When Should You Have Your Next Baby?

How Far Apart Your Pregnancies Should Be

Pregnant woman and toddler
Photo © Stephen Simpson Photolibrary/Getty Images

Having a baby certainly takes a toll on your body, your mind, and your energy. For many years the pregnancy community has not spent much time talking about what is best in terms of time between pregnancies in any real fashion. There has been more talk about doing what feels right for your family. While that certainly comes into play, it is also important to look at what the scientific evidence says about planning for your next pregnancy.

The Centers for Disease Control (CDC) wanted to look at what was happening in a snapshot of the United States. Taking data from birth certificates of over 36 states and over three million births, they were able to give a good idea of how far apart most pregnancies are for US women. They also compared it to another large study of women's birth spacing.

The basics are that if you have a short amount of time between the birth of one baby and the conception of another, less than 18 months you have a greater risk of complications. There is also an increased risk when the amount of time from giving birth to conceiving is greater than 60 months. So the sweet spot for conception is between 18 and 60 months. Typically you will hear 18 to 24 months is ideal from most practitioners.

The study looked at what the interpregnancy interval (IPI) looked like for these women. (That is defined as the time period between the birth of one baby and the conception of another baby.) A short interval was defined as an IPI of 18 months, so from the day you give birth until the day you conceive there was less than 18 months.

A long IPI was considered greater than 60 months or five years. The average amount of time between birth and conception was 29 months, though this also depended on where you lived, as some geographic regions had higher numbers and some lower.

What do you need to do practically? Well, first of all, no matter how many times we try to tell women that the postpartum period is only six weeks, remember, that's simply about a shrinking uterus, and not about how well your body has recovered from birth.

There is the toll that the lack of sleep, hormones, and breastfeeding take on your body. Your iron stores need to replenish.  There is a lot to do in order to be in the best shape possible for having another baby.

Younger mothers, including teens, had shorter spaces between pregnancies. Mothers who were older than 40 tended to have longer interpregnancy intervals. There were no significant differences in the timing in consideration to education, marital status, etc.

So do younger mothers lack birth control or knowledge? Do older mothers suffer from chronic medical conditions or do they have fertility problems? This is something that this study did not look at specifically. The goal here was merely to talk about the spacing of pregnancies.

Some people wonder if a short IPI will change whether or not a mother with a previous cesarean birth can attempt a vaginal birth. At this point the American College of Obstetricians and Gynecologists (ACOG), have not listed a shorter time period as being a reason to not attempt a vaginal birth after cesarean (VBAC).

In the end, here's what you need to keep in mind:

  • Your health status in general. Being healthy and having chronic conditions under control reduce the risks for you and baby.
  • Talk to your doctor or midwife. Together with them, they can help you choose the best time for conception.
  • Be kind to your body. Pregnancy and parenting can take their toll. Eat well, sleep enough, and exercise.

Sources:

Cheslack Postava K, Winter AS. Short and long interpregnancy intervals: Correlates and variations by pregnancy timing among U.S. women. Perspect Sex Reprod Health. 47(1):19–26. 2015

Copen CE, Thoma ME, Kirmeyer S. Interpregnancy intervals in the United States: Data from the birth certificate and the National Survey of Family Growth. National vital statistics reports; vol 64 no 3. Hyattsville, MD: National Center for Health Statistics. 2015.

Kennare, R, Tucker, G, Heard, A, Chan, A. Risks of Adverse Outcomes in the Next Birth After a First Cesarean Delivery. Obstetrics and Gynecology 109(2):270-76. 2007.

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