Expecting Better

I had been meaning to read this for forever, and I'm glad I finally did! I knew of Emily Oster from my J-PAL days, where I helped draft a policy brief about her menstruation in Nepal study (which gets a mention in the book!). Woo! That was 2011 or so, and I remember, when this book came out, being like, “Oh, she wrote a pop econ book? Oh wait, it's about pregnancy?!”

While I tend to think that high-flying economists (which Oster definitely is one!) have a TOO HIGH tendency to assume that, since they're high-flying in economics, they must be good at everything, I do - at the same time - agree with her basic assumption that having a background in academic economics gives you a useful decision making paradigm and some general literacy for reading academic articles and parsing quantitative research. Oster turns those skills to the Pregnancy Industrial Complex (PIC), and it's great - doctors do, after all, have a strong incentive towards being conservative, for fear of malpractice and generally things going tragically wrong. Patients, likewise, have a tendency towards imperfect compliance. And thus we have blanket, all-or-nothing statements about alcohol, caffeine, and so on.

This book is basically a giant lit review of pregnancy-related medical research, written in a fun, warm, pop tone. I found it mostly heartening and reassuring since, well, the PIC is scary and there is SO MUCH social judgment around pregnancy and parenting. Everyone seems to have found Jesus on this topic, and it's hard to separate fact from passionate belief. To epidural or not to epidural, etc. To that end, I liked that Oster offers (mostly) non-judgmental information and advice, with the overall message being, “You have your own risk tolerance, here are the facts.”