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

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:

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.

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