiled them here for you to read.  She does NOT rewrite the rules, or tell you what you should/shouldn't be doing during your pregnancy.  Instead, she presents you with the scientific findings for each question, and it is then up to you, as the babymaker, to use those findings to make informed decisions.

Oster covers a long list of topics here: alcohol/caffeine/smoking during pregnancy, the foods that are most likely to include a listeria risk (not what you would think), the true risks involved with sleeping on your right side/left side/back, proper amounts of exercise, pros/cons of an episiotomy, etc.

Admittedly, some parts can get a little dry (this is a compilation of scientific studies, after all), but I learned more from this book than I did from every other pregnancy guide combined.  I feel like a smarter, more informed baby-baker.  Does this mean I'm going against all of my doctor's advice because of what Oster wrote?  No.  But it does mean that I can ask smarter questions when I'm having discussions with her during appointments, and can advocate more clearly for myself in various labor situations.  For that alone, this book is worth its weight in gold.

It is true that Oster has been slaughtered a bit in the media for going against the "traditional" pregnancy advice in some areas.  For example, her research on drinking during pregnancy shows that a few drinks in moderation do not have negative effects on the fetus--definitely NOT what your doctor usually tells you.  However, as I said earlier, the thing I like about this book is that Oster is not telling you to drink.  She's putting the facts on your radar, and then it's your job to use that information to make your own decisions.  I'd like to think I'm an intelligent person, and as such, I appreciate the fact that this book empowers me to use that intelligence in my pregnancy decision-making.

I think it's safe to say that every pregnant (or hopes-to-be-pregnant) woman should read this book.  It will give you a better understanding of your pregnancy, and allow you to make better decisions for your baby--who doesn't want that?

What's your favorite pregnancy "manual"?  And if you're not interested in pregnancy or being pregnant, tell me something awesome about penguins, or something.  Haha...


  1. Wow, I'm not interested in pregnancy and I do know that penguins have on the order of millions of feathers per square inch of their body, but I'm still super impressed by your description of this book. I adore self-help books that are unbiased and grounded in research and this sounds like it was done very well.

    1. Glad you liked the review, AND I appreciate the penguin fact! :)

  2. I think I was in the middle of a couple pregnancy books when I got pre-eclampsia, so I ended up reading preemie books instead! I reaaaallllly hate being told what to do with no reasoning or research to back it up, so if I were to ever get pregnant again (likely not) I'd probably go get this one! Great review.

    1. Oh yikes! My mom had pre-eclampsia with me, scary stuff. Well I hope this manual will help you more if there is a next time. :)

  3. While not necessarily something I need right now, I'd like to put it on my future tbr list. Your review was so helpful in seeing how this book sets itself apart from others. My doctor actually told me that an occasional drink was okay. I was so shocked to hear that. I have a friend right now who's pregnant and her doctor said the same thing. BUT when she tried to have a glass of champagne on her wedding anniversary, the restaurant refused to serve her.

    1. My OB for my first pregnancy made the comment about the occasional drink as well, which was shocking to me--but the OB I have now is very zero-alcohol. It varies so much by doctor sometimes.

  4. I wish this would have been around when I was making people!

    1. Haha, it would have been quite helpful indeed! :)

  5. I don't plan on being pregnant for quite a while (if ever), but this book sounds like a great resource!

    1. Definitely take note for the (possible) future! :)

  6. I'll be putting on the list for "later in life" but have some people I may be sending this to fairly soon ;) I think it's interesting that the abstinence study included heavy cocaine users…. Obviously, that was not a good control factor!

    1. Agreed! That's a big reason why I always look at standalone statistics with skepticism. Until you have a better sense of how the study was conducted, you can't take numbers like that at face value.

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