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PREGNANCY AND CHILDBIRTH is one of the most consequential and stressful things that most women go through.
Given the potential dangers, and the fact that people are committing to 9-months of pregnancy followed by 18 or so years of child rearing, anxiety and caution are understandable.
Understandable caution too often ends up turning into excessive self-denial.
When University of Chicago professor Emily Oster got pregnant, she expected it to be similar to her professional life, a situation where there was good data, plenty of information, and a good basis for herself and her husband (also an economist) to make an informed decision.
She found a massive set of rules, and a lot of studies and doctors mixing up correlation and causation. Her own research, applying the data literate and occasionally skeptical eye of an economist to pregnancy ended up turning into a book, Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong – and What You Really Need to Know, which is coming out this week.
Here are a few highlights from the book, which is definitely worth picking up for anyone who’s considering or having a child for the expanded data and the coverage of pregnancy from conception to birth.
Alcohol and coffee are fine in moderation
We covered this in more detail in a previous post, but blanket prohibitions on either of the above are misguided. A few cups of coffee a day are fine, Oster finds, and continued her four-cups-a-day habit through pregnancy. As much as a glass of wine a day is fine after the first trimester, and a couple a week are fine even then.
Up to two cups are supported as fine by pretty much all evidence, most evidence supports three to four, and even for larger amounts of coffee, the links to miscarriage may be due to the fact that these women were less nauseous, which can indicate other issues.
And as for alcohol, heavy drinking and binge drinking are very much to be avoided. There’s no good evidence that light drinking hurts a baby.
Sushi is fine, and you should eat more, not less fish
The list of prohibited pregnancy foods is vast, and recommendations can be vague and contradictory. Oster took a closer look, and found a few bans don’t hold up to scrutiny.
Do avoid raw/rare meat and poultry, deli turkey (other deli meats are ok), unwashed fruits and vegetables, and queso fresco/raw milk cheeses. The first two put you at risk of toxoplasmosis and the latter two, listeria, both potentially very bad for your baby.
Sushi, though care should be taken to avoid high mercury fish, turns out to be fine. So do raw eggs. They may contain bacteria, but it’s not of a type that’s worse for pregnant women. Just don’t eat suspect discount sushi or a raw eggs from an old carton.
High mercury fish are bad, but many others are not only low in mercury, but high in beneficial omega-3s, which can boost IQ. The effect holds to the point where people that eat tons of fish have smarter kids on average, despite more mercury exposure. Avoiding it all together is a particularly poor outcome.
Skip canned tuna, eat lots of sardines and other little fish.
You can clean a litterbox and dye your hair, but don’t garden
Food bans are only the start. Women are also cautioned against flying, hair dye, hot tubs, gardening, and cleaning a cat’s litter box.
The fears over litter boxes focus on toxoplasmosis, but the likelihood of contracting it that way is quite low, especially if the cat is tested. The risk of contracting it from gardening is quite a bit higher. If you’re working with soil, consider a mask and use gloves.
Unless you’re a hairdresser, or injecting the stuff, hair dye isn’t a concern. You don’t absorb enough when simply colouring your hair.
The conventional wisdom about weight is wrong
The question of weight gain is particularly stressful, with many doctors giving women a hard time about gaining too much weight. Though the idea that you’re “eating for two” is wrong (you need to eat a bit more, but not a ton more) gaining a bit too much weight isn’t all that big of a deal. Most women manage to take it off.
Targeting some weight then worrying about being a pound or two over isn’t productive. Even 10 or 15 pounds over isn’t really important. If you gain more weight, the baby will be slightly larger on average. If you gain less, the baby could be smaller. Gaining too little weight and having an undersize baby is a larger concern.
“But mostly chill out,” Oster writes.
Exercise doesn’t really matter
Some women are encouraged to exercise, mainly due to concerns about weight. On average, women who exercise during pregnancy don’t end up changing their end weight all that much, and there’s not much evidence that there are other beneficial effects. Basically, most women should just keep doing what they’ve been doing, avoiding over-strenuous exercise or anything that might result in falling.
Bed rest doesn’t prevent premature birth and is bad for you
Preterm birth is fairly common, and can have significant negative impacts. Preterm babies get ill more easily, have lower IQs on average, and occasionally hearing or vision problems, though survival rates are much, much higher than they used to be.
Bed rest is frequently advised for people that could go into preterm labour, but there’s no real evidence that it works.
Not only that, it has negative consequences, including restricting women from working or doing much of anything to help their families, along with potential bone loss, muscle decay, and possibly decreased birth weight.
Doctors know this, but still often prescribe bed rest. The conventional wisdom has hung on, against the evidence.
Find Expecting Better here.
- Max Nisen
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Funny how we all got here before modern medicine stepped in.and the paranoia that companies use to sell there baby products is crazy.after kid number 3, I’m happy their catching the knives by the handles when juggling.
Knives are one thing, but chainsaws are a totally different matter.
As a rule, women should avoid juggling chainsaws at all stages of pregnancy whether they catch them by the handles or not.
Especially when the chainsaw is running.
Bob, up to the twentieth century and modern medicine, childbirth was always dangerous and frequently fatal for mother and child.
Thanks Joe, very important point.
Breaking news: economist writes book outlining for the umpteenth time the obvious dos and donts for pregnancy and claims to be the pregnancy sage of the world.
Seriously, every single one of these points are in every existing pregnancy book. Many of which are written by obstetricians and genuine professionals in the field.
Hippoctateeth:
No, she made no such claim.
Is it obvious how much a woman can drink in pregnancy? No and it can cause a lot of anxiety. Better to know the facts.
No, every one of those points is not in every pregnancy book though each may be in *some* book. She is pointing out that some of the advice touted has little or no scientific basis.
Disagree. Being currently pregnant I’m only too aware of the “restrictions” one should apparently put on oneself. No deli meat, no undercooked eggs, oily fish once or maximum twice a week, don’t dare drink more than 200mg coffee a day and whatever you do don’t even sniff a glass of wine or you’ll condemn yourself to judgement aplenty and your child to certain doom.
I, thankfully, am fairly immune to scaremongering and like to think I have a fair share of common sense but still, have discovered there’s a switch in the female brain which flicks at the moment of discovering a pregnancy which turns on a mild sense of paranoia and potential for self-blame if anything at all were to go wrong. Kudos to the author of this book for breaking down the research into something most women can digest and use in an attempt to stay sane through a very doubt-riddled, responsibility-laden period of time!
On my last pregnancy I read that in the US, it is considered almost a mortal sin to lie on your back in bed whilst pregnant. Mother of God! If you were to take on board all the advice, you’d be a shrivelling wreck by the end of it. Common sense, moderation in everything and maintaining a sense of enjoyment in life: makes for a happier you & ergo a happier baby.
We have had three and most of the nonsense we read about for the first has been erased. We had the 2nd and 3rd at home. Midwife didn’t make the 3rd it happened so fast. Three healthy kids, healthy parents, happy home.
People have been having babies for longer than there has been doctors… or economists! Dont fret, do what feels nature and everything in moderation.
Hairy lemon, people had also been losing babies and dying in much higher numbers before midwives! Doctors are a relatively new introduction to childbirth historically speaking!
Every single pregnancy is different. Your can’t say definitively that your pregnancy week be perfect if you cut out alcohol, coffee, certain dairy etc and did everything by the book (Pardon the pun) As my mother in law tells me there werent any of those “rules” when she was pregnant and all her pregnancies were fine. I actually laugh at the hospital when I see women and men reading these books coz there’s nothing that prepares you for cramps, twinges and movements never mind when the baby is born and you have a little person who takes over your life. First one is the learning curve and if you’re blessed enough or mad enough to have more, chances are both the pregnancy and baby that follow will be a whole new learning curve but at least you know whats ahead.
Exercise doesn’t matter? Hmm.
I thought the same thing! We aren’t advised to exercise just to lose weight,it is beneficial for when you are in labour and during the delivery. In fact,if you didn’t exercise before becoming pregnancy,it is highly unlikely that you would be advised to start during your pregnancy.
I think that was strictly in relation to weight gain during pregnancy. Certainly I know a lot of women who while staying fit still put on more weight than they “should” according the the books… Without a doubt that fitness helped them in a multitude of other ways though :)
This book was not just written for pregnant women and dads to be, but the general public also who feel they have a right to express an opinion on a woman’s pregnancy, weight, alcohol consumption, exercise, etc. I am qualified to say this being 6 months pregnant right now on my 2nd baby. I am so tired of listening to other people’s opinions, values, suggestions…some based on old wives tales and nothing more.
The point about eating fish to boost IQ was debunked over a year ago. A number of food and drinks companies hijacked some research on Omega3 oils and their beneficial effects for some people with brain developmental problems was used to promote it being of use for everybody.
The original researchers came out publicly a year or two ago to point out there was NO evidence for it to boost IQ in kids or adults with normal intelligence.
Mythbusters managing to sustain myths?
Alan, are you sure about this? I just did a Google and immediately found two studies published this year which found a correlation between Omega3 consumption and higher IQ in children.
20 years ago I was researching into Dyslexia for my first daughter, I read many papers and found one where Omega3 may help children with Dyslexia. Back then I found only one chemist shop that carried it in liquid form from some Scandinavian country. When I explained to the chemist what it was for she got excited too, and did her own research. The problem was though that it was very hard to get a consistent reliable source as no one knew of Omega3! All the research I did said nothing about boosting IQ
Do what feels you comfortable and what makes you feel relaxed. Wine, baths, hot tubs, not a lot of excercise, lots of good food, no fags, the occasional pint of stout all worked wonders for me and by extention, my three healthy babies.
We were advised to have a pint of stout or glass of sherry while breastfeeding in the evening to help the milk supply. Worked wonders.
FFS margaret – wine and stout? I can only imagine that you must have had your babies some time ago. It certainly isn’t recommended by health authorities and doctors these days, despite what this article says.
Seriously? People still read these books? There’s a huge wealth of free information on the internet, reliable information at that. When I was pregnant, if there was something I wanted to check up on, Google let me know what’s what.
Also, if it wasn’t for the internet, I would never got as far in breastfeeding as I did.
On my third pregnancy and the list of do.s and don’ts from the hospital has grown by a page each time, common sense goes a long way. As for these women spending months preparing their birthing plan I have to laugh, the only plan you can trust is that there is a baby inside you and the baby Will have to come out all the scented candles and mix tapes in the world are not going to matter when the time comes.
This is dangerous and ignorant to suggest that alcohol is fine during pregnancy. Alcohol is a toxin and can have adverse effects on the developing fetus brain. The nine months of development in the womb areprobably the most crucial in the growth of a healthy baby. you can see what adverse effects alcohol can have in fully grown adults, even in low doses it effects the brain, hence it’s illegal to drink and drive,. How is it going to effect a tiny fetus. To suggest that there hasn’t been evidence light drinking effects a baby just means they haven’t been able to pinpoint the effects not that they don’t exist. Toxins in the womb can effect brain development and perhaps lead to depression later. It’s ridiculous to think that something that doesn’t naturaly belong in the body might not have effects on a baby.
I think when they say alcohol is ok theyre not suggesting you go out and get locked every weekend or anything… I would have a few drinks in both my pregnancies and my 2 boys are perfect. I certainly didn’t put them in any danger by having a few drinks.
Totally agree. I had a glass of wine a few evenings a week with my dinner and sometimes a glass of guinness when out with friends, and my son is perfectly fine. I was active and ate well (and very varied – as far as I’m concerned you just need to make sure everything you eat is very fresh… but shouldn’t that be the case even if you’re not pregnant?) Unless people have been consciously trying to conceive then many will have been out for a few drinks at the weekend in the early weeks without realising.
What caused my blood pressure to rise however were 1) the french guy who seriously berated me one day while I was watching Ireland v France rugby in a pub with friends and a glass of guinness, and 2) the “concerned” american couple who came over to interrupt a lunch with my mother to tell me they were horrified that I was heavily pregnant and drinking a beer. The fact that I could point out to them that it was alcohol-free didn’t even dissuade them from the fact that it was still wrong. This is five years ago and these incidents still kind of bug me!
What a waste of breath. She’s repeating stuff that everyone knows, and claiming to be the fount of all knowledge.
With a few dangerous bits thrown in to excuse her addictions (loads of coffee is fine, it might not always cause miscarriage, and even when it definitely does, it isn’t really the coffee’s fault)
It’s nearly all common sense anyway, and the bits that aren’t have been said over and over by ACTUAL experts
If you can feel the effects of the alcohol then so too can the little defenceless foetus. Alcohol passes through the umbilical cord and can have an affect on the baby at any trimester. Foetal alcohol syndrome is a condition that babies can be born with as a result of their mothers drinking while pregnant. Yes the symptoms vary with some children showing minor symptoms, but child’s ability to learn can be affected as well as facial abnormalities and behavioural problems. Why take the risk. We don’t need alcohol while pregnant, baby should be first priority.
If a physician make those claims, he/she can lose the practice and face a severe law suit. You can not compare data from clinical trials without standardize the samples and methodology, which in the case of medical research is almost impossible. Pls don’t make this another case like the “vaccines causes autism”. Trust in your health care provider more than anything.
On a similar vein, this is an article from The Atlantic magazine where a scientist did the same thing; used her research background to look into decisions around her own pregnancy, and specifically birth.
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