•  Pregnancy

What to Expect When You're Expecting
By Arlene Eisenberg, Sandee E. Hathaway, Heidi E. Murkoff
Workman Publishing Co.
Paperback 504 pp $12.95

No sooner do you see the positive result on your pregnancy test than the questions start coming. Your response may be joy and relief, perhaps accompanied by the fleeting thought, "How in the world did this happen?"

You head for the obstetrician's office to confirm the pregnancy and find out when your baby is due to make his or her debut. Most women (and men) feel an instant need for information -- lots of it. But chances are that your prenatal visits simply won't be frequent enough or lengthy enough to satisfy your insatiable curiosity. Enter the pregnancy bibles. There are hundreds out there to choose from, but which one should you depend on? Here is an opinionated take on four of the most popular guides to those endlessly fascinating nine months.

From its first appearance back in 1984, What to Expect When You're Expecting has been the standard by which all other pregnancy books have been measured. Written by the mother-daughters team of Arlene Eisenberg, Heidi Murkoff, and Sandee Hathaway, What to Expect, as it's come to be known, was reassuring and down-to-earth, in contrast to the many previous pregnancy books with their clinical slant and condescending tone.

However, the truth is that today, What to Expect is no longer the model for either informality or reassurance. In fact, the authors' sometimes preachy tone and the stridency of some advice, particularly in the areas of diet and nutrition, turned off many a reader in the last decade. Rarely has a book been so frequently satirized in women's magazines and newspaper columns.

There are even humorous books for fathers titled, What to Expect When Your Wife Is Expanding and Every Guy's Guide as to What to Expect When She's Expecting. The problem is the "buck up and handle it" style of much of the authors' advice, which makes many women wince. After all, what pregnant woman suffering her eighth straight week of debilitating vomiting and nausea wants to be told that "morning sickness is unknown in some more primitive societies where lifestyles are simpler." (It's all in your mind, and if you could just slow down and relax everything would be fine!)

The truth is that everyone makes fun of What to Expect because everyone reads it. It remains far and away the best-selling pregnancy tome, with an astonishing 14.5 million copies in print. Maybe its appeal lies in the organization, with comforting subheaded sections such as "What you may be feeling" and "What you may be concerned about." Or maybe it's the easy-to-digest format, with lots of diagrams and bite-size boxes of information. Certainly it's one of the most complete guides out there. Far from talking down, it assumes a fairly high degree of intelligence on the part of the reader. And unlike many pregnancy books, this one doesn't sidestep the scary stuff, devoting an entire chapter to "When Something Goes Wrong." Finally, let's give credit where it's due: The revised edition attempted to address many of the longstanding criticisms, does tone down the preachiness considerably.

The Pregnancy Book: Month-by-Month, Everything You Need to Know From America's Baby Experts, by William Sears, MD and Martha Sears, RN (Little Brown and Co., Paperback 430 pp $21.95)

Unlike the authors of What to Expect, who trumpet their layman status loud and clear, William Sears puts his medical credentials front and center. The problem with this is that Sears is not an obstetrician or gynecologist -- he's a pediatrician best known for his child development guides such as The Baby Book and The Discipline Book. He deals with this issue by liberally quoting both of his cowriters: his wife, Martha Sears, a nurse and mother of eight, and ob/gyn Linda Hughey Holt, MD. However, his lack of daily experience working with pregnant women shows up in his almost total disregard for the very real physical problems and discomforts that many women experience while pregnant. He makes the rather astonishing choice to relegate to a glossary at the back of the book almost all pregnancy-related medical complications, such as diabetes and swelling, and even those that are dealt with by common medical practices.

On the plus side, Sears' trademark compassionate style allows him to address many concerns given short shrift by other pregnancy books, particularly on the emotional and psychological effects of pregnancy. His book is the only one I found, for example, that offers an explanation for the vivid dreams that many pregnant women experience. But the constant discussion of teariness, cravings, fears, and memory lapses begins to seem awfully patronizing after a while. Consider this pronouncement about car safety: "Remember, you are driving under the influence of pregnancy hormones, which may make you prone to fatigue, diminished concentration, or falling asleep at the wheel."

The stereotype of the ditsy pregnant woman is alive and well in this book. And Sears' approach can feel curiously gloomy, as in the passage on worrying, in which he states darkly that "studies relating maternal attitudes to the emotional development of the offspring do indeed reveal a tendency for anxious mothers to produce anxious babies." Not exactly words designed to reassure.

Sears' more psychological and less medical approach to birth does lead him to give alternative birthing methods more serious consideration than most of his competitors do. Those thinking about natural childbirth or planning to use a midwife or doula will find plenty of information here, including a section on the benefits of water birth -- something you're unlikely to find in any other mainstream pregnancy book. Then again, women whose hearts are set on an epidural to ease their agony will probably run screaming after reading statements such as, "Think of pain as the birth communicator." Oh, please.

Your Pregnancy Week by Week, by Glade B. Curtis, MD and Judith Schuler, MS (Fourth Edition, Fisher Books, Paperback 422 pages $14.95)

This comprehensive guide wins points for its format, which most closely mirrors the way most women monitor their pregnancies. And once your checkups become more frequent, it will best dovetail with the way a doctor usually presents information. Perhaps best of all, the weekly -- as opposed to monthly -- updates help pass the time, which can go by agonizingly slowly for many women, especially in that last trimester.

The downside to this book is definitely tone. Written by ob/gyn Glade B. Curtis with editor Judith Schuler, this book is the most "official"-sounding of the pregnancy bibles reviewed here -- in fact it sounds almost as terse and bland as those pamphlets handed out in the doctor's office. Clearly, Curtis' priority is providing medically accurate information, but unfortunately it's at the expense of emotional or psychological support. Sometimes this just means the reader gets the basics without any sugar-coating, as when Curtis describes breasts as made up of "glands, connective tissue to provide support, and fatty tissue to provide protection."

Readers with a fair understanding of reproductive biology won't feel talked down to. At times, however, his zealous pursuit of completeness leads Curtis to jump from a common pregnancy symptom or side effect to the most alarming cause or consequence. For example, a preliminary treatment of morning sickness includes in the second paragraph a warning about hyperemesis gravidarum, the most extreme form of a condition in which women cannot keep food or liquids down. Curtis then states flatly that "the pregnant woman is often treated in the hospital with intravenous fluids and medications," as if this were a common occurrence.

Serious complications for both mother and baby are lumped in willy-nilly with discussions of normal occurrences. He mentions swelling legs and feet, then follows it immediately with a section on blood clots in the legs, making it sound as if this is a possible consequence for anyone whose feet are puffy. (It's not.) Even more alarming is a section on the problems caused by cerebral fluid on a baby's brain, which follows oh-so-casually a discussion of fetal nervous system development. Not exactly comforting bedtime reading. And when Curtis informs the reader curtly in Week 14 that "maternity clothes may be a "must by now," it sounds oddly obtuse -- many pregnant women are barely showing at Week 14.

The Girlfriends' Guide to Pregnancy: Or Everything Your Doctor Won't Tell You, by Vicki Iovine (Simon &Schuster, Paperback 262 pp $14)

If you're going to buy only one book about pregnancy, The Girlfriends' Guide to Pregnancy isn't it. More fun rant than informational overview, Vicki Iovine's irreverent guide aims to be your best pal rather than your ob/gyn. That said, this book is a must-read for any pregnant woman fed up with the pastel-hued sincerity of other gestational guides. Whether discussing hemorrhoids ("little protrusions like peas that hurt or itch to distraction") or what she refreshingly terms "pregnancy insanity," this book tells it like it is with refreshing candor.

You know what you're in for from the first page, on which Iovine lists "The Top 10 Greatest Lies about Pregnancy," starting with "Lamaze Works" and finishing up with "Pregnancy Only Lasts Nine Months." It's hilarious. And only partially true, of course; breathing exercises have helped many a woman weather the pain of labor, and the medical definition of a typical pregnancy duration is technically between 38 and 42 weeks. But we also get exactly what she means and feel an immediate kinship that comes with our joint refusal to be bamboozled.

One important note, though: Although Vicki Iovine may talk to you as though she's one of your girlfriends, she may not remind you much of your actual gal pals. A former Playboy centerfold married to a Los Angeles music executive, Iovine has a lifestyle bias that comes through loud and clear. Those of us less preoccupied with weight, sex, fashion, and breast size or who -- God forbid -- were already a tad plump before getting pregnant, may feel a bit demeaned by some of her pronouncements.

These priorities clearly influence what gets covered in her book and what doesn't. Compare, for example, the 19-page chapter Iovine devotes to "Looking the Best You Can" to the scant 13 pages she devotes to all the prenatal tests lumped together. Or consider that the chapter on "What to Take to the Hospital" is longer than the chapter on labor itself. Iovine's assumption that yours will be an entirely "normal" pregnancy is so firm that she excludes all mention of most pregnancy-related complications and does not even mention the possibility of bed rest. Those whose pregnancies are more iffy or uncomfortable than hers may well feel left out in the cold.

Still, where else are you going to hear that lip balm is the one item you absolutely must not forget to bring to the hospital? These are the tidbits of information that women probably used to share with each other when we all lived in gossipy extended clans, but that many of us have no way of discovering nowadays. Thanks are due to Vicky Iovine for reviving an ancient tradition.

-- Melanie Haiken, who has worked as an editor at San Francisco magazine, Parenting, and BabyCenter, is a freelance writer based in San Rafael, California.

Last updated July 24, 2009
Copyright © 2002 Consumer Health Interactive

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