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Controversial New Pregnancy Book: Is it Dangerous Advice?

Katlyn Joy |20, August 2013


On August 20, 2013, a controversial new book was launched on pregnancy and the behaviors we engage in that may or may not be risky to our unborn babies. The book is Expecting Better: Why the Conventional Pregnancy Wisdom is Wrong—And What You Really Need to Know.

The author of the new book is Emily Oster. Not Emily Oster, M.D. Not Emily Oster, RN or even Emily Oster PhD. Her expertise is as an award-winning economist and a professor at the University of Chicago. She decided that conventional advice to pregnant women seemed too cautious and outdated and went about reading studies with an economist's eyes and perspective.

The results are controversial to say the least. And likely, Oster is happy with that fact because nothing sells books more than a bit of controversy. But her premise is where the fatal flaw is. Her aim is to get women to be more relaxed and less fearful about lifestyle practices while pregnant, such as drinking.

Her response to what she deemed overbearing medical advice was to think not like a doctor but like a numbers cruncher. "The key to good decision making is evaluating the available information—the data—and combining it with your own estimates of pluses and minuses.

Personally, when I want a study on marketing numbers, or whether I made a good investment, I will seek the advice of a numbers cruncher not a doctor. But when I am carrying a child, I will lean on the advice of a doctor not an economist. And if I err on the side of caution, I'm far more OK with that than having a false sense of security about doing things I can do without for a few months of my lifetime.

Here are some of Oster's bits of wisdom on pregnancy habits:

On pregnant women drinking alcohol, she advises women in the first trimester to not worry about having a drink or two a day, and having a daily drink in the last two trimesters.

A diehard coffee drinker, Oster seemed especially determined to find studies that supported her habit. She acknowledges the difficulty in obtaining clear cut results, as countless studies have come up with conflicting results. Caffeine can cross the placenta, entering the fetus's bloodstream, and it isn't clear how the fetus processes it. In addition, researchers have speculated that caffeine can inhibit fetal development by limiting blood flow to the placenta."

It's better to gain more weight than less weight in pregnancy, since Oster reasons there are more serious side effects associated with an underweight baby than a large baby and how much weight a woman gains while pregnant has a huge impact on how large her baby will be. "The main concern with a very large baby is difficulty in delivery. Very small babies have an increased risk of breathing problems and neurological complications."

Oster also weighs in on exercise, "Most exercise during pregnancy is fine (no rock climbing!), but there isn't much evidence that it has benefits."

Off-the menu for pregnant women items like soft cheeses and deli meat, due to the concern over the food borne illness, listeria, was also number crunched with Oster deciding that the main culprit in recent outbreaks was queso fresco, a Mexican soft cheese and other random food items so she kept deli meats in her diet and cut out the queso.

The backlash is sure to come, as the reasoning is problematic. Most pregnant women would rather be cautious and feel OK with their choices, than resent being told what to do. It's more than a mathematical equation we are dealing with; it's our child. Most of us would rather do all we can to protect our child than enjoy our favorite vices during pregnancy.

Alcohol is probably the biggest no no on the list for good reason. While Oster cites Australian studies on behavior and IQ outcomes based on maternal drinking, she ignores so many other studies that implicate light alcohol consumption with stillbirth, miscarriage, preterm birth and SIDS. Maternal drinking is the number one preventable cause of birth defects and fetal brain damage in the US.

Gaining too much weight in pregnancy doesn't just yield large healthy babies, it is now linked with obesity later in life in both mother and child, according to newer studies.

Oster ignores the simple advice to avoid the most likely culprits in listeria, and doing the simple task of heating deli meat to prevent problems like miscarriage.

While the book may be controversial and fun to argue back and forth, every mother must decide whether it's enough to risk or best to abstain from some things in order to best protect baby.

Katlyn Joy is a mother to 7 children, and a freelance writer. She earned her Master of Arts in Creative Writing and Poetry, and a Bachelor of Arts in English and was previously an adviser to new mothers on breastfeeding through a maternity home program. She currently resides in Colorado with her family.

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