Family planning: Get the facts about pregnancy spacing Show
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 StaffConsidering having another child? Pregnancy spacing is an essential part of family planning. It can affect more than how close your children are in age. Here's what you need to know. Why is family planning important?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. What are the risks of spacing pregnancies too close together?Research suggests that beginning a pregnancy within six months of a live birth is associated with an increased risk of:
In addition, recent research suggests that closely spaced pregnancies 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 breastfeeding can deplete your stores of nutrients, particularly folate. 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. Are there risks associated with spacing pregnancies too far apart?Some research also suggests that long intervals between pregnancies pose concerns for mothers and babies, such as an increased risk of preeclampsia in people with no history of the condition. 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. What's the best interval between pregnancies?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, people 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's no need to wait to conceive after a 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. What else do I need to know about pregnancy spacing?There's no perfect time to have another baby. Even with careful planning, you can't always control when conception happens. However, discussing reliable birth control options until you are ready to conceive and understanding the possible risks associated with the timing of your pregnancies can help you make an informed decision about when to grow your family. Feb. 12, 2022
See more In-depth . No, it’s not true that you won't be fertile until your period starts again. It's perfectly possible to get pregnant before having your first period after giving birth. You'll ovulate about two weeks before you have a period. This means you’ll have been fertile again during that time but you won’t necessarily know it. When will I be fertile again after giving birth?While it's unlikely, you can get pregnant in as little as three weeks after giving birth (postpartum), even if you're breastfeeding and your periods haven't returned yet (NHS 2018). So, if you don't want to get pregnant soon after giving birth, and experts recommend waiting a while anyway (FSRH 2020), it’s worth spending time working out what type of contraception is best for you. Chances are your GP will talk to you about contraception at your postnatal check anyway, if not before (FSRH 2020). Many women like to wait until their GP gives them the OK anyway at their postnatal check before having sex. This happens at around six weeks. But if you feel ready sooner that’s fine too, as long as you have birth control sorted, your bleeding (lochia) has stopped and any bruising, stitches or swelling has healed (NHS 2018). When will my periods come back after giving birth?If you’re bottle-feeding, or combining breast and bottle, your periods (menstrual cycle) will return about six to 10 weeks after your baby is born. If you're breastfeeding, it could be months before your period returns, but there's no way of telling exactly when it will happen (NHS 2021). Can I get pregnant if I'm breastfeeding?Yes you can. Generally, breastfeeding triggers hormones that stop ovulation and menstruation. The medical term for this is lactational amenorrhoea. Some mums use breastfeeding as a method of contraception, known as the lactational amenorrhea method (LAM). But it’s unreliable unless you're exclusively breastfeeding every few hours during the day and night and your baby isn't having any solids or any other form of milk (Tiwan et al 2018). Can I take the contraceptive pill while breastfeeding?The combined pill, contraceptive patch and the vaginal ring aren’t usually recommended during the first six weeks after birth if you're breastfeeding (NHS 2020). This is because contraception that uses a combination of the hormones oestrogen and progesterone can affect your milk supply. However, the mini-pill, also called the progestogen-only pill (POP), is fine (NHS 2020). Learn more about your contraceptive options while breastfeeding. When is the best time to get pregnant again after giving birth?If you’re keen to add to your family, bear in mind that experts recommend that you wait a year to 18 months before your next pregnancy. Research suggests that getting pregnant again before this can increase your risk of giving birth prematurely, or your baby having a low birth weight or being small for dates (FSRH 2020). Waiting before conceiving again will also give you time to feel you’ve fully recovered from your previous pregnancy. Your body will have a chance to recover physically and build up nutritional stores, particularly iron and folate, so that it can support and nourish a new baby. More on sex and relationships
ReferencesFSRH. 2020. FSRH clinical guideline: contraception after pregnancy. FSRH Standards and guidance. www.fsrh.org [Accessed August 2022] NHS. 2018. Sex and contraception after birth. Health A-Z, Baby. www.nhs.uk [Accessed August 2022] NHS. 2020. When can I use contraception after having a baby? Health A-Z, Your contraception guide. www.nhs.uk [Accessed August 2022] NHS. 2021. When will my periods start again after pregnancy? Common health questions, Pregnancy. www.nhs.uk [Accessed August 2022] Tiwari, K et al. 2018. A study on effectiveness of lactational amenorrhea as a method of contraception.International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7(10):3946-3950  Lorna Marsh is senior editor at BabyCentre. She has more than 20 years’ journalism and editing experience, including working for the NHS. |
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