Date May 14, 2024
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In ‘The Unexpected,’ a Brown economist shares data-driven approach to navigating pregnancy complications

Emily Oster’s new book uses data to help pregnant women make informed decisions related to complications ranging from miscarriage to postpartum depression.

PROVIDENCE, R.I. [Brown University] — Whether she’s engaging in research and teaching at Brown or working on her best-selling books about pregnancy and parenting, Brown University Professor of Economics Emily Oster says: “My whole life is about data and the things that one can learn from data.”

Through the books she’s written over the past decade, Oster has used her expertise in data analysis to help expectant parents navigate the highs and lows of those crucial nine months, as well as the postpartum period and beyond.

In her fourth book, "The Unexpected," published last month and co-written with Dr. Nathan Fox, a maternal-fetal medicine specialist, Oster focused her research on a more specific audience: parents who have already experienced a complicated first pregnancy and are wondering what the numbers say about how the next one might go.

Oster spoke about her research, teaching and her new book in a Q&A.

Q: What motivated you to write “The Unexpected?”

Since writing my first book about pregnancy about a decade ago, I have had a lot of conversations — maybe thousands — with women and their partners about pregnancy. A lot of them have involved a question related to something that happened that they didn’t expect, or was difficult, or was tragic — and they want help navigating that in a future pregnancy. They’d ask: What does the data say? What does the evidence say about recurrence? How do I navigate this with my doctor? So this book is really intended to answer some of the questions about things like miscarriage and gestational diabetes that people have asked so many times. There are aspects of the book that I think will be useful for somebody going through complications the first time, but the frame is very much: this happened before. The target reader for this book is the person who is already anxious, not necessarily the person who had an uncomplicated first pregnancy.

Q: Why is it important to study pregnancy and birth from a data perspective?

My goal is to help people make better decisions and to feel confident in the decisions that they make, particularly around pregnancy, birth and early parenting. For me — and I think for many of the people who read my books — taking a data-oriented approach delivers some of that confidence and helps give people a way to better understand the risks and benefits of some particular behavior and make a decision that works for them and their family. I feel pretty strongly that the tools from economics are relevant very broadly outside of the kind of research that scholars do. And they can be used to help people navigate conversations about, in this case, the risks of pregnancy complications. My co-author, Nate, and I spent a lot of time emphasizing how you can put together a set of questions, like a script, that will help you have the most productive conversation you can with your health care provider. It’s not that you’re going to be the expert, but you’re going to be able to talk about your particular situation in a way that can be really useful. 

Q: As you reflect on your research, are there any changes you’d like to see to the U.S. medical system?

The short of it is that the care that we give women, particularly women of color, is not good enough. And it results in outcomes for birthing people that are much worse than they should be, and worse than in other countries. One thing I think would help would be providing every pregnant person with a doula. That would have real impacts, especially on marginalized groups. Insurance companies should cover doulas for everyone because they would actually save them money. Research has shown that doulas significantly reduce Cesarean section rates, and C-sections are major surgical procedures that are a lot more expensive than vaginal births.

Q: What are some of the key lessons related to data and economics that you try to impart on your students at Brown?

One of my favorite things to talk about in class is the importance of distinguishing between correlation and causation and recognizing that just because two variables move together doesn’t mean that one of them causes the other. My research focuses on just how pervasive that problem is. In my view, the degree to which this is a problem with many of the conclusions that we draw about research is a much larger problem than many people think. I also like to draw attention to the fact that even credible research, like from the Centers for Disease Control and Prevention, is just a sample. In my lectures, I often use tangible, real-world examples, including those from my books, to illustrate the importance of analyzing data.