Birth Spacing
Birth spacing is an important maternal and child health intervention. USAID-sponsored studies have helped establish healthy pregnancy timing and spacing as an important intervention to improve infant, child, and maternal health.
Based on Demographic and Health Surveys (DHS) and other data, these analyses found that:
- Short birth-to-pregnancy intervals are associated with significant increased risk of neonatal, infant, child and under-5 mortality; low birthweight and preterm births; infant/child malnutrition in some populations; and stillbirths, miscarriages, and maternal morbidity (see figure below).
- From a public health perspective, birth-to-pregnancy intervals of at least two years (or three-year birth-to-birth intervals), but not longer than five years, are associated with the healthiest pregnancy outcomes.
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Intervals between abortions (spontaneous or induced) and the next pregnancy that are shorter than six months are associated with significant increased risk of adverse maternal and perinatal outcomes in the next pregnancy, such as low birthweight, preterm births, small-for-gestational age, premature rupture of membranes, and anemia.
Under-5 Mortality by Birth Interval
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| Source: S.O. Rutstein. 2005. Effects of preceding birth intervals on neonatal, infant and under five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. International Journal of Gynecology and Obstetrics, 89: S7-S24. |
In addition to these findings, earlier analyses found that pregnancies occurring to women under 20 years of age are associated with significant perinatal risks and that pregnancies in women under 16 are associated with significant maternal as well as perinatal risks.
Additional Resources
- Long-Acting and Permanent Methods (LAPMs): Addressing Unmet Need for Family Planning in Africa
Funded by USAID and produced by Family Health International, a new evidence-based advocacy package is available for program managers and policymakers. The package is a set of eight briefs on the LAPM class of modern contraceptive methods, which is comprised of four highly effective methods for delaying, spacing, or limiting births.
- USAID Issue Brief: Healthier Mothers and Children Through Birth Spacing [PDF, 83KB]
Helping women achieve healthy pregnancies and safe births is one of the highest priorities of USAID’s family planning program. One of the best ways is through birth spacing, which not only results in healthier pregnancy but also reduces under-5 mortality.
- Couple Years of Protection (CYP)
An overview of Couple of Years of Protection (CYP), the estimated protection provided by contraceptive methods during a one-year period, based upon the volume of all contraceptives sold or distributed free of charge to clients during that period.
- Healthy Timing and Spacing of Pregnancies
The health benefits of a minimum of two years between a mother’s last birth and her next pregnancy are well documented. The USAID-funded Extending Service Delivery (ESD) project has compiled numerous resources and tools to help family planning and reproductive health advocates integrate this message into their current programs.
- Birth Spacing and Risk of Adverse Perinatal Outcomes
This Journal of the American Medical Association (JAMA) study describes the effects of birth spacing exclusively on newborns during the first few days of life (the perinatal period) rather than when they are older.
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