Choosing the right balance: personalizing pregnancy decisions with costs, benefits, and uncertainty

Emily, both an expecting mom and an economist, faced decision fatigue as pregnancy seemed to come with endless rules and contradictory advice. One moment she was told not to touch coffee, the next that up to three cups were fine. Doctors recited cutoffs for tests and treatments without nuance. Standard screening recommendations declared strict age thresholds for interventions, never mind different priorities or lifestyles.

Frustrated by the feeling of being treated like a child—'just do as you’re told'—she leaned into what she knew best: structured decision-making. Emily listed the costs and benefits of each choice from both her own and her partner’s perspectives. Taking coffee as an example, she weighed the joy and productivity caffeine brought her against the best-guess miscarriage risks, finding the evidence for harm at moderate doses weak. The numbers, when put side by side, let her match scientific reality to her own comfort level.

For testing and interventions, she stopped defaulting to blanket rules about what 'most women' should do, instead calculating how much uncertainty she could tolerate. When she prioritized self-knowledge over outside pressure, she found her anxiety dropping.

This method draws on the economic principle of individualized cost-benefit analysis—recognizing variable values and different weights for each person, and integrating evidence, uncertainty, and subjective preference to own the process.

For your next big choice—from screening to everyday habits—write down your own list of the pluses and minuses on each side, using real numbers where possible and your gut on what matters most. Don’t let someone else’s priorities override your own unless you see a compelling reason. Trust that your unique weighing of these factors, based on both evidence and values, will lead you to the answer that lets you move forward with peace of mind. If doubt lingers, remind yourself that personalization isn’t selfish—it’s smart.