Expecting Better: Why the Conventional Pregnancy Wisdom is Wrong and What You Really Need to Know Paperback – 9 Aug. 2018

My sister recommended this book to me and now I want to recommend it to everyone expecting or trying for a baby, including men! It completely debunks all of the myths we’ve been fed about trying to conceive and what we should and shouldn’t be doing whilst pregnant. Using insights from sooo much research, it’s crazy that no one hasn’t thought to do this before. Game changer of a book!

The author of this book, Emily Oster, is an economics professor from the University of Chicago. I first heard about her on the Radio 4 programme 'More or Less', when someone was describing this book. She starts with the idea that in order to make sensible decisions about what to do and not to do when pregnant, you need information on the risks, combined with your personal information about what the pros and cons are.I think this is an excellent book. It doesn't set out the dos and don'ts, so if you're just looking for a list of rules to follow, or something that deals with every possible question, you're better off with 'What to Expect'. But if you want to know *why* you are being told to conform to so many rules, and the evidence behind them, this is a book for you.It's well written, and with a sense of humour as well as an analytical mind. It probably helps that I have a bit of an analytical background myself, and work with economists, but I think the language is easily understandable. It also includes plenty of anecdotes from her personal experience and that of her friends, which makes it very approachable, without compromising the information about evidence.She seems to have received most attention for her chapter on caffeine and alcohol, where she tries to separate out the risks of heavy consumption (bad in both cases) from the risks of low but not zero consumption. For instance, I had no idea that although caffeine consumption is linked to miscarriage, women who are nauseous are less likely to be drinking coffee, and nausea is a symptom that means you are less likely to miscarry. So it's possible (at least at low levels) that the women drinking coffee are just less likely to be the ones feeling sick.She seems to have received some criticism for saying it's OK to drink. She is emphatically not instructing anyone to behave one way or another, but instead presenting the evidence and the risks in a way that allows someone to decide for themselves. Personally, I really appreciate someone explaining what is going on, and what the evidence is for why you should do something - it makes much more sense to me than a simple rule that applies to everyone, when everyone is different.

This book is informative and reassuring - but mostly just makes you grateful that we have the NHS with its central and well evidenced guidance, versus what appears to be the Wild West of healthcare in the US. All guidance seems to be pretty in line with what the NHS tell you, however a digestible and easy to read way to read up on academic research into pregnancy and childbirth. Limited adaptation evident for the UK market. Not a book to prioritise if you’ve got a long list!

This book is written for women (like me) who are not satisfied with the overly-simplistic recommendations that are given to women during pregnancy. In my first pregnancy I got so tired of hearing "best avoid eating/drinking/doing it completely, just to be on the safe side" that I researched some of the evidence behind the recommendations myself. Although I often struggled to find (and sometimes understand) the evidence I wanted, I did find evidence that contradicted some of the recommendations I had been given (for example I was told to avoid eating peanuts which contradicts the latest research) and this made me distrust other advice. But I didn't have the time or academic skills to get all the information I felt I needed.Now I'm pregnant for the second time and I'm so glad to have found this book! The author has conducted a detailed investigation into the research on much of the advice given in pregnancy and childbirth and presents the risks and benefits so that the reader can make an informed decision on the risks they are prepared to take.Although the publicity around this book has focussed on alcohol and caffeine consumption in pregnancy, the book covers almost every recommendation (that I've come across) from eating sushi, to sitting in a hot tub, from which prescription drugs are safe to take, to whether to have an epidural during labour. For every issue, the author discusses the evidence and clearly explains what the statistics mean, but then also explains how she, when she was pregnant, made her decision and what that decision was. There are quite a few decisions, where the risks are so small or are not backed up by any credible evidence at all, that she gives her own recommendation (e.g. there's no evidence that dying your hair is at all damaging) but for the most part she does not tell the reader what they should or should not do. She explains the decisions she made and how she came to each decision but in many cases gives examples of friends who made different decisions to her and their reasons (such as home birth and epidurals).The only downside of the book is that, although it has been adapted for the UK market, it is still based on a woman's experience of giving birth in the US where healthcare around childbirth is very different. For example only 1% of women in the US have a midwife attending their birth and almost all babies are delivered by a doctor, but in the UK the majority of births are presided by a midwife with a consultant only being brought in for high-risk pregnancies or if there are complications.There were a few pregnancy recommendations which I had never come across, for example my midwife never discussed weight-gain with me (and rightly so given the evidence), and I was disappointed that the book did not discuss the risks of declining an induction at 42 weeks. The book also stated that women are rarely allowed to decline continuous monitoring during labour, which is not the case in the UK. Very worryingly, it was stated that, despite the evidence, almost all doctors would refuse to allow labouring women to eat or drink during labour (is it not against a person's human rights to deny them food or drink if they are hungry or thirsty?), which was not my experience, or that of any of my friends, giving birth in the UK.Despite the Americanisms, this book has been really helpful to me during my pregnancy and has enabled me to make informed decisions on how I can best protect my baby.I would, however, recommend first-time mothers read it alongside a book which more accurately reflects birthing practices in the UK.