We should all Expect Better, and then ask some more questions

admin — Tue, 20 Aug 2013 19:54:00 +0000

Yes, I know about Emily Oster’s new book released today that questions conventional pregnancy wisdom.Yes, I think her work is quality and that a social scientist’s interpretation of the data around pregnancy restrictions and recommendations is much needed in our discourse about women’s health.

Yes, I agree with a number of her conclusions–namely, that moderation is key. One of my favorite lines is “It isn’t that complicated: drink like a European adult, not a fraternity brother.” I think the most important conclusion that I share in common with Oster is that neither of us is actually making recommendations for other women’s pregnancies–we both study, research and investigate common pregnancy do’s and don’ts to navigate our own pregnancies and make our own decisions. In the end, though, readers should be left to their own decision-making mechanisms. In the case of my work, at least, I just hope they’re armed with enough information to make a decision based on knowledge and not fear.

Yes, Joe Scarborough makes my head hurt:

Emily Oster on Morning Joe

Do I think Oster’s work scooped my own project on the politics of pregnancy? No.

After a couple of weeks of indigestion, I calmed down and realized that the major do’s and don’ts that Oster tackles in her work are typically about ingestion and exposure to a long list of substances traditionally banned from pregnant women’s diets and lifestyles: alcohol, caffeine, raw milk cheese, hair dye, exercise, etc. She applies an economist’s eyes to the randomized trials and peer-reviewed research out there on these topics and comes to her own conclusions about the restrictions that seem hysterical and those that seem reasonable and evidence-based. Applying reason to pregnancy? Kudos to her.

I also tackle some of these debates, particularly when it comes to food and drink restrictions. For instance, I examine KRAFT’s involvement in lobbying for stronger pasteurization regulation and discuss how this shaped the average American’s taste for cheese.

But the do’s and don’ts of pregnancy include so many more decisions than randomized trials can help us study. There are decisions about the medical care you choose–an OB or a midwife?–which raises questions about the increasingly prominent role of insurance companies and medical associations in these matters. Then there are often difficult conversations to be had at work when first announcing a pregnancy and thinking ahead to negotiate leave entitlements, given our nation’s historical failure passing paid family leave legislation. Even finding out the sex of the baby can easily be politicized, with gendered assumptions and a blue-pink dichotomy that not only confuses history, but defies the logic of the color wheel itself. And, as I’ve discussed, there are child care concerns that parents have to consider far before the baby is born–that is to say, during pregnancy.

These are the questions that my book is going to answer. Building on Oster’s excellent work for sure, but asking a set of questions that asks how we got to this place of misinformation and fear in the first place.

You can’t fix something unless you know what exactly is broken.

Considering childcare

admin — Mon, 19 Aug 2013 21:23:00 +0000

Alissa Quart has a piece in The New York Times today that looks at the financial burden, and often impossibility, of child care on American families. Given that one of my chapters tackles exactly this topic, it piqued my interest. Why would a book on the politics of pregnancy discuss post-birth child care? Because we put our son on a daycare waitlist five months into our pregnancy—twenty months later, our number (a pessimistic 35) has not budged.

If parents are lucky enough to gain admission for their children, Quart discusses the crushing costs. Citing research from University of Massachusetts at Amherst sociologist Joya Misra, she writes that the cost of center-based day care surpasses one year of tuition at a public college in thirty-five states, as well as DC.

But it’s not only the price tag that has parents in despair. Despite resounding evidence that investing in young children’s care reaps huge social benefits, the United States is currently suffering from a severe scarcity of decent day care facilities. A survey conducted by the National Institute Child Health Development deemed only ten percent of facilities to be “high-care” nationwide and a recent cover story for The New Republic by Jonathan Cohn described the overall quality of day care in our country as “wildly uneven and barely monitored, and, at the lower end, Dickensian.”

An expose like this, on the dismal state of American child care, surfaces once every year or so. In general, comparisons are made to other industrialized nations, where states invest heavily in quality child care facilities and parents are even offered tax incentives if they stay home to take care of their own children, given that it is considered to save the state a huge sum of money.

Pamela Druckerman also discusses the American day care dilemma in her comparison between parenting in France and the United States, Bringing Up Bebe. As an American expat in Paris, she compares the quality of care that her first daughter receives from state run crèches with day care back home in the States.

At least half of any crèche’s workers, Druckerman writes, must pass rigorous tests in reasoning, reading comprehension, math, human biology, and psychological reasoning. Another quarter must have degrees in health, leisure or social work.

But what really wins Druckerman over with her own daughter’s experience in the crèche is its dining experience. Again, the rumored four course meal: “a cold vegetable starter, a main dish with a side of grains or cooked vegetables, a different cheese each day; and a dessert of fresh fruit or fruit puree.” Lunch is prepared by an in-house cook from scratch each day. Soon Druckerman admits to thinking of her daughters’ caregivers as the “Rhodes Scholars of baby care.”

The first day cares were established during the Industrial Revolution in both countries, because women simply had no choice but to leave their homes and enter the workforce. Horror stories of children being tied to bedposts all day while their mothers worked in factories became so common that the crèche was established in France in the mid 1800s. News of this arrangement spread to States soon thereafter. In France this child care system was seen as a state investment in helping create responsible new members of society, and enabled mothers to participate in the workforce with confidence that their children were in good hands.

In the U.S., however, born more out of necessity and continued for dubious reasons such as “Americanizing” the children of immigrants, child care never developed as an institution that could help socialize children into well-adjusted, independent and developmentally advanced individuals, as it did in other industrialized nations.

We do ourselves a disservice if we just think that this set of circumstances that conspire to disproportionately punish women in the workforce are happenstance. American day care is so dismal because the state has long seen the care of children outside of the home as inferior to a mother’s care—the proper place for a woman is in the home, tending to her children’s needs, so significant state subsidies have been nearly unimaginable for the majority of our country’s history.

Let’s not even deign to discuss the wild possibility that a father might also be considered a parent. When the government collects data on parents and work life balance, for instance, the mother is termed the “designated parent” and the father is a “childcare arrangement.” Yes, you read that right.

How might things have evolved differently in this country had our government established an agency that oversaw child care facilities, similar to the Mother and Infant Protection service that the French state formed after World War II? What might it take to convince our state that child care is a responsible investment, given the huge social benefits to not only children, but their working parents and the economy as a whole?

I’m not quite sure what my husband and I would have done had we not had an amazing network of family to care for Desmond while we both worked full time. He really hates bedposts.

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We should all Expect Better, and then ask some more questions

Considering childcare