Even Economists Can't Tell Us What to Expect When We're Expecting
I'll admit that I'm a little bit of a health nerd. I sometimes read through studies on websites such as PubMed and Cochrane Reviews to discuss medical decisions more intelligently with my doctor. (These sites post reputable medical information and analyses, with much less speculation and snake oil than many health websites.)
During my first pregnancy, I occasionally checked my doctor's advice against the most current recommendations of the American College of Obstetrics and Gynecology. When she told me to monitor my heart rate during exercise to ensure it did not go over 140 beats per minute, I nodded my head but continued to follow the more current ACOG recommendation, which didn't list a specific heart rate but instead indicated that I could exercise moderately. On the whole, however, I trusted and followed my doctor's recommendations—even a few that turned out not to be supported by the newest and best research. Oh, well.
Emily Oster, an associate professor of economics at the University of Chicago whose work was featured in Steven D. Levitt and Stephen J. Dubner's second book SuperFreakonomics, has written a new book, Expecting Better, that urges women to wrest control over their pregnancies from the partially incompetent hands of their doctors and other conventional sources of pregnancy advice, from the American College of Obstetrics and Gynecology to the omnipresent and imperious What To Expect When You're Expecting.
The subtitle of Oster's book—Why the Conventional Pregnancy Wisdom is Wrong—And What You Really Need to Know—might lead you to expect something along the lines of Ricki Lake's Business of Being Born, but Oster does not wage war on the medical establishment to the point of suggesting that you eschew doctors entirely.
Instead, she contends that the typical American pregnancy is "a world of arbitrary rules." She uses her training as a health economist to sift through the medical literature, attempting to separate the wheat from the chaff of pregnancy advice; to help women "take control and to expect better."
As an economist, Oster contends that women should simply be presented with the evidence and statistics to make decisions for themselves. This is a tough claim, because no matter how hard this English/biblical studies major tries to make sense of peer-reviewed medical studies, the bottom line is that it takes serious chutzpah to believe that a few hours' online research is going to put me in a position to decide that's superior to my doctors'. Further, it's hard to ignore the direct advice she herself dishes out in her own book. Each chapter of Excepting Better includes bullet-pointed "bottom line" list that clearly runs counter to this claim, plus countless arguments colored by Oster's own biases and preferences.
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