With all of my patients, as they enter the third trimester, I discuss what their contraceptive plans are for after the baby is born.
Many smile a beautiful, blissful, glowingly pregnant smile and say, “Oh no. I don’t think we will ever use contraception again. Hopefully we will get pregnant again right away!”
Fast forward to their postpartum visit. A sleep deprived, exhausted new mom sits before me. Her first topic of conversation: contraception. While she is madly in love with her new baby, the thought of having another right away is a little overwhelming. She is not physically ready to go down that road again.
Some women are ready right away. I once had a women ask me at delivery when she could try for another baby. My answer, “Well, you at least have to wait for me to get the placenta out!”
The decision on when to try for your next child, obviously depends on many factors. Finances, age, personal goals and beliefs on contraception are just a few. I was recently asked on our FB page what the ideal timing between pregnancies is from a medical stand point. According to studies looking at pregnancy outcomes, it is best to conceive 18 months to 4 years after your last delivery.
I find it interesting that the ‘optimal’ time for conception of the next child is about 18 months since this is when children are truly at their most adorable. Full of toothy grins and giggles as they toddle around. This stage of ultimate cuteness entices people to have another baby. They then proceed to conceive before their child hits the ‘terrific twos.’ Which while adorable, at least in my house, is a challenging time.
Pregnancies conceived less than 18 months since the last delivery have an increased risk of preterm delivery and low birth weight. Pregnancy takes a lot out of your body, and it takes time for a woman to recover from the stress and for her nutrient supplies to get back to normal. The theory is that the body has not fully recovered at less than 18 months causing the baby’s extra risk of not growing as well (low birth weight). The risk of preterm delivery is further amplified in teens who conceive again quickly, since teens have often used their nutritional supplies on their own growth as well as their baby’s.
VBAC: Women who attempted a trial of labor after a cesarean section have an increased risk of uterine rupture if the pregnancies are less than 18 months apart.
Pregnancies conceived less than 12 months since the last delivery have an increased rate of placental abnormalities, such as placenta previa and placental abruption. Placenta previa is a condition where the placenta covers the opening of the cervix making vaginal delivery unsafe and increasing the risk of hemorrhage. Placental abruption occurs when the placenta begins to detach from the uterus before the baby is delivered. It can result in hemorrhage and fetal distress.
Pregnancies conceived less than 6 months from delivery have an increased rate of neural tube defects and autism. Neural tube defect is associated with low maternal folate levels, so most likely in pregnancies less than 6 months apart, the mother has not had time to fully replenish those supplies.
Pregnancies conceived greater than 4 years from the last delivery have an increased rate of preeclampsia, fetal growth restriction and cesarean section. It is unsure why this increased risk is seen other than the possible health changes in the mom over this time.
The actual ‘increased risk’ in each of the cases is statistically significant but overall low for the average woman. Take preterm delivery, the risk increase with conceiving early is 20%. For the average mom with no history of preterm birth, this changes her risk from 1% to 1.2%, which is negligible. However, a woman with a previous preterm delivery sees her risk go from 15% to 18%. These increased risks are most significant for those moms who already have risk factors for these conditions.
For the average healthy mom with no medical problems and a vaginal delivery, the increased risks of these complications with conceiving again soon are extremely low. Women with a cesarean section should wait 18 months for their scar to fully heal, especially if they desire a trial of labor (VBAC). Those with a history of pregnancy complications listed above are advised to wait the suggested interval before conceiving.
- My adorable two year old as Peter the Panda.
Lots of prayer and being on the same page with your spouse should be at the forefront when you are making the decision on when to have another child. But knowing the medical facts is equally important for making sure you are ready – both body and mind – to grow your family.
From a practical standpoint, we’d love to hear from our readers who have multiple children on how the timing worked for you.
My new guy is 1 month old and big brother is 4 it has been great so far big is so proud and helpful …
Well ladies, I waited nine years to get pregnant with my third. My first two was from a different marriage that ended in divorce. My personal opinion is that no matter how short or long the duration, the prospective mother and father should be ready and committed to providing a decent life for the child. Nothing is worst than having a child and then the relationship does not work out. There is no explanation that will help the child in this situation. Don’t get me wrong, my older two children are better now, but this took lots of work. I would say just be ready and committed to raising a bright, healthy, Christian child.
Really great thoughts Jajaun. Being ready and committed are the most important things. Thanks for sharing!! Blessings to your family!
My husband and I are working through this one right now. Our first-born is 17 months old, and we always said we’d like our children to be around 2 years apart. That would mean already being pregnant now… but the thought of that kind of terrifies me! I tell people that I’ll know I’m ready for number 2 when amnesia has set in… aka, I forget about what it was like to be in labor, the pain of healing post-labor (I actually had to have surgery when my son was 6 months old because my tear didn’t heal properly…. 6 months of not being able to sit or walk without pain until I got that surgery!), nursing around the clock with a fussy baby, lack of sleep, etc. I know there will come a point when those memories aren’t quite so fresh, and the idea of having a newborn and a toddler won’t completely freak me out 🙂
On the other hand, before my son was conceived, we also suffered a miscarriage after a surprise pregnancy. We were not yet thinking about starting a family, and felt like we had other things that needed to be done before we had children. After the miscarriage, we were devastated and realized just how much we wanted that baby, and knew we wanted to try again as soon as we could. Just as we needed a surprise pregnancy to know that we were ready to have children, I believe we may never feel “ready” for number two… but God will ready us!
Hi Kate. Thanks so much for sharing here. I’m so sorry to hear about your miscarriage. You are right though. God’s timing is best. We didn’t have much say in when our kids came due to all of my complications, but God’s timing has worked well for us. : ) Blessings to you as you continue your journey to baby #2!
My daughter was 20 months when we got pregnant with our second. Unfortunately, that pregnancy ended in a miscarriage at 10 weeks. We conceived again about 5 months later. Our son was born 2 months before our daughter turned 3. This was perfect for us because I ended up potty-training our daughter when she was 30 months; that would’ve been difficult to do with a 1 month old newborn in tow. I agree, 2-3 years apart seems to be a good age difference.
Sarah,
I am so sorry to hear about your miscarriage. My kids are also about 3 years apart and it’s been great. Two in diapers is just too much for me! Thanks for sharing!
I think I would be willing to wait longer if I didn’t start my family so late in life. I’d really like to stop having children in the next few years & if I waited 18 months between each kid I’d be a little bit older than I wanted to. Plus I don’t really want to take birth control again so knowing me I’ll be that nutcase with babies uber close in age 😉
I am with you Jana. That’s why we’re only having two. They are spaced out more (3 years and 2 months) but since I started later, we are done! And it’s so common for women to not want to take birth control between babies. We’ll have to get Dr. Rupe to do a post on bc soon so she can maybe address that!
After several years of infertility, surgeries, procedures & heartbreak, we were surprised to discover we were pregnant – without medical intervention! We chose to forgo birth control, following our son’s birth & were blessed with 3 more pregnancies, much to the surprise of ourselves…and our doctors. Our children are very close in age & it has worked perfect for us. They are 6, 4.5, 2.5 & 10 months. The smallest gap is 19 months & the largest is 25 months.
Tiffany that is amazing! I just love stories like this. What a blessing to have all of those miracles. Thanks for sharing!
Thanks for the great information! Carabelle is 5 months now and I can still feel my body “healing”. That all makes a lot of sense. Believing for the Lord’s perfect timing. Thank you for all you do Dr. Rupe and Jessica!!
Thanks Bethany. Can’t believe Carabelle is 5 months old. Time sure does fly!!
We waited until our firstborn was almost 2 … she was almost 3 when baby #2 arrived and we were able have to her her potty trained!! So nice to have one out of diapers! : ) So… 2-3 years apart is my vote !
Totally agree Angela. Not having two in diapers is so wonderful! I can’t imagine changing all those diapers in a day!