August 19, 2013

New pregnancy book OKs coffee, wine and sushi

Author of 'Expecting Better' says data doesn't support some mainstream advice.

By LEANNE ITALIE/The Associated Press

(Continued from page 1)

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Emily Oster, author of "Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong-and What You Really Need to Know." (AP Photo/Penguin Press, Matthew Gilson)

AP

Isn't that what the American Congress of Obstetricians and Gynecologists is for? They have committees to vet research and keep up to date.

Yeah, it is, and actually in a lot of cases I found that women would do quite well to read the ACOG opinions. There were a few cases where I thought perhaps they were overly cautious but actually there's a lot of settings in which I think that would be a great place to start. There are certainly times in which practice hasn't really caught up to those 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. That's something you need to learn to think through on your own.

That leads me to the vices, including alcohol. You and ACOG differ on that one. ACOG recommends no alcohol.

 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. In some other countries the recommendations are it's OK.

When in this country did pregnancy become this exercise in self-denial? Are women needlessly suffering?

I think sometimes. 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. I think that's great. But I think there is, sometimes, this kind of shaming aspect to pregnancy. That's maybe not so productive.

The editors at Parents.com have already called some of your recommendations flat-out dangerous to pregnant women, particularly your views on alcohol and caffeine consumption.

Many of the OBs that I have spoken to and many of the women who I have talked to about the recommendations from their doctors have told me that the doctors say, 'Yeah, it's fine to have a couple glasses of wine.' This is a conversation which will continue to evolve.

What were some of the surprises when you started digging into the research?

One thing that came up that I found quite surprising is that a number of women that I knew who have been pregnant were put on bed rest. When I started looking into that more I found the evidence doesn't really support any benefit from bed rest in terms of preventing preterm labor. I think that lately doctors have started moving away from that pretty extensively. It has some negative impact, particularly around issues of muscle atrophy and other medical reasons.

Should women trust their doctors?

 Absolutely. But women have a responsibility to learn things about this process for themselves so they can actively participate in this conversation with their doctors.

What are your top five fallacies about pregnancy?

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, when I looked at the data on this, 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.

 

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