A new study says mothers should wait at least a year between giving birth and getting pregnant again in order to reduce health risks.
However, researchers say they need not wait as long as the 18 months currently recommended by the World Health Organization guidelines. Small gaps between pregnancies are known to increase the risk of premature births, smaller babies, and infant and mother mortality. The researches hope the new findings would be “reassuring” for older women.
“Older mothers for the first time have excellent evidence to guide the spacing of their children,” said senior study author Dr. Wendy Norman. “Achieving that optimal one-year interval should be doable for many women and is clearly worthwhile to reduce complication risks.” Dr. Norman said it was “encouraging news” for women over 35 who were planning their families.
The research was conducted by the University of British Columbia (UBC) and the Harvard TH Chan School of Public Health. Their findings were published in JAMA Internal Medicine and came from studying 150,000 births in Canada. They found 12-18 months was the ideal length of time between giving birth and becoming pregnant again.
The researchers also discovered:
- Getting pregnant less than 12 months after giving birth was associated with risks for women for all ages.
- There were risks to the mother only for women over the age of 35, while risks to the infant were found for all women, but were greatest for those aged between 20 and 34.
- Women over 35 who conceived six months after a previous birth had a 1.2% risk of maternal mortality or harm (12 cases per 1,000 pregnancies).
- Waiting 18 months between pregnancies reduced the risk to 0.5% (five cases per 1,000).
- Younger women who got pregnant six months after a previous birth had an 8.5% risk (85 cases per 1,000) of premature labor.
- This dropped to 3.7% (37 per 1,000) if they waited 18 months between pregnancies.
Laura Schummers, the study’s lead author, said: “Our study found increased risks to both mother and infant when pregnancies are closely spaced, including for women older than 35. The findings for older women are particularly important, as older women tend to more closely space their pregnancies and often do so intentionally.”
It is important to note, however, that the study only looked at women in Canda, therefore it is unclear how applicable the findings would be worldwide.
Researcher Dr. Sonia Hernandez-Diaz noted that spacing may reflect unplanned pregnancies, particularly among younger women. “Short pregnancy spacing might reflect unplanned pregnancies, particularly among young women.
“Whether the elevated risks are due to our bodies not having time to recover if we conceive soon after delivering or to factors associated with unplanned pregnancies, like inadequate prenatal care, the recommendation might be the same: improve access to postpartum contraception, or abstain from unprotected sexual intercourse with a male partner following a birth.”
Mandy Forrester, from the Royal College of Midwives, commented that the study was “useful research and builds on previous research into birth spacing”.
“Ultimately, it will be a woman’s choice, whatever age they are, about how long they leave between their pregnancies. What is important is that they are aware of the evidence around birth spacing and that they make their choice armed with the right information. Health professionals will always support a woman in her choice, which will be about what is right for them and their pregnancy.”
According to the Centers for Disease Control and Prevention (CDC), 17.5% of American families have a 13-24 month gap between the first and second children compared to 17.2% with a 25-36 month difference.
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