The unexpected : navigating pregnancy during and after complications / Emily Oster and Nathan Fox, MD.

Enhanced descriptions from Syndetics:

From the New York Times bestselling author of Expecting Better , a guide to navigating a second pregnancy when the first did not go as planned--with Dr. Nathan Fox, maternal fetal medicine specialist

In Expecting Better , Emily Oster revolutionized the pregnancy landscape with her data-driven approach. In the years since, she kept hearing questions from readers on how to approach a second pregnancy when the first has not gone as planned.

While The Unexpected is a book that Oster hopes no one needs, the reality is that 50 percent of pregnancies include complications, a fact we don't talk about. Preeclampsia, miscarriage, hyperemesis gravidarum, preterm birth, postpartum depression: these are lonely experiences, and that isolation makes treatment harder to access--and crucial research and policy change less likely to happen.

The Unexpected lays out the data on recurrence and treatments shown to lower or mitigate risk for these conditions in subsequent pregnancies. It also provides readers road maps to facilitate productive conversations with their providers, with insights from lauded maternal fetal medicine specialist Dr. Nathan Fox.

By bridging the knowledge gap and making space for difficult conversations, The Unexpected promises to make the hardest parts of pregnancy a little bit less so.

Reviews provided by Syndetics

Library Journal Review

Oster (economics, Brown Univ.; The Family Firm) and Fox (ob-gyn and maternal fetal medicine, Icahn Sch. of Medicine, Mt. Sinai; host, Healthful Woman Podcast) help parents navigate the fears and questions of a pregnancy with health complications. Their book is divided into into trimesters and common complications, such as severe vomiting, gestational diabetes, preeclampsia, premature birth, miscarriage, and more. The authors talk women through how to best talk to their providers and ask questions about these challenges and how to make the best decisions for themselves and their situations. Their book highlights pertinent definitions, summarizes each chapter, and includes statistics about Black women having a higher risk of complications and 2.3 times the maternal mortality rate of white and Hispanic women. Their numbers also indicate that higher-income Black women with health issues have a higher maternal mortality rate than white mothers who make far less. The book points to other resources that explain these inequities in greater detail. It also comes with recommendations for supplements, vitamins, tests, and preventions. VERDICT A vital reference that steers women toward healthy and successful pregnancies.

Publishers Weekly Review

Oster (The Family Firm), an economics professor at Brown University, teams up with obstetrician Fox to provide a thorough primer on preeclampsia, fetal growth restriction, miscarriage, and other pregnancy difficulties. In each chapter, Oster details recurrence rates and care options for a condition, and then Fox describes how he treats patients experiencing it. For instance, Oster explains that gestational diabetes, which can occur when "the hormones of the placenta affect processing of blood sugar," has a roughly 48% chance of recurring in future pregnancies and is typically treated through diet and exercise. Fox then assures readers that for most people, gestational diabetes is a "nuisance... but not a dangerous one" and can usually be kept in check by eating fewer carbohydrates and increased protein. The authors demonstrate a keen awareness of how the pregnancy following a previous complication can cause psychological distress, as when Fox reports that pregnancies after a stillbirth often revive feelings of grief. To cope, he recommends patients "assemble a strong support system," which might include a psychologist, support group, or loved ones. Oster's cogent presentation of scientific data manages to be informative but not dry. It's a valuable resource for parents who have experienced pregnancy complications. Agent: Suzanne Gluck, WME. (Apr.)

Kirkus Book Review

A guide to the trials and tribulations of second pregnancies. In the first part of the book, Oster, author of Expecting Better, and Fox, a maternal fetal medicine specialist, offer "a general framework for how you might approach a pregnancy with or after complications." The second part offers "condition-specific chapters." Oster has written extensively about pregnancy, parenting, and health economics, and her goal in this book is "to bring maternal health complications into the light" and provide "an avenue toward more productive conversations with their providers." The authors emphasize preparation of all kinds, and they cover everything from gestational diabetes and preterm birth to "severe maternal morbidity" and postpartum mental health. When it comes to records and medical history, "ground yourself in the necessity of accuracy and honesty, both for yourself and for your provider." The authors recommend a litany of questions for medical providers, including, "Are you able to explain in simple terms what happened to me and, if you know, why it happened to me?" Throughout, the authors include instructive first-person accounts of women. Of preterm birth stories, for instance, Oster writes, "While the experiences these two women had were extremely different, the feeling of trauma is not." Regarding the specific trauma of miscarriage, the authors are encouraging and empathetic: "The majority of miscarriages are due to a genetic abnormality in the embryo (it's not your fault).…With time, continued trying, and sometimes interventions, nearly all couples will have a successful pregnancy (there is every reason to be optimistic)." The authors also recommend screening for preeclampsia at every prenatal visit because "it can happen to anyone without warning" and "often has no symptoms until later stages." On every page, the authors offer extensive research and support: "It is perfectly reasonable to want a repeat cesarean. It is your birth!" A comprehensive, empowering resource. Copyright (c) Kirkus Reviews, used with permission.