Review: Expecting Better
Aug. 17th, 2025 08:20 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
livingdebI found Emily Oster's Expecting Better: Why the Conventional Wisdom Is Wrong--and What You Really Need to Know (updated for 2019) in my closest little free library.
I am not pregnant, never have been, and never will be. The same is true for most of the people I know. So why am I reading this? For the same reason I read my favorite fiction--I like the main character (the author).
She does illustrate the principal that if you give a kid a hammer, everything's a nail. Her hammer is economics research: 'here is the thing: the tools of economics turn out to be enormously useful in evaluating the quality of information in any situation.'
She tries to teach her students 'that making good decisions--in business and in life--requires two things. First, they need all the information about the decision—they need the right data. Second, they need to think about the right way to weigh the pluses and minuses of the decision (in class we call this costs and benefits) for them personally. The key is that even with the same data, this second part--this weighing of the pluses and minuses--may result in different decisions for different people.'
In my own brain, the part about my own preferences is part of the data.
In this book, we get to see the data she found and also her opinions (rare in nonfiction). For example if you're trying to conceive (or trying not to), you might be interested in temperature charting. You take your temperature daily because the day after ovulation, it goes up a half a degree or more. 'The biggest issue is that it tells you only after you ovulate. So although it is useful for predicting the next month [if you're regular], it doesn't help with this month. Also, it's not as simple as it seems. To really make this work you need to take your temperature at the same time everyday, ideally first thing in the morning after four to five hours of continuous sleep. The results can get screwed up by jet lag, a fever, or a bad night of sleep.
'I liked this method a lot, if only because it enabled me to feel like I was doing something proactive every day (and because it produced data, which I could use to make attractive charts). The downside is that I was never especially good at it.’ Ha! Pretty charts!
Summarizing her research on prenatal yoga: 'the word on yoga is positive. So positive, in fact, that I even considered trying it. Once.' See, she's a character!
She decided to [try to] go without the epidural. It doesn't hurt the baby, and it greatly reduces pain, so why not? 'I'd summarize it as harder labor versus easier recovery.' As her husband (also an economist) summarized the data, 'It seems crystal clear that epidural lengthens labor, increases fever risk and worsens fetal position, very likely that it increases instrumentation [using the fancy salad tongs or plunger to get the baby out] and probably that it increases C-section.' And yet he would definitely choose it were he having the baby. Her 'mother, who had three children in a period when epidurals were not widely used, was especially incredulous. "They have drugs now!" she kept telling me, before launching into a description of her 96-hour unmedicated labor with me, which concluded with (in her telling) four orderlies pushing down on her stomach to get me out.' FYI, she succeeded in not getting an epidural, for both her kids.
And here's a fun psychology-related observation: 'One thing I quickly realized was that, by and large, women who want to avoid the epidural also want to avoid any other medical intervention. The natural childbirth community is negative on basically any medical interventions during labor--the epidural, yes, but also any other drugs during or after labor, fetal monitoring, any movement restrictions, and so on.
'The world really seems to contain two groups: those who would like to avoid any medical interventions, and those who embrace whatever is the standard birth practice. I had a strong instinct to want to align completely with one group or the other--I think this must reflect some basic human desire for group identity--but I didn’t want to do this blindly. I wanted to do it with evidence.'
I've only noticed this sort of thing once, for political parties. I didn't feel the need for a group identity, but I did wonder what I might be missing on issues I didn't agree with, especially the ones in the party that I was most likely to agree with.
Okay, here's one more fun quote for you. 'Planning for juice or sports drinks [during labor] may be a good idea for another reason [besides hospitals often don't let you bring food into the delivery room]: once labor gets going, you probably are not going to feel like eating. Marathon runners don't typically stop for a ham sandwich, and you probably won’t want to take a break for one either.'
Of course most of the book is about pregnancy-related research studies, so I won't be re-reading this. I looked up other books by this author on Goodreads, but they are all about parenting. And her professional publications are economics articles, so I'm done.
Have you enjoyed any nonfiction because of interesting or fun character(s)?
Disclaimer: I've read several travelogues (looking for interesting books set in other countries) and in general do not like them. Apparently it's common for people to travel to an exotic foreign land to find themselves, but be whiny, first-world snooty, and unappreciative of all the cool things around them the whole time, and then write a book about it. I mostly try to stay away from those books now.
I am not pregnant, never have been, and never will be. The same is true for most of the people I know. So why am I reading this? For the same reason I read my favorite fiction--I like the main character (the author).
She does illustrate the principal that if you give a kid a hammer, everything's a nail. Her hammer is economics research: 'here is the thing: the tools of economics turn out to be enormously useful in evaluating the quality of information in any situation.'
She tries to teach her students 'that making good decisions--in business and in life--requires two things. First, they need all the information about the decision—they need the right data. Second, they need to think about the right way to weigh the pluses and minuses of the decision (in class we call this costs and benefits) for them personally. The key is that even with the same data, this second part--this weighing of the pluses and minuses--may result in different decisions for different people.'
In my own brain, the part about my own preferences is part of the data.
In this book, we get to see the data she found and also her opinions (rare in nonfiction). For example if you're trying to conceive (or trying not to), you might be interested in temperature charting. You take your temperature daily because the day after ovulation, it goes up a half a degree or more. 'The biggest issue is that it tells you only after you ovulate. So although it is useful for predicting the next month [if you're regular], it doesn't help with this month. Also, it's not as simple as it seems. To really make this work you need to take your temperature at the same time everyday, ideally first thing in the morning after four to five hours of continuous sleep. The results can get screwed up by jet lag, a fever, or a bad night of sleep.
'I liked this method a lot, if only because it enabled me to feel like I was doing something proactive every day (and because it produced data, which I could use to make attractive charts). The downside is that I was never especially good at it.’ Ha! Pretty charts!
Summarizing her research on prenatal yoga: 'the word on yoga is positive. So positive, in fact, that I even considered trying it. Once.' See, she's a character!
She decided to [try to] go without the epidural. It doesn't hurt the baby, and it greatly reduces pain, so why not? 'I'd summarize it as harder labor versus easier recovery.' As her husband (also an economist) summarized the data, 'It seems crystal clear that epidural lengthens labor, increases fever risk and worsens fetal position, very likely that it increases instrumentation [using the fancy salad tongs or plunger to get the baby out] and probably that it increases C-section.' And yet he would definitely choose it were he having the baby. Her 'mother, who had three children in a period when epidurals were not widely used, was especially incredulous. "They have drugs now!" she kept telling me, before launching into a description of her 96-hour unmedicated labor with me, which concluded with (in her telling) four orderlies pushing down on her stomach to get me out.' FYI, she succeeded in not getting an epidural, for both her kids.
And here's a fun psychology-related observation: 'One thing I quickly realized was that, by and large, women who want to avoid the epidural also want to avoid any other medical intervention. The natural childbirth community is negative on basically any medical interventions during labor--the epidural, yes, but also any other drugs during or after labor, fetal monitoring, any movement restrictions, and so on.
'The world really seems to contain two groups: those who would like to avoid any medical interventions, and those who embrace whatever is the standard birth practice. I had a strong instinct to want to align completely with one group or the other--I think this must reflect some basic human desire for group identity--but I didn’t want to do this blindly. I wanted to do it with evidence.'
I've only noticed this sort of thing once, for political parties. I didn't feel the need for a group identity, but I did wonder what I might be missing on issues I didn't agree with, especially the ones in the party that I was most likely to agree with.
Okay, here's one more fun quote for you. 'Planning for juice or sports drinks [during labor] may be a good idea for another reason [besides hospitals often don't let you bring food into the delivery room]: once labor gets going, you probably are not going to feel like eating. Marathon runners don't typically stop for a ham sandwich, and you probably won’t want to take a break for one either.'
Of course most of the book is about pregnancy-related research studies, so I won't be re-reading this. I looked up other books by this author on Goodreads, but they are all about parenting. And her professional publications are economics articles, so I'm done.
Have you enjoyed any nonfiction because of interesting or fun character(s)?
Disclaimer: I've read several travelogues (looking for interesting books set in other countries) and in general do not like them. Apparently it's common for people to travel to an exotic foreign land to find themselves, but be whiny, first-world snooty, and unappreciative of all the cool things around them the whole time, and then write a book about it. I mostly try to stay away from those books now.