Spacing In Pregnancy- What, Why and How?

Pregnancy spacing is an important part of family planning where spacing refers to the time interval between childbirth and the next pregnancy. It is also known as the birth-to-pregnancy interval. Having two childbirths within a short period of time can be harmful to the health of the mother, as well as the child.

The ideal pregnancy spacing interval must be between 3-5 years. This means the couple must plan for the next pregnancy not less than 3 years and not more than 5 years after the birth of the first child. Whereas, publications by the World Health Organization (WHO) and other international organizations recommend waiting at least 2–3 years between pregnancies to reduce infant and child mortality, and to benefit maternal health. However, studies suggested that longer birth spacing, 3–5 years, might be more advantageous

World Health Organization recommendations on birth spacing

Recommendations for spacing after a live birth

After a live birth, the recommended interval before attempting the next pregnancy is at least 24 months in order to reduce the risk of adverse maternal, perinatal, and infant outcomes.

Recommendation for spacing after an abortion

After a miscarriage or induced abortion, the recommended minimum interval to the next pregnancy is at least six months in order to reduce risks of adverse maternal and perinatal outcomes.

What are the risks of spacing pregnancies too close?

According to research, getting pregnant again within 6 months of the birth of the first child has a higher risk of:

  1. Premature birth of the baby

  2. Placental abruption- Detachment of the placenta from the wall of the uterus before delivery

  3. Low birth weight of the baby

  4. Congenital disorders- Birth defects in the baby

  5. Miscarriage

  6. Newborn death

How does it affect the mother?

  1. Pregnancy and breastfeeding can exhaust the nutrient stores of the mother

  2. Iron deficiency can cause anemia in the mother

  3. Folate deficiency in the mother can cause birth defects in the child

  4. Inflammation of the genital tract during the first pregnancy which was not completely healed before the next pregnancy could also cause complications

How does it affect the family?

Financial burden- Spacing two pregnancies closely increases the financial stress on the couple to raise two children at the same time.

Divided attention of the parents- can affect the mental state and development of either child

How to space pregnancies?

There are a variety of contraceptive methods available to avoid unplanned pregnancies without any side effects.

Some commonly used temporary contraceptive methods are:

  1. Barrier contraceptives- Condoms, cervical caps or diaphragms

  2. IUDs- intrauterine devices which can be inserted soon after delivery of the first child, effective for up to 5 years

  3. Oral contraceptives

  4. Implant- skin implant of a capsule containing hormone that releases slowly for a long time (up to 3 years)

  5. Injectable progestins- Hormone preparations injected every 2-6 months

Take away message

  1. Optimal spacing between two pregnancies prevents complications to the health of the mother and the baby.

  2. It is also beneficial for the couple as it reduces the financial burden and enables them to provide better care for both children.

  3. There are a variety of safe, effective, and temporary contraceptive options that can be used for preventing early pregnancy.

Understand the importance of pregnancy spacing and what factors to consider before you conceive again.

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