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Family planning: Get the facts about pregnancy spacing

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. It can also have an impact on your health and your baby's health. Find out what you need to know about family planning and timing pregnancies.

Why is family planning important?

Whether you're thinking about getting pregnant for the first time or you already have children, it's important to think about family planning and your reproductive goals. Knowing whether you do or don't want to have children in the next few years can help you and your partner choose appropriate contraception — such as birth control pills, contraceptive injections or implants, or an intrauterine device (IUD). Family planning can also help you determine when you might begin preconception planning, which is sometimes recommended up to a year in advance of getting pregnant.

After your first child is born, 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? It's also important to consider the timing of your pregnancies. While you and your partner might have preferences about how close in age you'd like your children to be, some studies show that spacing pregnancies too close together or too far apart can pose health risks for both mother and baby.

What are the risks of spacing pregnancies too close together?

Limited research suggests that a pregnancy within 12 months of giving birth is associated with an increased risk of:

  • The placenta partially or completely peeling away from the inner wall of the uterus before delivery (placental abruption)
  • The placenta attaching to the lower part of the uterine wall, partially or totally covering the cervix (placenta previa), in women who previously had a C-section

A 2011 study also suggests a link between pregnancy intervals of less than 12 months and autism risk in second-born children.

In addition, a pregnancy within 18 months of giving birth is associated with an increased risk of:

  • Low birth weight
  • Small size for gestational age
  • Preterm birth
  • Uterine rupture in women who attempt vaginal birth after a C-section (VBAC)

Some experts believe that closely spaced pregnancies don't give a mother enough time to recover from the physical stress of one pregnancy before moving on to the next. For example, pregnancy and breast-feeding can deplete your stores of essential nutrients, such as iron and folate. If you become pregnant before replacing those stores, it could affect your health or your baby's health.

It's also possible that behavioral risk factors, such as smoking, substance abuse, failure to use health care services and unplanned pregnancies, as well as stress and socioeconomic disadvantage, are more common in women who have closely spaced pregnancies. These risk factors — rather than the short interval itself — might explain the link between closely spaced pregnancies and health problems for mothers and babies.

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References
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  2. Closely spaced pregnancies are associated with increased odds of autism in California sibling births. Pediatrics. 2011;127:246.
  3. Stubblefield PG. Interpregnancy interval and pregnancy outcome. http://www.uptodate.com/home/index.html. Accessed Feb. 17, 2011.
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  7. HTSP 101: Everything you want to know about healthy timing and spacing of pregnancy. World Health Organization. http://www.who.int/pmnch/topics/maternal/htsp101.pdf. Accessed Sept. 3, 2010.
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  9. King JC. The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies. The Journal of Nutrition. 2003;133:1732S.
  10. Healthy people 2020 summary of objectives. U.S. Department of Health and Human Services. http://www.healthypeople.gov/2020/topicsobjectives2020/pdfs/FamilyPlanning.pdf. Accessed April 1, 2011.
  11. Preconception care questions and answers. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/preconception/QandA.htm. Accessed April 1, 2011.
  12. Kottke M. Nondaily contraceptive options: User benefits, potential for high continuation and counseling issues. Obstetrical & Gynecological Survey. 2008;63:661.
  13. Recovering from birth. The National Women's Health Information Center. http://womenshealth.gov/pregnancy/childbirth-beyond/recovering-from-birth.cfm. Accessed April 1, 2011.
  14. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. April 4, 2011.
  15. Your Pregnancy and Childbirth Month to Month. 5th ed. Washington, D.C.: American College of Obstetricians and Gynecologists. 2010;282.
  16. Bujold E, et al. Risk of uterine rupture associated with an interdelivery between 18 and 24 months. Obstetrics and Gynecology. 2010;115:1003.
  17. Getahun D, et al. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstetrics and Gynecology. 2006;107:771.
  18. Conde-Agudelo A, et al. Effects of birth spacing on maternal health: A systematic review. American Journal of Obstetrics & Gynecology. 2007;196:297.
  19. Zhu BP, et al. Labor dystocia and its association with interpregnancy interval. American Journal of Obstetrics & Gynecology. 2006;195:121.
MY01691 May 27, 2011

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