A prospective L.A. mother looking for advice recently shot off an e-mail to some friends.
Hello recent moms,
I had my first appointment with Dr. Dwight yesterday . . . He did my first ultrasound--the size and texture of a large kidney bean! . . . At this point I feel like I should be reading up on this child raising business! Any books you found helpful or essential? Any you strongly disagreed with? I've read nothing, and the selection on Amazon is too vast to interpret. Ladies, my mind is a sponge . . .
What followed was, well, unexpected:
Pls avoid "What to Expect When You're Expecting." This is negative propaganda. I loved "The Girlfriend's Guide to Pregnancy" . . .
Oh . . . how exciting!! I'm afraid that the only book that I haven't given away is the dreaded "What to Expect"--if you keep [above] caveat in mind, you might still find a few pieces of useful information . . .
Who'd have thought a question about pregnancy guidebooks could hint at an emerging cultural divide? In her continuously evolving book, pregnancy guru Heidi Murkoff delivers an encyclopedic run-down of everything you ever wanted to know about having a child--from weight gain to hemorrhoids to fluctuations in sex drive. Although some women credit it with helping them diagnose dangerous medical conditions their doctors had missed, others now say that they're overwhelmed by the sheer exhaustiveness of the book, that it makes them feel as if the road to pregnancy is a minefield with the baby a test at the end. There's also this: At a time when having a baby and becoming a mom is yet another chance for women to assert their styles, "What to Expect" is written in a straightforward manner, without attitude or any discernible sensibility. And that makes some women dismiss it as outdated.
At the eye of that unanticipated storm is a woman struggling to keep her once-groundbreaking franchise relevant in this Age of Relentless Advice.
Virtually every woman of childbearing age in America is familiar with "What to Expect When You're Expecting." For pregnant women, reading it is a rite of passage. When you spot the pastel-toned cover peeking out from under a stack of magazines in a friend's living room or stashed under the bed, you know she is with child, or plans to be soon.
Since it hit stores in 1985, Murkoff's book has sold more than 14 million copies, and as of July 8 the guide will have been on the New York Times bestseller list for 319 weeks. Its success has spawned a fantastically lucrative franchise made up of nearly a half-dozen pregnancy and parenting books, many of which also have sold millions of copies.
A 1998 USA Today survey found that 93% of pregnant women who read a book about pregnancy will read "What to Expect When You're Expecting." The book is handed out by doctors and studied in medical schools. It shifted the paradigm in pregnancy publishing so completely that it has been imitated in some way by nearly every pregnancy book that has followed.
The book also has been featured in the films "Nine Months," "The Next Best Thing," "How Stella Got Her Groove Back" and "A Mighty Heart," as well as in the TV shows "The Practice" and "Friends." It recently made a prominent cameo in "Knocked Up." In one scene, the father-to-be recounts a list of the book's can't-dos, which bugs those who rail against this pregnancy bible: "Can't eat sushi. Can't drink. Can't smoke. Can't smoke pot."
But in a splintering culture, "What to Expect" appears to be one of the few things that actually bridge class, race and income gaps. From prison moms to PhDs, women devour what has become a cultural touchstone.
The woman behind this sprawling empire lives in a Mediterranean mansion in Hancock Park. When the door swings open, there stands the reigning queen of American pregnancy.
At 48, Murkoff is petite and stylish, dressed in a loose-fitting Indian cotton tunic and low-cut jeans. Her kitchen is the spotless domain of a Type A personality. She says she works seven days a week on her "What to Expect" franchise and its charitable foundation from a corner of this room, surrounded by dozens of pictures of her two children and other members of her family.
Murkoff credits her free-spirited parents, both freelance journalists, with nurturing her creativity and passing on their facility with words. But from an early age, she says, she knew she was different from the rest of her "disorganized, clutter-embracing, always late, schedule-phobic" family. Murkoff found disorder discombobulating and imposed her own rules and deadlines. She was neat, making her bed even when she didn't have to. She craved routines and gave herself a bedtime in fourth grade because she felt she needed one to do well in school. And she always turned her assignments in on time.
During her first pregnancy, Murkoff remembers that the classic books she found were written by male doctors and that some seemed patronizing. Another book, written by a woman who had never had a child, "scared the pants off me," she says, because of its alarmist tone.
Murkoff called her mother and pitched an idea to write an accessible book about pregnancy from the perspective of a woman who had actually given birth. She had her first baby, Emma, when she was 24, finishing her proposal for "What to Expect" just two hours before going into labor. Murkoff wrote the book during the first year of her daughter's life, with writing help from her late mother and editing help from her sister, who has since left the franchise.
The book was born of her own experiences at a time when most obstetricians were men and doctors were treated like gods. Doctors gave women little information about what was happening to their bodies, and women had few other resources. That's hard to imagine in this era of confessional mommy blogs, tell-all websites such as UrbanBaby and personalized daily e-mails that update a fetus' development down to the minute.
Everything about the book was groundbreaking. It was written by a mother, for mothers. It had an informal Q&A; format organized around questions that pregnant women might ask--if they dared. It broke pregnancy down month by month, telling mothers about the growth of their baby and what questions they might want to ask the doctor at their monthly appointments.
"I just thought, 'If I can help a handful of parents sleep better at night I will have succeeded,' " she says. "That was the only thing I was trying to do. My mission hasn't really changed. It's just grown."
Indeed. Murkoff tapped into the cultural zeitgeist. The book was a combination of inspiration, intuitive genius and luck, yet Murkoff recalls going to an American College of Obstetricians and Gynecologists meeting soon after it was published and overhearing a male doctor mutter to a colleague, "What do mothers know about pregnancy?"
"Every so often in publishing you get a manuscript and you think there have to be about a million books like this already, and you check, and there isn't a single one," says Suzanne Rafer, executive editor at Workman Publishing, who has edited Murkoff's books from the beginning.
Workman had only 4,000 orders from the book's first print run. Many bookstores declined to stock the book, saying there were enough pregnancy titles already. There was no advertising. But word began to spread. One woman would buy a copy, tell a friend, who'd tell her friends. "It was very grass roots," Murkoff recalls. "Very slow, very organic. It was 'word-of-mother.' "
Five years later, in 1990, it appeared on the New York Times bestseller list for the first time. "It was not something I expected," Murkoff says. "I never set out to write a best-selling book."
The "What to Expect" backlash exploded in September 2005 with a piece in the New York Times Style section headlined, "Expecting Trouble: The Book They Love to Hate." The story included a warning from a prestigious obstetrics and gynecology practice affiliated with Brigham and Women's Hospital in Boston that women avoid "What to Expect When You're Expecting," as well as a catalog of criticisms from Amazon reviewers, new parents and doctors.
So much has changed since Murkoff's book first appeared. Women are working longer, having children later and demanding more of a say in everything they do. Pregnant women often are forced to take sides in the birthing debate practically from the minute they conceive, if not before. Writing up a birth plan can be like choosing a political affiliation--and mothers often have to defend their choice.
"There is just an overwhelming quantity of information you need to filter through," says Ceridwen Morris, a coauthor of the new pregnancy book "From the Hips." The 39-year-old New Yorker has a 3-year-old son and is pregnant with a second child. "Polarized voices come at you from every angle."
A certain class of women cynically refer to Murkoff's book as "What to Freak About When You're Expecting" and to its accompanying food guide, 1986's "What to Eat When You're Expecting," as "What to Expect if You Want to Develop an Eating Disorder." (Murkoff reworked the 1986 book into a friendlier, gentler guide, "Eating Well When You're Expecting," which was published in 2005.) Something about the tone of the books just gets under some women's skin.
Terri Demarest, a mother of three living in North Hollywood, says she "hated" the original "What to Expect." "It either made me feel like a moron or made me worried."
"I read 'What to Expect' as though it was the Bible--but it's an alarmist book," says Jo Stein, who lives in Mexico City with her 1-year-old.
Morris' "From the Hips," coauthored with Rebecca Odes, and Tracy W. Gaudet's recent "Body, Soul, and Baby" take different approaches. In "From the Hips," Morris and Odes present information in a fresh, accessible way and try to soothe anxiety rather than create it. The book focuses on the basics and refers readers interested in a particular topic or birthing technique to other sources, sort of like hypertext on a website.
In "Body, Soul, and Baby," Gaudet, director of the Duke Integrative Medicine Center in Durham, N.C., reminds women that birth is an amazing and sacred experience. Women experience such incredible pressure now to have the perfect pregnancy, Gaudet says. "I think it is a manifestation of where we are culturally, that we think we can manage and control it all. We are one step away from where we have an artificial womb, and the fetus is here in the test tube, and you can grow it and pick it up in nine months."
Odes says that when she got pregnant she was startled to find the library of pregnancy books so backward.
"It's 2007 here," says Odes. "It's time for an update."
Murkoff is not content to let the royalties roll in. She works nonstop to maintain, update and expand the franchise. In 2000, she cofounded the What to Expect Foundation to help low-income women. The foundation began publishing "Baby Basics," a simplified guide to pregnancy written for women who can read only at a third-grade level. Since 2002 Murkoff's foundation has donated more than 250,000 books to poor pregnant women across the country through public clinics.
In April 2005, the "What to Expect" franchise launched a website as an interactive companion to the books. Murkoff cruises the message boards, answering questions during live chats and gathering feedback and resources for a new edition of the original book and other future projects.
She defends her decision to include negative information in her book. She says letters from readers always ask her to include more--to explain details about a condition they did not find. She doesn't talk much about the backlash to her books and claims she does not look at competitors' books. The negative New York Times piece devastated her, she says, and she felt the story was not representative or balanced. When she goes to medical conferences, she adds, the feedback from doctors is overwhelmingly positive.
"I was upset when I read it, because as the guardian of 'WTE,' I care so deeply," she says. "It hurt, and then I went back to work knowing that it wouldn't have any impact on what I do and why I do it. And it hasn't."
But perhaps it changed her.
She has updated the original "What to Expect When You're Expecting" hundreds of times with information gleaned from medical journals, conferences and doctors. She currently is working on the fourth edition, due next spring. She has included more on sex, added an entire chapter on multiple births and made the diet less restrictive. She moved almost all of the information on complications to a single section in the back of the book so worry-prone mothers can skip it if they wish. The new edition, she promises, will be chattier and "have more of a sense of humor."
"This is never going to be a finished book," Murkoff says. "Times change."
Yet that magical sense of reflecting the cultural zeitgeist now seems missing. Though "From the Hips" and "Body, Soul, and Baby" seem like 21st century books, even the cover of Murkoff's book seems sweetly outdated. Also, the content seems clinical rather than drawn from the stuff of life. In nearly a quarter century, she has gone from being the outsider radical to being the establishment authority.
Maybe it's just one of those predictable stages of development. Murkoff had her last child 21 years ago. She is too busy running her foundation, revising her books and managing her website to be overly concerned about changes in the zeitgeist. And, ultimately, does it matter? Even though her books might be considered uncool, pregnant women still turn to them because they know "What to Expect" will answer their questions--perhaps even better than their doctor.
"As cynical as I am, the book is on my bedside table," says Dani Klein Modisett of Atwater Village, who is pregnant with her second child. "If you really follow all the book's recommendations, it makes pregnancy a full-time job. But if anything happens, if I get some weird leakage or strange pain, I know I can check it. It's the ultimate accessible reference guide."
Chat online with Heidi Murkoff at 3 p.m. Monday, July 30, at chat.latimes.com
(BEGIN TEXT OF INFOBOX)
JUDGING BOOKS BY. . .
The cover of Heidi Murkoff's "What to Expect When You're Expecting" and "From the Hips," a just-released book on pregnancy by two modern moms, shows how views of pregnancy have changed during the past 22 years.
The cuddly patchwork cover of "What to Expect" features a pregnant woman in an old-fashioned rocking chair, staring out at readers with a cryptic expression. The cover of "From the Hips," by contrast, shows the naked, fuchsia silhouette of a pregnant woman in a strong, almost defiant pose, hands on her hips and belly bared for all to see.
"The way women are visually represented in pregnancy books is about 10 years behind the way they are represented anywhere else," says "From the Hips" coauthor Rebecca Odes, who illustrated the book. "Everything is soft, nonconfrontational, wimpy. This is a strong design for strong women."
Murkoff says plans are underway to redesign the cover image of her fourth edition. "She's definitely due for some fashion-forward refreshing. Who knows, maybe she'll even be off her rocker the next time around."