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.
AP: That leads me to the vices, including alcohol. You and ACOG differ on that one. ACOG recommends no alcohol.
Oster: 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.
AP: When in this country did pregnancy become this exercise in self-denial? Are women needlessly suffering?
Oster: 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.
AP: 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.