Expecting Better and millions of other books are available for site site. Mayo Clinic Guide to a Healthy Pregnancy: 2nd Edition: Fully Revised. Emily Oster is a professor of economics at Brown University and the author of Cribsheet:A Data-Driven Guide to Better, More Relaxed. Online PDF Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--And What You Really Need to Know, Read PDF Expecting Better: Why the. Emily Oster writes Expecting Better, a rational pregnancy book that Better - Why the Conventional Pregnancy Wisdom is Wrong" as PDF.

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Title: [PDF] Download Expecting Better Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really, Author: anyldsgs, Name. PDF-DOWNLOAD Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--And What You Really Need to Know Popular Collection by Emily Oster. Better đ đ đ. HOW TO FIGHT THE. PREGNANCY ESTABLISHMENT. WITH FACTS But what I didn't expect at all is how much I would put the.

Your earlier cycles may be longer and may not lead to ovulation.

But it has no long-term effects on fertility. Women going off the pill were less likely to get pregnant in the first 3 months, but just as likely within a year. Duration of pill usage has no effect on fertility or time to return to normal cycles. Women who used IUDs took a month longer to get pregnant than women who stopped using the pill but otherwise were the same.

Detecting Ovulation Temperature Charting In the first half of your period cycle, your temperature will be low, usually below 98 degrees F. Check your temperature when you wake up, before you get out of bed and move around. Travel, jetlag, and fevers can affect this. So odds are decent. Cervical Mucus Right before you ovulate, your cervical mucus will be stretchy like egg whites better for sperm to swim through.

The day when it transitions to this form is a good day to try conceiving. To do this, reach into your vagina and run your finger around the cervix. The benefit of this method is you can detect the day of ovulation in your current cycle, vs temperature charting which detects changes only after. Some women combine this and temperature charting. Ovulation Detection Sticks These pee sticks detect luteinizing hormone, which peaks the day before ovulation. Chapter 3: The Two-Week Wait After you ovulate and try to conceive, it takes about 2 weeks to see if you have your period.

What do you do in this time — namely, can you drink alcohol or caffeine, and eat deli meats? Kill too many cells and the embryo will fail to develop. But the false positive rate is very low.

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Normally this ends in what appears to be a heavy period. Fun fact: hCG used to be detected by injecting urine into infantile mice or rabbits that were then dissected. If the urine contained hCG, the animals would ovulate.

Some organizations now collect urine from pregnant women to extract hCG for fertility treatment. Remember that weeks in pregnancy are counted from the time of your last period.

So 5 weeks in is 1 week past your missed period. In perhaps the most controversial part of Expecting Better, Oster argues that caffeine and alcohol, in moderation, show no evidence of being harmful to the child. To cut to the chase: Pregnant women can drink alcohol 1 drink a day in the second and third trimesters, and 0.

Smoking is never OK. Poor Studies and Why Myths Exist A common problem in pregnancy studies is insufficient controls for confounding factors. Picture a study where you divide the population of mothers into abstainers and drinkers, then study their kids.

If you picture the type of woman who has 0 drinks a week vs 2 drinks a week vs 10, you can already imagine differences in education, wealth, and location. What does this say about miscarriage rate? The results of these poor studies are further warped by popular media, and before you know it myths start perpetuating. The gold standard study is the randomized controlled trial, where people are randomized into a control group and a treatment group.

Another reason cautionary guidelines exist is that doctors fear a slippery slope — if they tell someone that one drink a day is ok, then they might creep up to drinks per day. Oster finds this understandable but also patronizing. Alcohol The common conception is that no amount of alcohol is safe during pregnancy.

Oster argues a more nuanced approach. The main concern is fetal alcohol disorder, which manifests in cognitive symptoms like developmental delays and learning difficulties. Binge drinking more than 5 drinks at a time is clearly bad. This is broadly confirmed by the literature. Your body is capable of processing a regular amount of alcohol per hour, and below a certain amount, the fetus may be unaffected.

Biologically, the body metabolizes alcohol into acetaldehyde, and then into acetate.

Oster argues the acetaldehyde is the toxin that impacts development. It also seems that alcohol itself causes oxidative stress, neuronal structural defects, and alterations in gene expression. Either way, the more alcohol and byproducts you have floating around, the more the fetus is damaged. The arguments in favor of light drinking not being a big deal: Generally studies show no impact of drinking up to 1 drink per day on preterm birth, child IQ, test scores, behavior problems.

In fact, many studies find women who drink moderately have kids with higher IQ scores, but this is likely not causal and may instead correlate with education or social factors. She also argues that 1 of 14 children with FAS had a reported exposure of just 1 drink per day, so mild drinking can still lead to FAS.

In contrast, invasive tests have, but pose a risk of miscarriage according to Oster, 1 in Then testing may just cause undue anxiety. If so, then you might just skip to the invasive test anyway. Spoiling the punchline: The sensitivity true positive rate is remarkably high — in one large-scale study, The false negative rate is also low, at 0.

Given your age, then, what is the likelihood of your child having Down Syndrome depending on your result? Oster provides this very helpful chart: Technical note: When the baseline rate is high and the test is positive, chances are better that the test is correct, compared to younger mothers. Conversely, the detection rate for younger women is also lower, because otherwise healty women are told not to worry if they get a negative result.

An additional second trimester test draws blood and tests for alpha-fetoprotein, hCG, unconjugated estriol, and inhibin A. CVS is performed earlier between weeks, while amniocentesis is done between weeks. The accuracy of both tests is very high Oster neglects to put numbers to this, violating her complaint about doctors. The risk of miscarriage is the worrisome part — inserting the needle might hit the fetus or pierce the placenta.

Common wisdom puts the risk of miscarriage at 1 in Oster argues this number is outdated and based on research from the s, which found a non-significant increase of miscarriages from 3. With better procedures using ultrasound to guide the needle , Oster believes the risk of miscarriage is now closer to 1 in , if there is any risk at all. However, one factor may increase risk — the popularity of cell-free DNA testing has lowered the need for CVS, and practitioners may become rusty.

So if you want to get invasive testing, go to someone who still does them often. Now equipped with this information, you can make a choice about risks and what you gain. The invasive test has a chance of miscarriage of 1 in If yes, then proceed to the invasive test. For her second child at age 35, she believed the risk of miscarriage was less important now that they already had one child, and she chose to have amniocentesis in the second trimester.

As Oster stresses, this was her personal choice, not what she dictates for everyone.

A quick run-down of common activities barred during pregnancy: Cats present a risk for toxoplasmosis only during their first exposure. If you have kittens when pregnant, you increase risk. There is a strong association between working with soil and toxoplasmosis. So if you garden, wear gloves and maybe a mask. High dosing in animals leading to birth defects is probably what popularized this misconception.

A study of hairdressers found a small significant increase in low-birth-weight babies, but this was not replicated and may be due to other things like standing a lot. Hair dye is likely safe, particularly after the first trimester.

Raising your body temperature above degrees in the first trimester increases risk of gastroschisis and anencephaly, a neural tube defect. Hot tubs and Bikram Yoga are around degrees, as are very hot days, so avoid in the first trimester.

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After the neural tube forms in first trimester, it may be safer. A Spanish study did find that very hot days seemed to induce labor earlier by about 5 days. Go nuts. The cervix is more sensitive, so hitting it may induce some bleeding, which is normal. The recommended limit on radiation exposure for the duration of pregnancy is 1 mSv millisievert.

This is conservative, with experts suggesting there are no definitive data showing fetal harm at doses below 20 mSv. Oster does note that exposure to twice this limit might increase the risk of the child having a fatal cancer by 1 in 5, How does this translate to flying? A single 4-hour flight would deliver at most 0. And flight attendants receive around 1.

How about airport security? A single screening has a maximum of 0. But you can always opt for the pat-down. For fun, here are radiation dose examples: Weight gain is a top topic for your prenatal care visits. Gain too much or too little weight, and the child is at risk and your doctor will probably complain.

Here are the guidelines for suggested weight gain over pregnancy: But both have concerns: Eating too little in pregnancy could cause the fetus to be smaller for gestational age SGA , causing these effects: Eating too much in pregnancy could cause the fetus to be large for gestational age LGA , causing these effects: Another concern is that too much weight gain may cause your child to be overweight later in life.

Expecting Better by Emily Oster – review

This has been shown in animal studies, with a possible mechanism being insulin resistance in the womb leading to insulin resistance in life. But this is hard to control from environmental factors and parent habits, and Oster argues the effects are small.

One long-term study found that for every kg Mom gained, BMI increased by 0. One study found that women who gained the recommended amount ended up 5 lbs heavier 6 months after delivery. And gaining 1 pound over the guideline 36 instead of 35 pounds is not a big deal.

Oster argues doctors should weigh concerns more heavily toward too little weight gain, when currently they balance the two equally. My OB listened and then put a little note in my file. There is little evidence suggesting that exercise has effects on preterm birth, rate of C-section, length of labor, or baby APGAR scores. Exercise does show a modestly lower weight gain 1. Sleeping may be tough in later pregnancy due to aches and positioning. The recommendation is to sleep on the left side, not the back.

The evidence is currently inconclusive — some studies show sleeping on the back or right side doubled stillbirth rate. However, a blood flow study found that lying on your back found no particularly bad impact on blood flow. Some women feel faint on their backs — if so, then they should switch to their left side.

Taking OTC sleep aids like Unisom are fine. The baby is exposed to most drugs the mother takes, except for large molecules eg heparin and drugs that get stuck in the placenta eg buprenorphine.

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Drug safety is hard to test in pregnant mothers because of ethical concerns. Trauma remains from the use of thalidomide in the s leading to thousands of infants with birth defects and thousands of deaths. Early-term is between weeks, and full-term is 39 and beyond. Over the past decades, survival for preterm babies has increased dramatically due to improvements like assisted ventilation lungs develop later in pregnancy.

Their IQs were points lower. Chances of a preterm baby are thus sizable but still in the small minority. Oster argues there is no evidence that bedrest works at preventing preterm birth. It also entails risk from taking leave from work and medical risks like muscle atrophy and weight loss.

This scary chapter goes through major complications of pregnancy in the third trimester, their consequences, and treatments. Oster did not include the baseline rates for these and risk factors, so I did the research and add them here thus any inaccuracies are not her fault. Note the vicious cycle here — placenta previa leads to C-sections which increases risk of placenta previa. Mother produces antibodies that can cross placenta and lead to destruction of fetal red blood cells. Painless dilation of the cervix before reaching term.

Poor fetal growth, usually due to poor nutrition or inadequate oxygen to fetus. Symptoms include headache, abdominal pain, sudden weight gain. Placenta forms an abnormally firm and deep attachment to the uterine wall.

Starting at week 37, your doctor will measure your cervix for a few predictors of labor: Bishop score and cervical effacement are predictive of vaginal deliveries.

Oster argues that Pitocin may increase pain in labor and increase risk of C-section, which is why she was willing to wait until the very last moment to induce. Vaginal births after C-section may increase infant complications and maternal hemorrhage. Babies are normally delivered head-first.

Coming feet-first is called breech, and it carries risk of oxygen deprivation to the baby or injury to the skull. Thus, most breech babies are delivered via C-section. This is usually done after 37 weeks given self-resolution of breech position.. An epidural is an analgesic injected into the spine during the first stage of labor.

It drastically reduces the pain of labor to virtually no pain, and it helps the mother get rest for the physically demanding pushing part of labor. The epidural does raise the risk of a maternal fever during labor, which could prompt doctors to administer antibiotics to be safe and thus expose the baby to antibiotics. Oster ultimately chose to deliver both children without an epidural.

OBs and nurses have a slight aversion to them because they may signal some inflexibility to do what they think is best in critical situations. Now there are just a few more actions to know about. Studies also show that births at home show fewer vaginal tears and lower infection rates. In contrast, hospitals are useful for interventions — emergency C-sections, Pitocin to reduce hemorrhage, epidurals, doctors who have seen plenty of unique birth situations before.

Research is mixed on infant death and outcomes on home birth vs hospital birth. Up to a third of mothers planning first-time home births change their mind during labor and deliver in the hospital. This abrupt transition will probably be more disruptive than starting in the hospital. If you do choose home birth, Oster suggests working with a certified nurse-midwife , who will have the most training and certification. A good compromise — your hospital may have a birthing center, a comfier room with a tub, bigger bed, and less fetal monitoring.She starts off with how to increase the chance of conception and different ways to track the ideal time for uhhh The best fish are: Author downplayed randomization and statistical significance when it validated her desire to do something "bad", but when it validated that something might be "bad", her emphasis is focused on the randomization in a subtle but unequal way when compared to the first.

Based on the same research, I'm going with an epidural.

When she was pregnant, she was dismayed at the quality of pregnancy information. I just hope no one out there relies on this book more than they do their physician.

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