Pregnancy spacing is an essential part of family planning. Understand the importance of pregnancy spacing and what factors to consider before you conceive again.By Mayo Clinic Staff
Considering having another child? Pregnancy spacing can affect more than how close your children are in age. Here's what you need to know.
Knowing whether you do or don't want to have children in the next few years can help you and your partner prepare for conception or choose appropriate contraception.
If you're already parents, family planning takes on new meaning. Having another child will change your family's lives. Are you and your partner ready to take care of a newborn again? How will your other child or children react to sharing your attention with a new baby?
The timing of your pregnancies is important, too. While you and your partner might have preferences about how close in age you'd like your children to be, some research shows that how you space your pregnancies can affect mother and baby.
Research suggests that beginning a pregnancy within six months of a live birth is associated with an increased risk of:
- Premature birth
- The placenta partially or completely peeling away from the inner wall of the uterus before delivery (placental abruption)
- Low birth weight
- Congenital disorders
In addition, recent research suggests that a pregnancy within less than two years of a live birth might be associated with an increased risk of autism in second-born children. The risk is highest for pregnancies spaced less than 12 months apart.
Closely spaced pregnancies might not give a mother enough time to recover from pregnancy before moving on to the next. For example, pregnancy and breast-feeding can deplete your stores of nutrients, particularly folate and iron. If you become pregnant before replacing those stores, it could affect your health or your baby's health. Inflammation of the genital tract that develops during pregnancy and doesn't completely heal before the next pregnancy could also play a role.
Some research also suggests that long intervals between pregnancies pose concerns for mothers and babies. A pregnancy five years or more after giving birth is associated with an increased risk of high blood pressure and signs of damage to another organ system, often the kidneys (preeclampsia).
It's not clear why long pregnancy intervals might cause health problems. It's possible that pregnancy improves uterine capacity to promote fetal growth and support, but that over time these beneficial physiological changes disappear. Unmeasured factors, such as maternal illnesses, might play a role too.
To reduce the risk of pregnancy complications and other health problems, research suggests waiting 18 to 24 months but less than five years after a live birth before attempting your next pregnancy. Balancing concerns about infertility, women older than 35 might consider waiting 12 months before becoming pregnant again.
The risks and recommendations don't apply to couples who have had a miscarriage. If you're healthy and feel ready, there might be no need to wait to conceive after miscarriage.
Choosing when to have another baby is a personal decision. When planning your next pregnancy, you and your partner might consider various factors in addition to the health risks and benefits. Until you make a decision about when to have another child, use a reliable method of birth control.
There's no perfect time to have another baby. Even with careful planning, you can't always control when conception happens. However, understanding the risks associated with timing your pregnancies too close together or too far apart can help you make an informed decision about when to grow your family.
Feb. 25, 2017
- Report of a WHO technical consultation on birth spacing. World Health Organization. http://www.who.int/maternal_child_adolescent/documents/birth_spacing05/en/. Accessed Jan. 12, 2017.
- Cheslack-Postava K, et al. Closely spaced pregnancies are associated with increased odds of autism in California sibling births. Pediatrics. 2011;127:246.
- Shachar BZ, et al. Interpregnancy interval and obstetrical complications. http://www.uptodate.com/home. Accessed Jan. 12, 2017.
- DeFranco EA, et al. Influence of interpregnancy interval on neonatal morbidity. American Journal of Obstetrics & Gynecology. 2015;212:386.
- Zerbo O, et al. Interpregnancy interval and risk of autism spectrum disorders. Pediatrics. 2015;136:1.
- Conde-Agudelo A, et al. Birth spacing and risk of adverse perinatal outcomes: A meta-analysis. Journal of the American Medical Association. 2006;295:1809.
- Ball SJ, et al. Re-evaluation of link between interpregnancy interval and adverse birth outcomes: Retrospective cohort study matching two intervals per mother. BMJ. 2014;349:4333.