Pregnancy spacing, or the amount of time in between giving birth and conception of your next child, is an important part of planning what your family will look like. How many kids you want and their age gaps are deeply personal decisions for each family. But spacing your pregnancies can have a significant impact on the health and well-being of mother, baby, and the family unit as a whole.
The Spacing Sweet Spot
According to the American College of Obstetrics and Gynecology (ACOG), the recommended time between giving birth and getting pregnant again is at least 18 months and less than five years.
“From a maternal health standpoint, it allows for physical recovery after delivery, as well as mental recovery,” says Ann Bruno, MD, an assistant professor in the Department of Obstetrics and Gynecology at University of Utah Health. “There are also potential chronic health conditions to consider, such as gestational diabetes or chronic hypertension, where a longer interpregnancy spacing can allow for optimization of health.”
Closely spaced pregnancies are associated with the following risks:
- Pre-term birth, meaning birth before 37 weeks’ gestation
- Low birth weight
- Maternal anemia
- Emotional and physical strain
- Higher likelihood of complications such as uterine rupture
These risks are highest if the interval between pregnancies is six months or less.
“The data are very consistent that a pregnancy interval less than six months is associated with higher risks for poor outcomes for mom and baby,” Bruno says. “That is particularly true for those who had a cesarean delivery. A longer interval is going to optimize maternal and neonatal health.”
A longer spacing between pregnancies can have other benefits for maternal health, such as:
- Better nutrition. Eating well is essential both for your health and the health of your unborn child. Longer pregnancy intervals give women more time to replenish their nutritional stores, especially if they are breastfeeding.
- Bonding time. A longer interval gives you more time to breastfeed or simply have one-on-one time with your newborn.
Waiting longer than five years between pregnancies may increase the risk of developing conditions like pre-eclampsia, which is high blood pressure during pregnancy, or difficulties with labor that may result in needing a c-section.
Making the Best Choice for Your Family
Every family unit is different, and having an informed conversation with your doctor can help you decide what a safe pregnancy interval would look like for you.
Some people may desire to space their pregnancies closer together than the recommended 18 months for social or cultural reasons, or if the mother is over the age of 35. Unintended back-to-back pregnancies can also happen.
“If a patient strongly desires a shorter interval,” Bruno says, “we want to make sure that, if they do have complications from a prior pregnancy, we have the opportunity to meet with them and optimize their health before they pursue pregnancy.”
If you suffer a miscarriage, you do not have to wait 18 months before trying again. Bruno recommends waiting until you feel emotionally and mentally ready.
Stillbirths, meaning a loss after 20 weeks’ gestation, are more nuanced based on what caused the stillbirth. But preconception appointments with your doctor can help you make an informed decision for your situation.
“If there’s an explanation for why the stillbirth occurred, then we might recommend a longer delay in getting pregnant again,” Bruno says. “But we would talk about some of the risk factors and potential causes of the stillbirth, along with how we could manage it in the next pregnancy.”
Being in Control
While unintended pregnancies can happen, there are ways to prevent them so that you can decide when you’re ready to get pregnant again.
Your doctor will likely counsel you about your birth control preferences while you are still pregnant. Having a plan immediately after your delivery can take some stress off your plate while you are newly postpartum—and can help ensure your pregnancies have the best spacing for you and your family.