Expecting Better – Emily Oster
A few years ago, when I decided to get pregnant in 2022, I started asking my friends who had already been through it for advice and book recommendations. Expecting Better was at the top of everyone’s list. I even saw it on my dentist’s waiting room table!
Given my background in research and data, this book resonated with me on a whole different level. Now, it’s my top recommendation for anyone seeking pregnancy advice. If you’re diving into the world of pregnancy, Expecting Better is a must-read!
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About Expecting Better
Expecting Better gives readers a fresh, evidence-based approach to navigating pregnancy decisions. Economist and author Emily Oster dives deep into the data and research, questioning many of the traditional beliefs and guidelines we’ve all heard about pregnancy.
Oster excels at breaking down complex research into easy-to-understand everyday language. She explains why some commonly accepted advice might be outdated or not even based on solid evidence.
From the beginning, she delves into the research on conceptionβwhat works, what doesnβt, and what the science really says. As you read the book, Oster tackles the ever-growing list of pregnancy “rules” we’re often bombarded with.
What makes this book stand out is how Oster doesnβt shy away from tough or controversial topics. She digs into the safety of medications during pregnancy and weighs the pros and cons of different childbirth options. Her straightforward, unbiased presentation of the evidence allows readers to make informed decisions for themselves.
Updated in 2021, Expecting Better now includes the latest data and research. Itβs the first in a three-part series on parenting, spanning about 300 pages and also available in audio format for those who prefer to listen on the go.
7 Interesting Things I Learned from Reading Expecting Better
As someone who spends a lot of time reading research articles about health and current medical standards, I consider myself well-informed. So, I was pleasantly surprised to find out that I didn’t have all the information and that this book could fill in quite a few gaps in my knowledge.Β
There is only about a 5-day window each month in which pregnancy is likely.
We all know the window for getting pregnant is tight, but Expecting Better really breaks down just how precise it needs to be. The best chance to conceive is the day before or the day of ovulation. Interestingly, the research Oster highlights shows that sperm can live up to five days inside the reproductive tract, so insemination a few days before ovulation might still work. However, once ovulation has passed, the chances drop to nearly zero.
This insight was crucial for me. With a limited supply of sperm, the timing was everything. While working with a fertility clinic, I had to track my ovulation and time the insemination meticulously. Missing that tiny window could mean wasting hundreds of dollars.
More than a quarter of pregnancies are lost at the early stages (often before pregnancy is detected).
One of the more sobering facts I learned from the book is that many pregnancies end before we even know theyβve started. A 1980 study discussed in the book found that about 22% of pregnancies are lost before theyβre detected, often just appearing as an unusually heavy period. Back then, without todayβs technology, these early losses went unnoticed.
Thanks to the advancements highlighted in Expecting Better, we can now detect pregnancies much earlier. This early detection leads to more reports of early miscarriages. However, this doesnβt mean that miscarriages are more common today. Instead, it shows that weβre now better at identifying them.
For me, this fact was a bit terrifying. Knowing that I only had a limited number of chances to conceive and carry a pregnancy to term added a lot of pressure. It took weeks for the reality of being pregnant to sink in and for me to feel confident about it.
Both caffeine and alcohol are OK in small, controlled amounts.Β
Moderation is key in so many areas of life, and Expecting Better reassures us that pregnancy is no different. Osterβs thorough research couldnβt find solid evidence against small amounts of caffeine and alcohol.
For caffeine, up to 2-4 cups of coffee a day (about 300mg) is generally considered safe, as explained in the book. Risks increase if youβre drinking 7-8 cups daily. When it comes to alcohol, Oster’s findings suggest that up to one drink a day in the second and third trimesters is typically fine, and less than one drink a week in the first trimester. The reasoning is that our bodies filter out the alcohol before it reaches the placenta.
However, since “one drink” can mean different things to different people, many professionals just say to avoid alcohol altogether. As a coffee lover, learning that I could still enjoy my morning brew without guilt, especially on those sluggish days, thrilled me. And while Iβve had the occasional glass of wine, I canβt wait for the day I can savor a pint of beer without any worries. Reading these insights helped me relax a bit about those rare indulgences.
Most forbidden food is due to the increased chance of contamination and not the food itself.Β
It often feels like the list of foods you should avoid during pregnancy is endless, but Expecting Better clarifies that the real issue is the risk of contamination, not the foods themselves.
Oster explains that food-borne bacteria and viruses like toxoplasmosis, salmonella, and listeria are the main concerns. These pathogens can show up in a variety of foods, from deli meats to spinach.
During pregnancy, your immune system is lower, making it harder to fight off these infections. If these bacteria or viruses cross the placenta, they can be very dangerous for both you and the baby.
Toxins, like mercury found in large fish, are another concern. High levels of these toxins can cause developmental issues for the baby. So, moderation is once again key. An occasional tuna sandwich or a bite of swordfish wonβt ruin everything.
Nausea is normal and can even be a good sign in pregnancy.
Most people expect some level of nausea during pregnancy, commonly known as morning sickness. What surprised me in Expecting Better was learning that nausea is often a good sign.
Emily Osterβs research found that having nausea in the first trimester is linked to a lower risk of miscarriage. In fact, if you donβt feel nauseous at all, it might be worth a conversation with your doctor, as it could sometimes indicate issues with pregnancy progression.
Even more interesting, some studies suggest that more intense and longer-lasting nausea can be a sign of a well-progressing pregnancy. Those queasy feelings mean the pregnancy hormones are active and doing their job.
So, while nausea isnβt fun, knowing it often signals a healthy pregnancy helped me cope a bit better.
There are alternatives to Aminosantese when detecting chromosomal abnormalities.
As an older mom-to-be, I felt convinced Iβd need an amniocentesisβa procedure where a needle samples amniotic fluidβto check for chromosomal abnormalities. The thought of this invasive test was pretty intimidating.
But Emily Oster explains some less invasive alternatives that were a real relief:
- NIPT (Non-Invasive Prenatal Testing): This is a simple blood test done as early as 10 weeks. It analyzes tiny fragments of fetal DNA in the motherβs blood. Itβs highly accurate for conditions like Down syndrome and carries no risk for the baby or me.
- First Trimester Screening: This combines a blood test with an ultrasound around 11-14 weeks. The blood test measures certain proteins and hormones, while the ultrasound checks the fluid at the back of the babyβs neck. Together, they give a reliable estimate of the risk for chromosomal abnormalities.
Learning about these options in Expecting Better was empowering. I discovered that I had choices beyond the invasive amniocentesis. It allowed me to talk with my healthcare provider about which tests made sense for me, based on my age and health.
Knowing I could opt for a less invasive approach made me feel much more in control of my pregnancy journey.
The virus found in cat poop is more likely in your garden than in your cat litter box.
As a cat owner, I worry about the risk of toxoplasmosis from cleaning the litter box. However, I was surprised to discover that garden soil poses a higher risk of toxoplasmosis than an indoor catβs litter box. The virus comes from eating raw meat, so unless your cat is hunting outside or is young and recently exposed, the chances of it bringing it into the house are low.
However, the book points out that your garden could be a different story. Itβs accessible to many wild animals that might leave behind contaminated droppings, and manure in soil is another potential source. So, if youβre gardening, gloves and a mask are good precautions.
These are just a few nuggets I gained from reading this book. Oster covers so much more, like the link between weight gain during pregnancy and birth weight. You might find it surprising, but gaining more weight during pregnancy often benefits you more than not gaining enough. Expecting Better is a treasure trove of information, making it a must-read for anyone on the pregnancy journey.
Recommend Expecting Better
Overall, Expecting Better is an invaluable resource for expectant parents who want to make informed and empowered decisions about their pregnancy.
I recommend this book to anyone on their pregnancy journey. We all need to make our own decisions, and it is great to have informed information about what each of those decisions could be.
There has been some criticism of this book, as Emily is not a medical doctor and has not conducted any research herself. However, as a fellow research scientist, I can speak to the level of training and education we undergo to become critical examiners of existing research.Β
For more book reviews, check out my list of all the books I’ve reviewed so far.
