It seems a very long time ago that I conceived of Expecting Better. I was thinking about that the other day and dug up the first email I sent, almost at random, to my now agent with my initial, slightly shaggy book proposal.
I said: “This brings me, finally, to the basic idea, which is a book which covers decision-making during pregnancy, focusing on what the medical literature actually says about risks, procedures, etc. I do not think this type of book exists. There are a lot of books about pregnancy (obviously), many of which go through recommendations on behaviors, and some things on decision making. I have yet to find one which actually presents any evidence.”
I sent this email in February 2011; Penelope was born in April. I’m not sure what I was thinking in committing to writing a book during that first year, but anyway here we are.
Expecting Better has undergone a number of revisions, the largest of which I did just last year. With each of them, I’ve gone back to consider what the new data says, whether there are topics missing, whether there are changes in the way I want to talk about various issues. With the latest revision, I’ve gotten a chance to put many of the updates in the newsletter. So the roundup below pulls together most of the pieces I’ve updated over these past years.
Before we get into it, though, let me try to answer one crucial question that I get all the time, which is not addressed in any of the editions of Expecting Better: Does eating dates make you go into labor?
If you aren’t heavily into the world of fruit-induced labor, you may wonder why on earth eating dates would have anything to do with childbirth. Yes, they are a delicious sticky fruit, but so are figs, mangoes, prunes, and more. Why dates?
There are various theories you’ll see thrown around — something about hormones, or vitamins — but the answer to “why dates?” really lies in a few papers that argued that, for whatever reason, dates seemed to prompt labor. Perhaps the best-known is a 2011 paper that compared 69 women who consumed six dates a day for four weeks with 45 women who did not. The study wasn’t randomized, but the authors did find that a much larger share of the women who ate dates went into labor spontaneously (96% versus 79%) and that their labor was less likely to need augmentation.
The conclusion of the paper was that the finding warranted a randomized controlled trial. And following that, there were a number of them. This study randomized 77 women into a seven-date-a-day group and 77 others into a control group. It found that the date group did have less need for labor augmentation but were no more likely to go into labor spontaneously. A second paper with a similar-size trial found date consumption leading to shorter labor. A third randomized trial showed the date consumption group had more “cervical reopening” (i.e. more movement toward progress in labor) than the no-date group.
What to take from this? I would say good news and bad news for the date-labor plan. On the downside, if you are past your due date and your hope is to down a giant pile of dates to encourage labor, that is not likely to work. (Also, eating that much dried fruit all at once is a mistake for other reasons.) On the plus side, this actually does suggest that eating a smaller number of dates regularly over the last weeks of pregnancy might make labor slightly smoother. These effects aren’t huge, but they seem consistent. Perhaps worth a try
Roundup of other updates
Here are a couple categories of updates. Some of these made it into the new Expecting Better edition, some didn’t.
Posts about “Can I have [fill in the blank] while pregnant?”
- Cannabis and Pregnancy. Marijuana is more legal now. Is it OK in pregnancy?
- Alcohol and Pregnancy, unpacking a new study. (This post is from October 2020 and starts with a discussion of how I’m trying to generate a feeling of control by cleaning out my fridge. I’m considering trying that again now…)
- Tylenol, Pregnancy, and ADHD. There’s a study and people are scared. Help!
- Scary but bad study on caffeine and pregnancy. There’s a study and people are scared. Help!
- Can I use acne medication?
Posts about prenatal care (and birthing choices)
- Does Extra Prenatal Care over 35 Matter? Yes. Bonus, lots of statistics in this post!
- Should I be induced at 39 weeks? Unpacking the ARRIVE trial, perhaps the most impactful large trial on pregnancy in the past few years.
- Are epidurals bad? [Note that a lot of people didn’t understand the ironic tone of the title of the post. I feel I’m so funny, but fair point that people do not always agree.]
As a final note, I would be remiss not to recommend that you read this post on how it is totally fine to sleep on your back if you want to while pregnant.