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Expecting Better: Why the Conventional…

Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What… (original 2013; edition 2014)

by Emily Oster (Author)

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923190,355 (4.2)1
Title:Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know
Authors:Emily Oster (Author)
Info:Penguin Books (2014), Edition: 1, 336 pages
Collections:Your library

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Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong―and What You Really Need to Know by Emily Oster (2013)

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Recommended by (and borrowed from) Hilary W.

A pregnancy book by an economist? In the words of Amy Poehler...yes, please! Emily Oster's point of view could be boiled down to "more information is better than less" (p. 204), and I agree. Chapter by chapter, she examines conventional wisdom and advice pregnant women and new moms receive from their doctors, and seeks out the sources for that advice. Are recommendations based on the results of reliable studies? Oster finds out what the best and most current research says about everything from caffeine and alcohol consumption to weight gain to sleep positions to epidurals. Both useful and reassuring.

xii Evaluate quality of information - decision science
xvii "probably fine" is not the same as a number
xx weak studies --> conventional wisdom
xxii information and preferences (p. 40 w/ the right info, I can make the decision myself)
6 numbers are not the same as interpretation
34 opinions are not the same as agreements
39 coffee and alcohol - 1 drink/day in 2nd and 3rd trimesters OK
71 12 week social norm (p. 72 chart)
88 good fish (high in omega 3s, low in mercury)
140 birth weight related to pregnancy weight gain SGA/LGA
162 sleep positions, "impractical advice"
183 premature birth - find out the NICU level of your hospital. 3C/4 is best/highest
194-195 avg. woman w/ 1st child goes 8 days past due date; 70% of all babies born before due date
196 births by week of gestation: about 10% at week 37, about 19% at week 38, about 26% at week 39, about 8% at week 40
198-199 effacement is a better indicator than dilation. cervical check, Bishop score
202 Pitocin may increase labor pain and risk of a C-section
204 More info is better than less
218 (1) early labor (1-3cm) can be hours/days, active labor (3-7cm) is slower, transition (7-10cm) is quicker (2) pushing (3) placenta
222 if breech, try ECV
233 epidural: good pain relief, lengthens labor, increases fever risk, worsens fetal position, increases risk of emergency C-section, increases use of instruments (forceps/vacuum), slower recovery
242-243 Water allowed, clear energy drinks e.g. gatorade also. Usually no food, but no evidence of danger. Eat before hospital!
248 continuous fetal monitoring is TMI! Intermittent (every 20 min) is better
252 NO routine episiotomy!
258 vitamin K shot standard for baby. antibiotics in eyes? donate cord blood? ( )
  JennyArch | May 17, 2015 |
As a social scientist and newly pregnant woman, I really appreciated this evidence-based approach to managing health and decision-making during pregnancy. And the author didn't once refer to me as "Mommy." Many thumbs up, highly recommended. ( )
1 vote being_b | Feb 2, 2015 |
The basics: The subtitle of Expecting Better really says it all: why the conventional pregnancy wisdom is wrong--and what you really need to know. Emily Oster is a health economist, and in this book she offers up her analysis of what the data behind the pregnancy rules (the good, bad and unnecessary). While she offers her decisions, she also leaves room for the reader to make her own informed decisions about her pregnancy.

My thoughts: Expecting Better made headlines when it came out last August. I vividly recall the NPR headline "Pregnant? It's okay to have a glass of wine*" with the asterisk indicating "according to an economist." Which is true, but also according to doctors across Western Europe and Australia, but I'm getting ahead of myself. In August, we were still in that very frustrating stage of trying to get pregnant, so I purchased the book for my Kindle and impatiently waited until I was actually pregnant, which blessedly finally happened in December 2013, to start reading. Then I discovered the first section is about getting pregnant. Live and learn.

I'm not a fan of arbitrary rules, and being pregnant is no exception. Some are obvious, of course, but before I blindly follow rules, I want to understand the why, and that's what Oster does in Expecting Better. When I talk about being pregnant with women 20-30 years older than I am, they are quick to tell you all the things they were allowed to do that are forbidden now (soft cheese, steak cooked less than well-done, cold cuts, etc.) And as they're always quick to point out, my kids turned out okay. Admittedly, as much as I wanted a baby, I was never looking forward to actually being pregnant. I'm a sushi-eating, rare-steak loving, blue cheese devouring, wine-drinking fool. Nine months without them? It sounded unpleasant. I won't go as far to say I'm happy to do it, but if it's really putting my baby in danger, of course I will avoid things. If, however, there isn't a good answer to the "why?" question, then why make myself even more miserable if it's not helping my baby?

I'll let the data in Expecting Better speak for itself. I didn't make all the same choices as Oster did, but that's the beauty of this book: it's not about the advice; it's about the data. It's about equipping yourself with the right information so you (and your partner) can make informed decisions about your pregnancy. Oster distills it for you, but she also features extensive citations so you can read the actual data for yourself when you're so inclined.

As hard as it is, I avoid red meat that isn't well done (and that one is getting harder as grilling out season gears up.) I avoid unpasteurized cheeses (I did thankfully find a great pasteurized Stilton to satisfy my blue cheese craving.) I eat sushi. I eat runny eggs. I drink a glass of wine most nights (only twice a week in the first trimester.) I even have one glass with lunch and one with dinner on occasion. I cut back on caffeine in the first trimester, but I never cut it out. We opted not to do first trimester prenatal screening, which surprised me. I'm opting for an epidural.

The verdict: Expecting Better is a must-read for pregnant women, women trying to get pregnant, and anyone interested in the science of pregnancy. As an economist, Oster brings a Freakonomics-style approach to analyzing pregnancy data. She also brings her personal experience of being pregnant (plus many stories from her sister and friends, who often received different information from their different doctors.) I read it in a single day (the day I found out I was pregnant), but I've continued to refer to it throughout my pregnancy, particularly when people try to tell me not to eat cold cuts or enjoy my pregnancy-portion of wine. It's a book I'll keep giving to my pregnant friends for years to come. ( )
2 vote nomadreader | May 9, 2014 |
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To my sweet Penelope, who inspired this book, and to my mormor, who would have loved to meet her.
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In the fall of 2009 my husband, Jesse, and I decided to have a baby.
As unpleasant as it is, nausea is a sign of a healthy pregnancy. Miscarriage rates are much lower for women who are nauseated than for those who are not. In early pregnancy the differences can be quite large: one study showed that the overall risk of first-trimester miscarriage was 30 percent for women without nausea, versus just 8 percent for those who were nauseated.

Knowing this, the sicker I felt in the morning during my first trimester, the happier Jesse was. There is nothing quite like waking up, feeling terrible, and having your spouse tell you how excited he is that you feel bad. I don't think I've ever seen him quite as happy as the one day I actually threw up.
Pregnancy seemed to be a world of arbitrary rules. It was as if when we were shopping for houses, our realtor announced that people without kids do not like backyards, and therefore she would not be showing us any houses with backyards. Worse, it was as if when we told her that we actually do like backyards she said, "No, you don't, this is the rule." You'd fire your real estate agent on the spot if she did this. Yet this is how pregnancy often seemed to work.
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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. Rules for prenatal testing are hard and fast--and unexplained. Are all of these recommendations right for every mom-to-be? Here, the author shows that pregnancy rules are often misguided and sometimes flat-out wrong. Pregnant women face an endless stream of decisions, from the casual to the frightening. Expecting Better presents the hard facts and real-world advice you won't get at the doctor's office or in the existing literature.… (more)

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