Why "What to Expect" Will Make You Crazy

If you're thinking about having a baby any time soon, you may already be too late. That's the message of What to Expect Before You're Expecting, the latest in the wildly popular What to Expect series. Like its companion volumes and website, this What to Expect is designed to alleviate women's anxiety about pregnancy and early motherhood. But in order to ease anxiety, it must first create it. It's never too soon, apparently, to start worrying about your children.

According to What to Expect Before You're Expecting, a woman should start planning her pregnancy at least three months—even a year—before she gets pregnant. What with the lifestyle overhaul that conception may require—eliminating drugs and alcohol of course, but also lowering her BMI (that’s body-mass index) and starting a vitamin and exercise regimen while simultaneously reducing her stress level—she probably should have started strategizing the moment she set eyes on the father-to-be. Maybe even before. When it comes to conception, planning is out; pre-planning is in.

As someone who has tracked my cycles, taken multiple ovulation tests, even searched fruitlessly for "ferns" in ovulation saliva tests, I understand all too well the anxieties this book is meant to address. I'm now six months pregnant with my second child. I'm sympathetic to the women who aren't as lucky as I am. No doubt the What to Expect editors are tapping into very real anxiety that stems from research about advanced maternal age (at least among certain socioeconomic groups) and other factors that affect fertility and the chances of birth defects. But for a woman who is already worried, this book will only turn her into her most neurotic self, which can’t, after all, be so healthy. "A book like this is organized around anxiety,” Georgetown bioethicist Maggie Little told Time magazine. “It would take a normal person and make her crazy."

The premise of What to Expect Before You're Expecting is not just optimizing the chances of conception, but "optimizing pregnancy outcome," as Yale obstetrician Charles J. Lockwood explains in the foreword. “Healthier moms and healthier dads can create healthier pregnancies and healthier babies," the book argues, and backs its claims with research from a slew of experts and organizations. But the book "tends to blur the line between important and well-established risks," Little points out, "and small or merely theoretical risk for which there is absolutely no evidence," such as coloring your hair, or the condition of your teeth.

What to Expect Before also takes preconception to a whole new level, making it seem like a lifestyle overhaul, or a full-time job. What happened to the joy of pregnancy—and for that matter, the sex that creates it? The decision to have a baby is rightly considered one of the most profound decisions in a woman’s (and a man’s) life. What to Expect Before reduces it to something akin to choosing a mortgage or buying a car: a consequential choice but not necessarily a sacred one. By treating conception (and pre-conception) as an occupation, a duty—and mind you, one it admits is “pretty female-centric”—baby-making (aka, sex) just becomes another “to-do” on an ever-growing list.