Emily Oster isn’t a baby doctor. She’s an economist and a mom who wanted to know more about all those rules handed down to women after the pregnancy stick goes pink. Only two cups of coffee a day! No alcohol. Beware deli meats.
Being pregnant, she said, felt a lot like being a child, so she decided to take a deep dive into research. What she found was some of the mainstays of pregnancy advice are based on inconclusive or downright faulty science.
To this data-cruncher, an associate professor in the University of Chicago’s business school, those magical nine months became a question of correlation and causation.
Some of her conclusions? Light drinking is fine (up to two glasses of wine a week in the first trimester and up to a glass a day in the second and third trimesters). And much of the evidence supports having three to four cups of coffee daily, which made Oster very, very happy.
And she happily reports in “Expecting Better,” her book corralling all the research for other women to share, that her 2-year-old daughter, Penelope, is healthy and happy.
A conversation with Oster:
Q: Are most pregnant women ill-informed? Are doctors and other pregnancy professionals lax in keeping up to date on research that might lead to more specific recommendations?
A: I actually think pregnant women are really well-informed, but I think that there’s a tremendous amount of confusing and conflicting information out there.
Q: Isn’t that what the American Congress of Obstetricians and Gynecologists is for? They have committees to vet research and keep up to date.
A: Yeah, it is, and actually in a lot of cases I found that women would do quite well to read the ACOG opinions. A lot of the choices that women need to make in pregnancy, it’s sort of not possible for ACOG to tell them the right answer.
For example, if you think about prenatal testing you’re thinking about a case in which you’re trading off more information about the baby for some small risk of miscarriage. Ultimately that needs to be combined with women’s own ideas about how they feel about a miscarriage versus how they feel about a developmentally delayed child and that’s not something a recommendation can tell you.
Q: That leads me to the vices, including alcohol. You and ACOG differ on that one. ACOG recommends no alcohol.
A: I think we can all agree that heavy drinking and binge drinking, even occasionally, is very dangerous, and I certainly say that in the book. What I found is there are a large number of quite good studies with a lot of women that show having an occasional glass of wine does not seem to pose a problem, that children of pregnant women who drink occasionally have similar or in some cases even better outcomes than children of women who abstain. This is a very personal choice.
Q: When in this country did pregnancy become this exercise in self-denial? Are women needlessly suffering?
A: I think we’ve moved this way over time and in some ways it’s very good, thinking through pregnancy and parenting in a thoughtful and careful way. But I think there is, sometimes, this kind of shaming aspect to pregnancy. That’s maybe not so productive.
Q: What are your top five fallacies about pregnancy?
A: One is that much of the evidence suggested an occasional drink is OK. Bed rest is not a great idea. Gaining too much weight may in fact be less risky than gaining too little weight. Sushi is OK. And coffee in moderation is fine.
And in terms of toxoplasmosis, which is a parasitic infection that can cause birth defects, there’s actually no evidence that women who clean the cat litter box or have cats are more likely to get this, but I do see some links between doing a lot of outdoor gardening and having this infection. There are all kinds of animals that might poop in your garden. Not just cats.