Emily Oster is not for everyone. Occupying a niche so niche that it’s exclusively her own, the economist–cum–parent influencer has the kind of cool self-assuredness that anxiety-ridden parents covet—and that some physicians find alarming. Her first book, Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong—and What You Really Need to Know, came out in 2013 and has sold over a million copies, unseating What to Expect as a fixture on many pregnant people’s bedside tables. Look at the data and make your own choices, she urged. With our occasional, small glasses of wine and our sushi, my mom friends and I pitied the people who had been pregnant before Expecting Better. But as an economist and not a physician, Oster raised eyebrows for sharing guidance on health-related decisions, particularly when that guidance went against carefully crafted guidelines from medical groups. That criticism has continued as she pumped out two more best-selling parenting books (Cribsheet and The Family Firm) and built ParentData, a popular newsletter and online parent community with tens of thousands of paid subscribers.
Though she’s far from alone in a crowded sea of parenting experts like Dr. Becky Kennedy — whose audience of sturdy-parenting adherents overlaps heavily with Oster’s — Oster stands out in part because being a wildly successful parenting expert is just a side hustle. Her full-time job: economics professor at Brown University. Through waves of backlash (which arguably reached a fever pitch in the pandemic, when she advocated for a return to in-person learning before medical authorities had deemed it safe), her devotees have remained fiercely loyal. And in her forthcoming book The Unexpected (Penguin Press, April 30), it is clear that Oster cares deeply for her audience, too.
She has been moved, she tells me, by the frequency with which her followers turn to her with questions about their worst, most private fears as well as joys. Many of these reader anecdotes and intensely personal reflections dot the book, which, for the first time, she has co-written with a physician: Dr. Nathan Fox, an OB-GYN in Manhattan and a father of four. Trimester by trimester, Oster and Fox work to demystify the often voiceless experience of complication in pregnancy — from preeclampsia to stillbirth.
In The Unexpected, we encounter a strikingly softer version of Oster — one who is toying with the idea that not every experience in parenthood can or should be viewed through the lens of statistical analysis or can or should be optimized. This is an Emily Oster who gives as much room on the page to radical acceptance as she does to hard data.
When your first book came out, Instagram was a very different landscape — known for still images of food and flowers — and TikTok didn’t exist. Now, parents are besieged by information all day. Your assertion has been that having more information can make you a more confident parent, but many parents seem more overwhelmed than helped by the volume of information coming at them. How do you think about your place in this ultra-anxious parenting moment?
The two pieces that generate the most anxiety are the feeling of “I’m doing it wrong,” which is a common feeling. And beyond “I’m doing it wrong,” the feeling that you could always be doing better. Even if I’m doing a good job, I could always have less screen time or more wooden toys.
The other piece is that information is coming in your face in a way that you have a hard time evaluating. The most anxiety-provoking days on social media for me are when there’s some panic headline and I get a million “Is this real?” DMs. The problem is not that they got too much information; it’s that the information is bad. What I’m trying to do is to say, “Here’s some good information.” That’s where I see my role in this. But I definitely hear the feeling of many people — and have it sometimes myself — that “wouldn’t it be easier if we just knew nothing?”
I get that for some people, the answer is to Dr. Spock it and just trust your gut. Basically, whatever you’re doing is fine. At the end of the day, you know more than you think you do.
It sounds like you hold more space for gut-level parenting or even parental improvisation now than you used to.
There have been two big evolutions in how I approach this. One came with Cribsheet, where I thought I would have a lot of places where I would see that the data really tells you, “This is a good thing to do.” But in those data sets, there’s almost nothing like that. In writing that book, I softened way down. Like, I stopped giving people advice. I tried to dial down my bossiness with both my family and the general population.
Then, during COVID and with The Family Firm, I spent so much time communicating about how to make decisions that are hard. The realization that came out of that is that data is not bossy. So much of how we choose to run our lives is going to involve, yes, looking at the data, but then combining it with our preferences. Because people have different values, it will lead it somewhere different.
I do think there’s a sense in which one can expect too much from data and expect too many answers from studies or from evidence.
After Expecting Better came out in 2013, you became an influential voice in the parent culture of this country, and you’ve experienced your share of criticism. Have your views changed since you wrote that book? Does The Unexpected represent an evolution or amendment of your perspective?
Yes and no. Everything I have done — in the previous books, in the writing that I do online, in how I talk on Instagram, in this book — is a commitment to figuring out what the data says and to reporting that out. As a professor, I do data; I write papers about statistical analysis.
So I have this particular approach. In some moments, people are going to like that approach better than others. It’s the only approach I have. That’s the expertise I can bring.
What’s very different about this book than my other books is they are books that I wrote in service of and reflecting my own experiences, which is not true of this book. It comes out of, in some ways, a completely different part of my life, and it isn’t about my own experience.
On the surface, this book is about helping pregnant people feel more informed and prepared to engage with doctors when dealing with a complicated pregnancy or pregnancy after complications. But ultimately, it seems that this is really a book about uncertainty, loss, and grief, which are a huge, if taboo, piece of the pregnancy experience for many of us. In tone, if not topic, the book feels like a departure for you, and maybe a passion project. Does it feel that way to you?
Yes. I have spent the last ten years talking to pregnant people about data, and I’ve spent a fair amount of that time hearing from people at their worst moments. The ability to be there in some of those moments, and sometimes be helpful, that is the greatest privilege.
I don’t typically think of your work as activism, but the lack of good, conclusive data about pregnancy and women’s health is a constant refrain in this book. You write, for example, that 50 percent of stillbirths have unknown causes. How do you think about that notable lack of data?
There is absolutely a sense in which I see the call to action of this book as, “Let’s understand this better.” Let’s talk about it more. Let’s recognize that one of the reasons we talk about it more is so people will think, That seems important. That’s something people are talking about. We should give funding to that. That’s a problem that people would want us to solve.
It will also always be true that, in this space, there’s a lot of uncertainty. No matter how much research we do, a lot of the times when somebody has a stillbirth, we’re not going to know why it happened. Every case is different. The work of this book is to say, “Here’s the amount you can understand. Here’s how to navigate the uncertainty.” In the stillbirth chapter, Nate uses the term “radical acceptance” to say even when this awful terrible thing has happened, sometimes the only way forward is to accept that it happened, even if you’ll never understand why.
It feels like this book is working hard to be of service to the many women who have barely 15 minutes to have incredibly complex conversations with their OB about things like rare chromosomal deletions. Do you see your work as addressing a void in our health-care system?
Yes. The void is in bringing people to the point where they know enough to have the right conversation. The chromosomal stuff is a good example. The doctor says, “Do you want to do this, or do you want to do this? It’s your decision.” And the patient is like, I’m not equipped to make that decision. I see my work as translation, as trying to take these complicated decision problems and complicated data and translate them into a language that people can engage with.
The conversations in the book between you and Dr. Fox, your co-author, reinforce the idea that the meaning of data is in the hands of its interpreter. For example, at the end of the chapter on pregnancy after stillbirth, one of your takeaways is that, based on data, you would recommend kick counting, whereas Dr. Fox doesn’t.
Yes. One of the places this came up most for us is in talking about how one communicates risk. From where I sit, I would want to have a conversation about recurrence risk — i.e., the risk that a complication you experienced in your previous pregnancy will happen in a subsequent pregnancy — in the context of how precise we can get those numbers. And Nate’s approach to communicating recurrence risk is: “Less than 10 percent means it’s unlikely. Ten to 50 percent? It might happen again. Greater than 50 percent? You should expect it to happen again, but it’s not a certainty.”
He’ll say, “Some people are crazy like you, Emily, and I can engage with that. But for most people, this is the kind of breakdown that helps them make the decision.” It’s always interesting to think about the difference between what you would want as a statistician and what you want as a clinician.
Yes. I tend to be more like you in that I feel that more information makes me feel less anxious.
Not everybody feels that way.
I had an abnormal 12-week ultrasound and had to go through a bunch of testing from 12 to 22 weeks until I got to the fetal echo, which was my “all clear.” I live in Oregon, and my OB reassured me early on that we had time to go through ten weeks of testing and still terminate up to 24 weeks. In post-Roe America, that’s a macabre kind of luxury. The book touches on abortion rights in the introduction briefly, but abortion restriction feels like the elephant in the room throughout the book.
It is. We thought about how to address this in the book. It’s an incredibly difficult situation.
I feel for every woman who is in any of these situations — the situation you were in or, worse, in a situation in which there isn’t choice and in which you’re constrained inside some set of decisions that you’re not ready to make because of laws or because of resource constraints. We want the book to be for everyone. The questions that we think are most relevant for everyone overlap some, but not in a complete way, with this set of issues.