Birth spacing: How far apart is best?

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Pregnancy, labor, birth, and breastfeeding can be hard on a woman’s body. Women need time to recover from all of this before considering pregnancy again. Pregnancy spacing is an important part of family planning and well-woman care.   

Choosing when to have another baby is a personal decision, but when planning your next pregnancy, you and your partner need to understand the health risks and benefits. It also goes without saying that a reliable method of birth control is a great way to help prevent unplanned pregnancy.

Right now the Centers for Disease Control and Prevention, American College of Nurse-Midwives, The American College of Obstetricians and Gynecologists and March of Dimes recommend spacing pregnancies at least 18 months apart. This spacing means your children will be at least 27 months apart.

This recommendation is based on research about what risks are increased when women have babies close together.  

Many studies have found that beginning a pregnancy within six months of birth is associated with a number of increased risks:

• Premature births.   

Premature rupture of membranes (Water breaking early, which can cause increased risks to babies). 



Maternal anemia (Related to moms not being fully recovered from their last pregnancy and birth). 

Placental abruption (When the placenta partially or completely peels away from the inner wall of the uterus before delivery). 

Low-birth-weight babies who may sometimes struggle with temperature regulation, feeding, and blood sugars when born.

My final recommendation is that women who are not using reliable birth control and women planning pregnancy should all be on a prenatal vitamin or multivitamin containing at least 0.4 mg of folic acid daily. This supplement helps prevent birth defects in very early pregnancy before women know they are pregnant.  

About the writer 

Lauren Andronici is a certified nurse midwife at Vancouver Clinic. She holds a master of science in nursing with a specialty in midwifery from Oregon Health & Science University.