August 13 2013
Saturday's Wall Street Journal ran an article covering the many warnings pregnant women face today. It wasn’t just the content of the piece that caught and kept my attention; it was what the writer represented—a woman in charge of her own health and the health of her baby. This woman wasn’t going to be pushed around or unnecessarily frightened by the alarmists.
In “Take Back Your Pregnancy,” writer Emily Oster examines her own journey through pregnancy and takes on the many warnings she received from well-meaning doctors. She says she understood that pregnancy would bring with it lots of warnings and decisions about what to consume. She says she figured she’d be given the information and would be able to make her own informed decisions with guidance from her doctors.
I didn’t quite turn out that way.
In reality, medical care during pregnancy seemed to be one long list of rules. Being pregnant was a good deal like being a child again. There was always someone telling me what to do, but the recommendations from books and medical associations were vague and sometimes contradictory. It started right away. "You can only have two cups of coffee a day." I wondered why. What did the numbers say about how risky one, two or three cups were? This wasn't discussed anywhere.
Oster also asked her doctor about drinking wine and was given the standard “one or two glasses a week is probably fine” advice (I was also given this advice along with a stern warning that I “should probably just avoid it altogether”). As an economist, Oster wasn’t satisfied with the “probably fine" line. She wanted hard numbers, real data. So, in a move I wish more women would take when hearing these scary health warnings, Oster went in search of real answers. She says she “combed through hundreds of studies—the ones that the recommendations were based on—to get to the good data” and was surprised by what she found:
The key problem lies in separating correlation from causation. The claim that you should stop having coffee while pregnant, for instance, is based on causal reasoning: If you change nothing else, you'll be less likely to have a miscarriage if you drink less coffee. But what we see in the data is only a correlation—the women who drink coffee are more likely to miscarry. There are also many other differences between women who drink coffee and those who don't, differences that could themselves be responsible for the differences in miscarriage rates.
This problem is partially surmountable with better data, and I found that the best studies often painted a picture different from the official recommendations. Actually getting the numbers led me to a more relaxed place—a glass of wine every now and then, plenty of coffee, exercise when I wanted it. The economist's toolbox may not be known as a great stress reliever, but in this case it really was.
Oster’s most important advice comes early in the piece when she tells women to check the facts and to perform some basic risk analysis. She says:
The key to good decision making is evaluating the available information—the data—and combining it with your own estimates of pluses and minuses. As an economist, I do this every day.
And so should all women. We live in a culture of alarmism these days where everything from your household cleaning to your garden hose to that plastic container holding last night's leftovers is being painted as a potential child killer. Women need say enough is enough. IWF has been doing this for a while. IWF Managing Director Carrie Lukas has written of her own frustrations during pregnancy. She's detailed her own feeling of betrayal by the flip-flops of the medical community who told her during one pregnancy to do this, only to reverse that advice for later pregnancies. I've also touched on this subject in my own writing on food regulations. What pregnant woman hasn't experienced this frustration?
I encourage everyone to read Oster's piece and behave a bit more like her when facing these ubiquitous claims of danger. Demand facts, data, proof. It's the only way to fight the alarmists.