About

amy pumpkin patch

Me and my two kids, Fall 2015

I am a research scientist and mother of two. I was born in Chicago, but for the past 10 years I have lived in the San Francisco Bay Area with my software engineer husband (a cliché, I know).

I love digging into the scientific literature and summarizing research findings. In this blog, I try to present an unbiased and sane take on research topics of interest to soon-to-be and new parents.

I always love getting feedback and suggestions from my readers. You can contact me here.

Some More Background About This Blog

Here I cover the science behind conception, fertility treatments, pregnancy, breastfeeding, and early childhood. Many of these posts are born of my friends’ and my own personal quandaries, which have sent me burrowing into the research literature to find out more and to help us make educated, informed decisions.

Oddly enough, this blog was inspired in part by my desire to experience savasana during my second and third trimesters of my first pregnancy. Being my first–as opposed to second or third–pregnancy, I was still attending my regular yoga classes about three times a week. (With two kids under four, yoga 3 times a week sounds like an unbelievable luxury right now.) After I was about 3 months along, I told some of my instructors that I was pregnant. They explained that once in my second trimester, I would need to stop performing any poses that required lying on my back. Savasana, my favorite pose, was going to require bolsters.

At that time, I had recently finished my postdoctoral fellowship at UCSF and was living in San Francisco. It seemed natural to go to UCSF for my prenatal care. Unlike many centers, UCSF had a rotating practice. Instead of being assigned a single OB, each patient would see multiple OBs and nurse practitioners, depending on who was available. This setup–whatever its drawbacks–gave me the opportunity to ask the exact same question of multiple OBs. I was basically guaranteed a second opinion.

I was intrigued and a bit confused by the prohibition regarding lying on my back. At my next prenatal appointment, I asked the OB, “Can I safely lie on my back during pregnancy? What about sleeping on my back?” She replied that it was fine to lie on my back for now, but starting once I was 4 or 5 months along, I would definitely need to avoid it.

A few weeks later, I came back for a routine check up with a different OB. Taking advantage of the free second opinion, and still a little foggy on exactly why I needed to avoid lying on my back, I asked her the same question. She told me that I didn’t need to worry about this until I was about 7 or 8 months pregnant.

Perplexed, I asked yet a third OB at my follow up appointment, who told me that I was probably fine until the last few weeks before delivery. Neither she, nor the other two OBs, seemed to know where this advice came from. She did not know at what angle it was okay to lie on my back (couldn’t I just prop myself up with a couple of pillows?). Nor could she answer seemingly straightforward questions: What was the data behind this recommendation? Just how risky was sleeping on one’s back for mom, or for the baby? As the third OB, clearly flustered by this unexpected interrogation, was ushering me out the door, I realized I was going to have to look into this myself.

A quick search through the major parenting sites–I won’t name names–came up lacking. Most of the pregnancy- and parent-oriented were filled with advice and opinions, but provided scant real data or even information about their sources.

And this is when I realized I was very, very lucky. I had the background and training to search through and understand the relevant medical research. Apart from a mountain of student debt, my many years of postgraduate education had granted me a thorough understanding of medical research. Experimental design, randomization of subjects, observational studies, sample size, meta-analysis, and hypothesis testing–these were my bread and butter. I knew how to sift out good studies from bad, and how to fit a single study into a larger research context. I knew when researchers had used some statistical sleight of hand, and when more research was needed to draw a firm conclusion.

In the case of lying on one’s back, after a thorough search through the research, I became convinced there was no data behind this recommendation. None at all.* In fact, I found a research review expressing the same opinion:

“In conclusion, advising women to sleep or lie exclusively on the left side is not practical and is irrelevant to the vast majority of patients. Instead, women should be told that a small minority of pregnant women feel faint when lying flat. Women can easily determine whether lying flat has this effect on them, and most will adopt a comfortable position that is likely to be a left supine position [lying on one’s back tilted towards the left] or variant thereof.
Since healthy pregnant women often require more pillows than non-pregnant cardiac patients, and since finding a comfortable position in bed in late pregnancy is not easy, physicians should refrain from providing impractical advice.”

From then on, I did much of my own research on the pregnancy and parenting topics.

So, the purpose of this blog is to share what I have learned. Here I promise to share real data, to make clear what comes from research and what is my own opinion, and to provide all my sources, because we all need to be able to make our own informed decisions.

*Since then, a study was published suggests that sleeping on one’s back may increase the risk of late stillbirth. More on this here.

Disclaimer: The information and opinions on this site do not constitute medical advice. Please consult your obstetrician, pediatrician, or other medical professional if you have medical questions.

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21 Responses to About

  1. Wow I feel so lucky to have had a midwife the first time around who told me I could lie/sleep on my back unless I felt faint (i.e. that was how I would know the baby might be cutting some bloodflow off, the reason she gave for why people say to avoid it) I blissfully lay on my back whenever comfortable. Which was hardly at all. The irony.

    I can’t see any where how recently (or not) you started this blog?

    Like

  2. Marissa Tsugawa says:

    Thanks for having a blog like this! I am a mechanical engineer studying engineering education now. I just found out I am pregnant and all the “what to expect” and “baby bump” websites are so annoying because they don’t have the research to back up anything they say. I really appreciate that you put together some research that I can look into about pregnancy. I definitely love to know the science literature!

    Liked by 1 person

  3. Ard Louis says:

    Really love this blog! I’m professor of physics in the UK and a recent father. Have found getting good summaries of the best research remarkably hard to come by. There is a lot of low quality analysis out there that typically then induces fear into what is already a pretty complex and unpredictable process. This is a breath of fresh air. Thanks, am truly grateful!

    p.s. You need to write a book.

    Like

  4. Eva says:

    Great blog! Your do a fantastic job of filtering through the sea of noise. Keep up the good work.

    Like

  5. CS says:

    Hi Amy,
    Thanks so much – as a Radiographer I have a background of knowing that information should be research-based and peer-reviewed (ideally). Having scientific-based evidence is much more helpful for so many statistics! I am really early, and anxious to get a scan to see the heartbeat, but having a friend miscarry between 8 weeks and 12 weeks has really shaken me and I’m finding it hard to shake my own concerns now. Thank goodness for your site! I have a question regarding the risk of miscarriage once heartbeat detected vs prior to detection – it seems the risk of miscarriage in the same weeks gestation is different between the two groups – do you know why? – please forgive me if I have overlooked something (I am exceptionally tired). I was basically trying to ease my anxiety by finding a risk of miscarriage data set and found your blog!

    Like

    • Amy Kiefer says:

      A heartbeat signals normal development, so the risk of miscarriage in the subsample of pregnancies in which a heartbeat has been detected is lower than in all pregnancies, which consist of pregnancies with hbs and without hbs.

      Like

  6. Rachel says:

    I’m so glad to have found this blog! I’m a grad student and my husband is a resident physician, and I’m currently 22 weeks with our first child. The overwhelming majority of websites and books available are based on extremely poor data, if any at all. We have spent countless hours comparing studies over the last few months. This is really a fantastic and helpful resource.

    Like

  7. Louisa says:

    Hi Amy
    I’m an Anaesthetist (Anesthesiologist) in Australia and I came across your blog when looking up miscarriage statistics related to maternal age (I’m 38 and now 23+2 weeks pregnant with our first baby and also an asymptomatic back-sleeper 😉). Your blog is fantastic; easy to read for lay-people but the information provided is well-supported by evidence (or otherwise as the case may be when the evidence is lacking, or not of good quality!).

    I saw a pelvic floor specialist physiotherapist in early pregnancy (from a prophylaxis point of view given my advanced maternal age) regarding pelvic floor dysfunction. She told me that, from a “pelvic floor safety” point of view, a pregnant woman should not load her pelvic floor with any more than 10kg e.g at the gym, lifting items (where at all possible), regardless of pre-pregnancy level of fitness or previous level of resistance training. This was a blanket statement for all women of any size and fitness level! I’m not an elite athlete or Olympic weight-lifter by any means, but I am dubious about the evidence base for this statement. Are you aware of any evidence to support or refute this claim? I’d be very interested to read a blog of yours on this topic!

    I’m due to see her again in third trimester and also post-partum, so I will be asking her for the evidence next time I see her. I suspect it might be dogma…

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  8. Helen says:

    Hi Amy,

    Thank you for making this page, I love it! I’m a postdoc in Australia and I find myself trying to consult the literature whenever I am curious about an aspect or pregnancy or confused by the vague information available in books and online. Sometimes it is hard knowing the best search terms or where to start so having your summaries and a bunch of references removes a lot of the hard work. It’s also nice to know other scientists are doing the same thing since it gives me a sense of nerdy-solidarity!

    Like

  9. Victoria says:

    For a lack of better description there is so much shit on the internet that has no evidence to it at all! What a relief to find your site with its references. I am only just pregnant, and my twin has just had a babe and had such ridiculous mixed advice from midwives (is there no set standards with advice/practice for these guys?!). I am an ED nurse currently doing research so can’t handle advice that is given without any evidence.
    Keep up the awesome work.

    Like

  10. Elizabeth says:

    Hi Amy-

    I’ve been looking around for evidence for first trimester ultrasounds (vs waiting until later anatomy scan). Seems some providers order them and others don’t. Have you read much about that? I’m not finding much info.

    Like

  11. Your blog is awesome! I’m 8 months pregnant and just came across it. As a med school student, my current vocation is to become someone capable of making informed decisions and judgment calls! I’m all about that EBM, evidence based medicine 😉 … This blog definitely caters to that, contrary to a looooot of sites that pretty much rehash the same old advice.

    Like

  12. Lori says:

    I’m super excited I found this blog. I always go down a rabbit-hole gathering scientific data whenever I’m trying to learn about something important. There’s so much junk information out there that presents opinions as facts or mis-represents scientific evidence.

    I would love it if you did a blog post about the ideal amount of time for maternity leave (for mother and baby’s physical and emotional health). Most of the advice I’ve found just says vague or useless stuff like “take as much time off as you can.” I live in the US, so I don’t get any paid time off. I can afford to take a fairly long period of time off unpaid, but I don’t know exactly how long I should take and I would love to have some research to back up my decision (and help convince my husband!).

    Thanks again for all the awesome information!

    Like

  13. Karla Zepeda says:

    Thank you for your blog. I came across your post on miscarriage, and you are the only place where I have read helpful scientific base information. Much thanks.

    Like

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