I used to love pregnancy books — and get a secret thrill out them — but then I actually went through pregnancy. Now they piss me off.
When I first found out I was pregnant, my first response was not to buy a onesie, as several of my friends did. I didn’t sign up with a baby site, such as BabyCenter. I didn’t start thinking of baby names. I didn’t join an online pregnancy support group.
I wanted books. Fast. Lots of them.
I’m a data-driven person. I want to know what I’m supposed to do in any given situation, and what I’m not supposed to do. And I want to know why. I was growing an alien body inside my abdomen, and I wanted to know how that was going to happen and what I should do about it.
I quickly reserved as many books as I could from the library and became one of Amazon’s best customers. Friends gave me pregnancy books. Soon I had piles of books stacked on my night stand. I read them all. I wanted to know three basic things:
- What should I be doing as a pregnancy woman?
- What should I not do?
- What were the numerical risks associated with doing — or not doing — any of those things?
At first, decision-making was pretty easy because I was so consumed by morning sickness that seemed to last forever. I felt so awful that I didn’t want to do anything. I didn’t care about what I could eat or not eat, drink or not drink, exercise, sleep. My only goal was to make it through the day without puking.
Then I gradually felt a lot better, got more energy, and realized that I still hadn’t answered many questions about decision-making. I had to make choices about first-trimester screenings. Was I going to eat cold cuts at that afternoon’s faculty meeting? What about wine on Thanksgiving next week? How much should I be running? Should I run at all? What about if I can’t sleep? Does it really matter if I don’t lie on my side?
For a lot of those questions, I couldn’t get any hard and fast answers. Sometimes the answers contradicted themselves. But still I read on and on and on.
As the months went by, my pregnancy was fairly uneventful. But one thing that was omnipresent throughout was one feeling: guilt. I felt guilty for taking a prescription medication in the pregnancy category “C” for a mild infection, even though it was prescribed by my doctor. I did drink a glass of wine occasionally but felt guilty sometimes about it as well. I felt guilty for not gaining enough weight, and then in my third trimester for gaining too much. I felt guilty for secretly knowing that I would get an epidural, despite my natural childbirth training and my doula’s cautionary tales about the risks of induction. I felt guilty for changing the kitty litter once in a while when it got really disgusting and stuck up the house and my husband wasn’t there. I felt guilty for not getting more prenatal testing done — an amnio or CVS — given my age of 36. I felt guilty about not getting enough sleep. I felt getting for doing too many things, and then sometimes for doing too little. I felt guilty for not buying a million types of prenatal vitamins and supplements. I felt guilty for getting Strep B — whatever in the world that is — and then didn’t understand what the evidence said that I should do about it. I felt guilty about worrying about my pregnancy, because — as everyone knows — anxiety harms a fetus, right?
And when I was most desperate for answers — a week after my due date, when my OB/GYN said that I could not postpone induction any longer — the books failed me completely. I did not want an induction and refused it as long as I could. No matter what I read or who I asked, I did not have a clear picture of the true risks of waiting until labor started naturally. No one — not the books, not the doula, not my doctors — could give me any hard numbers. Finally, the night before my mandatory induction, nearly two weeks after my due date, I went into labor. Hard, fast labor. Less than two hours after feeling any labor pains, I was in the hospital, begging for an epidural. (Also telling my wonderful, kind doula quite harshly that, no, I did not want to labor at home. I would not do my breathing exercises. I did not want soothing music. I was not interested in the birthing ball. I did not want, for God’s sake!, to walk around with her. And, also, please don’t touch me because I do not want a back rub.)
An hour or so after that, I was fully dilated and pushing. Soon after that, I was signing release papers and being rushed into the complete chaos of yelling doctors and flying surgical tools of an operating room. I would have an emergency c-section because my son’s umbilical cord was too short and his heart rate had fallen dangerously low. I had been suddenly transported into an episode of ER, and not one of the romantic ones where George Clooney smiles a lot of dimply grins and kisses Julianna Marguiles in supply closets.(Do you remember that horrible episode in which the laboring mother died? Yes, that’s what was flashing through my head.)
I didn’t remember reading about any of this in the pregnancy books.
Next time, if and when there is a next time, there is only one pregnancy book that I will re-read. It’s Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong-and What You Really Need to Know by Emily Oster. In an earlier post, I sang the praises of her decision-making framework of balancing the costs and benefits, given your own tastes and preferences, of any pregnancy-related choice.
When Oster herself became pregnancy, she quickly discovered that “pregnancy medical care seemed to be one long list of rules” and that “being pregnant was a lot like being a child again. There was always someone telling you what to do.” Instead of telling a pregnant woman just how risky any particular behavior is, she is instead given “one-sizes-fits-all” and arbitrary rules. Oster concludes that pregnancy recommendations — and sweeping prohibitions — overall
“increasingly seemed designed to drive pregnancy women crazy, to make us worry about every tiny thing to obsess about every mouthful of food, every pound we gained.”
According to Oster, understanding the statistics — actual numbers and data — can make pregnant women a lot more relaxed about nearly everything and reassure them that their choices may differ from friends’ decisions because each woman has different values, different needs, and different life experiences. And that’s okay; they’re both being good future moms. For many choices during pregnancy — how much coffee to drink, whether to drink a glass of wine with dinner, if you’ll have that sushi roll, if you’ll plan to have an epidural — there’s no right or wrong answer that should apply to all women.
Through each chapter of the book, she lays out precise information about the current research findings suggest on a whole host of issues, from gardening to prenatal screening and home births to exercise and pain relief.
And that to me — information, facts, and data — is more calming than any prenatal yoga DVD, meditation workshop, or breathing exercise.
In a recent Time article, Oster tells women to “lean in” to pregnancy: do your research, ask for the data, ask questions about what you’re told to do and not do, figure out what’s best for you personally, and stop being passive. Just like Sheryl Sandberg, Oster is asking women to stand up and take responsibility for their choices. Come up with their own conclusions about what’s best for them and, based on the available evidence. Don’t accept the conventional wisdom because it’s not always right.
So finally this could be a type of “leaning in” that I could actually be good at and can really get behind.
If you know a pregnant woman, if you might get pregnant again, or even if just want good information about making decisions about reproductive health, pick up the book and spread the word. It comes out next week, August 20th!