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Zusammenfassung von Expecting Better

Name: Expecting Better
Rating: 3.9 (77 reviews)
Author: Emily Oster

Emily Oster

Why the Conventional Pregnancy Wisdom is Wrong and What You Really Need to Know

3.9 (77 Bewertungen)

25 Min.

Themen

Women's Health & Maternity Self-Help Self-Care

Inhaltsübersicht

Expecting Better
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What’s in it for me? Practical and pragmatic guidance through the labyrinth of pregnancy.

If you’re pregnant or planning a pregnancy, it’s easy to be overwhelmed by all the restrictions and guidelines. Maybe you’ve been told to cut out coffee and cold cuts, but you have no idea why. Maybe your doctor scolds you every time you gain a bit more weight than is recommended for pregnant women, and you’re paranoid about how it’s going to affect the baby.

During her own pregnancy, the author, Emily Oster, found that women are usually given a list of accepted rules to abide by without any explanation or scientific evidence. So she decided to evaluate the data, an endeavor made considerably easier by her experience as a leading economist. In the end, she discovered that, more often than not, these rules were either misguided or downright wrong.

These blinks unveil Oster’s discoveries, debunking myths and untangling the more convoluted aspects of pregnancy, from conception to gestation to labor.

In these blinks, you’ll learn

whether or not you should have that glass of wine;
the risks associated with prenatal screening and invasive testing; and
why TV water-break scenarios can be misleading.

Using the basic tools of economic decision theory, you can make informed choices about your pregnancy.

When leading economist Emily Oster got pregnant, she found that every decision came with a strict set of dos and don’ts. She was wary of believing recommendations or opinions that weren’t supported by reliable evidence, but much of the available information was flawed or contradictory.

Her doctor also tended to offer edicts instead of answers. When Oster asked her obstetrician about certain medical or lifestyle choices, she expected to receive an outline of potential risks and benefits, along with supporting evidence. Instead, there were rigid guidelines: “amniocentesis is only for women over 35” or “pregnant women should quit drinking coffee entirely.” Oster wondered how many of these guidelines were simply arbitrary social norms perpetuated by misinformation.

So she put her economic decision-making principles to use and waded into the world of prenatal medical care.

An economist’s framework for making decisions requires two things. The first is good data, which was lacking in most pregnancy books and articles. For example, having one or two drinks per week was “probably fine,” and prenatal testing was “risky.” But what did “probably fine” and “risky” mean numerically? For concrete numbers, she had to go directly to the source: the academic medical literature that the official recommendations were based on.

Pregnancy research ran the gamut, from high-quality studies and trials to low-quality ones, and Oster was well-trained in differentiating between the two. Because economists don’t always have access to randomized trials – the gold standard for research – they tend to be experts in gleaning information from observational data. Studying pregnant women and alcohol, for example, a researcher couldn’t ethically require subjects to drink. She could glean observational data from those women who do it anyway, though. Applying this skill to pregnancy research, Oster found that many recommendations were based on not just flawed studies, but on overly cautious interpretations of those studies.

The second element of an economist’s framework is an assessment of the costs and benefits of a decision. Of course, this is a highly personalized matter, especially when it comes to pregnancy. After all, different women have different preferences and value different things. But it’s nonetheless helpful to have a clear idea of what a decision’s costs and benefits might be. With that information, women can make smart decisions instead of blindly following recommendations.

In the following blinks, you’ll find the conclusions Oster came to after unearthing research on the many aspects of pregnancy. Some of her findings support conventional wisdom; others challenge or outright disprove it. The evidence won’t make your decisions for you, but it will help you to take control, think critically, and make your own informed choices.

Reviewing the research paves the way for a smooth pregnancy.

If you’re trying to get pregnant, you probably have plenty of questions. How old is too old to get pregnant? Does taking birth-control pills affect fertility? There are lots of things to consider while planning your pregnancy, and there are others that you shouldn’t be too worried about.

Age, for example. Are your eggs really “best used by 35,” as one paper offensively phrased it? Not at all. It’s true that fertility declines with age, dropping off precipitously after you turn 40. However, in a study of 2,000 women trying to conceive, 36 percent of those over 40 got pregnant within a year.

The first trimester of pregnancy comes with lots of big decisions – and some fears.

If you’re anything like most women, you’ll spend at least part of your first trimester concerned about miscarriage. It’s scary, so if someone tells you to avoid certain things during pregnancy, it’s better to be safe than sorry, right?

Not necessarily. For example, despite popular opinion, alcohol, coffee, and sushi don’t need to be purged from your diet.

A good decision framework is vital when it comes to decisions about prenatal testing.

To prenatal test or not to prenatal test? And if so, how? This is one of the more emotionally fraught decisions for many pregnant women, and there’s no right answer.

What exactly is it, though? Well, prenatal testing detects chromosomal abnormalities such as Down syndrome. There are two testing methods: prenatal screening and invasive testing.

The second trimester brings various decisions, including whether or not to find out the sex of your child.

Each stage of pregnancy carries its own unique characteristics and concerns. In the first trimester, you’re adjusting to a change in lifestyle; in the second, you’re in the thick of it and things like exercise and healthy eating are especially important.

Too many doctors go overboard when looking at weight gain, though, scolding their patients if they’re even just a few pounds over the recommended weight. In reality, unless you’ve gained a lot more than the recommended amount of weight, it’s a much bigger concern to have gained too little. A mother’s weight gain affects her baby’s weight, and babies who are small for gestational age face an elevated risk of complications such as diabetes and lower cognitive skills. The most significant complication for large for gestational age babies, by contrast, is the increased chance of needing a C-section.

In the third trimester, it’s time to tackle any big problems and make decisions about delivery.

In your third trimester, the risk of complications is the highest of any point in your pregnancy. That makes it more crucial than ever to arm yourself with solid information – there’s no better way to face your worries.

One of the biggest of these is premature birth. Many doctors recommend bed rest as a way to avoid this, but there’s no evidence that it actually works. Nor is it worth risking bone loss and muscle atrophy, two common side effects.

Know the detailed timeline of labor before you arrive in the delivery room.

The timeline of labor is usually presented vaguely, with something like, “could be a few hours, could be a whole day.” But there are three distinct stages to labor, each with its own potential complications.

Stage one has two parts, dilation and active labor, and it can take days or even weeks.

When it comes to preferences during labor and delivery, one size doesn’t fit all.

As you research birth practices, you might notice a stark divide between women who want medical intervention when they give birth, and those who don’t. There is a middle path, though.

Consider pain medication. Most women in the United States opt for it, but it can complicate the birth process. For instance, an epidural, which is usually administered during the first stage of labor, numbs the lower half of your body. It can’t harm the baby, but because you can’t feel anything or move around much, the baby might not get into the right position.

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Worum geht es in Expecting Better?

Expecting Better (2013) gives moms-to-be peace of mind by cutting through the haze of pregnancy myths and laying bare the real facts. Author Emily Oster, a leading economist, challenges and reevaluates conventional wisdom so that you can make your own decisions for a happy and healthy pregnancy.

Bestes Zitat aus Expecting Better

Im not crazy about the implication that pregnant women are incapable of deciding for themselves – that you have to manipulate our beliefs so we do the right thing.

—Emily Oster

Wer Expecting Better lesen sollte

Expectant mothers or people planning a pregnancy
Anyone looking for concrete facts about pregnancy and childbirth
People overwhelmed by all the pregnancy decisions they need to make

Über den Autor

Emily Oster is an American economist and professor at Brown University. She is also the author of the best seller Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, from Birth to Preschool.

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