Does One REALLY Have to Give Up Wine, Coffee, Sushi, and Dyeing One’s Hair…

…just to have a healthy baby?

I really wanted to like University of Chicago economist Emily Oster’s new book, Expecting Better. I’m well aware that many of the things that are standard procedure in American pregnancy and birth are not supported by good research (for example, continuous fetal monitoring during labor and the gestational diabetes test don’t seem actually to help either mothers or babies). But I was supremely disappointed by this book, not only because it has an annoying, “economists-know-best” tone, but because it seems fairly obsessed with what I’d consider trivial things and–like many American pregnancy books, actually–has no sense of where these things fit within the larger scheme of things. I do realize the danger of judging a book by what it doesn’t talk about, but the broader trend of things that were once matters for public reform and collective action becoming all about individual choices and personal ‘empowerment’ is troubling.

And it’s troubling when things like giving up wine or dyeing your hair for 40 weeks–even if the risks to the baby are minimal is construed as an unreasonable limitation on a woman’s freedom.

Or maybe I’m just a cranky-pants.

Anyway, here’s a bit from my review of the book at Her.meneutics. And no, I am not pregnant.

I’ll admit that I’m a little bit of a health nerd. I sometimes read through studies on websites such as PubMed and Cochrane Reviews to discuss medical decisions more intelligently with my doctor. (These sites post reputable medical information and analyses, with much less speculation and snake oil than many health websites.)

During my first pregnancy, I occasionally checked my doctor’s advice against the most current recommendations of the American College of Obstetrics and Gynecology. When she told me to monitor my heart rate during exercise to ensure it did not go over 140 beats per minute, I nodded my head but continued to follow the more current ACOG recommendation, which didn’t list a specific heart rate but instead indicated that I could exercise moderately. On the whole, however, I trusted and followed my doctor’s recommendations—even a few that turned out not to be supported by the newest and best research. Oh, well.

Emily Oster, an associate professor of economics at the University of Chicago whose work was featured in Steven D. Levitt and Stephen J. Dubner’s second book SuperFreakonomics, has written a new book, Expecting Better, that urges women to wrest control over their pregnancies from the partially incompetent hands of their doctors and other conventional sources of pregnancy advice, from the American College of Obstetrics and Gynecology to the omnipresent and imperious What To Expect When You’re Expecting.

The subtitle of Oster’s book—Why the Conventional Pregnancy Wisdom is Wrong—And What You Really Need to Know—might lead you to expect something along the lines of Ricki Lake’s Business of Being Born, but Oster does not wage war on the medical establishment to the point of suggesting that you eschew doctors entirely.

Instead, she contends that the typical American pregnancy is “a world of arbitrary rules.” She uses her training as a health economist to sift through the medical literature, attempting to separate the wheat from the chaff of pregnancy advice; to help women “take control and to expect better.”

{Continue Reading…}

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