MAMACAN Book Club - Expecting Better by Emily Oster

Updated: Dec 14, 2019


There are quite literally hundreds of books about pregnancy (trust me, I’ve read a fair few of them!) but much like the title of this book, I was often left thinking there must be something better out there. Something anchored in knowledge, facts and science to allow you to make your own assessment, rather than the usual run-of-the-mill offering, re-hashing the same old advice with little or no evidence backing it up. Expecting Better by Emily Oster is the book I was looking for and I found myself nodding along to every word of the intro.

An economist by profession, on becoming pregnant, Oster very quickly finds that much of the medical advice surrounding pregnancy is woolly, restrictive and without foundation, leaving pregnant women (and their medical advisors) erring on the side of caution, tradition and risk aversion, for lack of a better alternative. Instead, she seeks to gather the information and data and allow the reader to combine it with their own personal estimates of pluses and minuses in order to make an informed decision for themselves. As anyone who has been pregnant will know, this is the opposite of how pregnancy related advice normally works: you are given no data, you are told what decision is best, and if you query it you run the risk of looking like a tricky dicky who is about to have social services called.

She covers all manner of topics pregnant women will commonly be seeking information on, from conception, the effects of alcohol, caffeine and smoking, diet, antenatal screening, medical interventions and miscarriage. She comprehensively gathers and analysis the data herself, presenting her findings in an accessible, often witty fashion, and almost uniquely in the pregnancy and parenting world, neutrally and without a whiff of agenda.

New discoveries are being published all the time about the mechanics of human gestation, but the findings are so rarely analysed and filtered through to government policies and NHS advice. For example, alcohol is not as dangerous as the NHS guidance and most midwives’ advice of total abstinence would lead you to believe. The studies repeatedly fail to bear out any harmful effects of light-to-moderate drinking and Oster articulates well the anti-science science of it "One phrase I kept coming across was 'no amount of alcohol has been proven safe' … this seemed to me to have two problems. First, too much of any goods can be bad. If you have too many bananas, the excess potassium can be a real problem. But no doctor is going around saying 'no amount of bananas have been proven safe!' … Second, what is all this evidence if not proof? It's exactly this type of evidence that leads us to conclude that binge drinking is problematic. But if you are willing to conclude that, why wouldn't you be willing to conclude that light drinking is fine? That is what the evidence shows."

In a world where medicine seems to bow to superstition with the stated intent of protecting the unborn baby, this book counters that approach with data. It allows pregnant women to step out of the realm of stupefied participant, to informed and central to their decision making process. Everyone, not just women, should read this book - and yes, I’m looking at you too Mr Opinionated Sushi Waiter.


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