Birth spacing

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Family planning, such as the use of contraceptives can increase inter-pregnancy interval. Breastfeeding and extended breastfeeding can also increase birth spacing due to lactational amenorrhea.{{Cite journal|last1=Tommaselli|first1=Giovanni A|last2=Guida|first2=Maurizio|last3=Palomba|first3=Stefano|last4=Barbato|first4=Michele|last5=Nappi|first5=Carmine|date=April 2000|title=Using complete breastfeeding and lactational amenorrhoea as birth spacing methods|url=http://www.contraceptionjournal.org/article/S0010-7824(00)00101-3/abstract|journal=Contraception|language=en|volume=61|issue=4|pages=253–257|doi=10.1016/S0010-7824(00)00101-3|pmid=10899480|issn=0010-7824|url-access=subscription}}{{cite journal | vauthors = Kennedy KI, Rivera R, McNeilly AS | title = Consensus statement on the use of breastfeeding as a family planning method | journal = Contraception | volume = 39 | issue = 5 | pages = 477–96 | date = May 1989 | pmid = 2656086 | doi = 10.1016/0010-7824(89)90103-0 }}{{Cite journal|last1=P|first1=Caldwell|last2=JC|first2=Caldwell|date=1981|title=The function of child-spacing in traditional societies and the direction of change.|url=https://www.popline.org/node/384780|language=en|access-date=2018-04-25|archive-url=https://web.archive.org/web/20190704151639/https://www.popline.org/node/384780|archive-date=2019-07-04|url-status=dead}}{{Cite journal|last1=Konner|first1=M.|last2=Worthman|first2=C.|date=1980-02-15|title=Nursing frequency, gonadal function, and birth spacing among !Kung hunter-gatherers|journal=Science|language=en|volume=207|issue=4432|pages=788–791|doi=10.1126/science.7352291|issn=0036-8075|pmid=7352291|bibcode=1980Sci...207..788K}}

Cultural and religious attitudes towards both sex and the use of contraceptives,{{Cite journal|last1=Bavel|first1=Jan Van|last2=Kok|first2=Jan|date=2004-06-01|title=Birth Spacing in the Netherlands. The Effects of Family Composition, Occupation and Religion on Birth Intervals, 1820–1885|journal=European Journal of Population / Revue Européenne de Démographie|language=en|volume=20|issue=2|pages=119–140|doi=10.1023/B:EUJP.0000033860.39537.e2|s2cid=153453194|issn=0168-6577}} price and availability of health care, and poverty are all factors which can affect inter-pregnancy intervals.{{cite news | url = https://www.gatesnotes.com/2017-Annual-Letter?WT.mc_id=02_14_2017_02_AL2017GFO_GF-GFO_&WT.tsrc=GFGFO | title = Warren Buffett's Best Investment | first1 = Bill | last1 = Gates | first2 = Melinda | last2 = Gates | name-list-style = vanc |work=gatesnotes.com|access-date=2018-04-22 }}

Short inter-pregnancy interval is associated with an increase in maternal mortality,{{Cite journal|last1=Conde-Agudelo|first1=Agustin|last2=Belizán|first2=José M.|date=2000-11-18|title=Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study|url= |journal=BMJ|language=en|volume=321|issue=7271|pages=1255–1259|doi=10.1136/bmj.321.7271.1255|issn=0959-8138|pmid=11082085|pmc=27528}} stillbirth, and child mortality.{{cite journal | vauthors = Fotso JC, Cleland J, Mberu B, Mutua M, Elungata P | title = Birth spacing and child mortality: an analysis of prospective data from the Nairobi urban health and demographic surveillance system | journal = Journal of Biosocial Science | volume = 45 | issue = 6 | pages = 779–98 | date = November 2013 | pmid = 22958417 | pmc = 3785173 | doi = 10.1017/S0021932012000570 }} Inter-pregnancy interval of lower than 18 months is associated with an increased risk of pre-term birth.{{Cite news |title=How long should you wait before getting pregnant again? |url=https://www.marchofdimes.org/pregnancy/how-long-should-you-wait-before-getting-pregnant-again.aspx |access-date=2018-04-03 |work=The March of Dimes |language=en-US}}

Short inter-pregnancy interval after a prior C-section can be a contraindication for having a vaginal birth after a prior C-section (VBAC). In one study inter-pregnancy intervals shorter than 6 months were associated with 2-3 times increased risk of uterine rupture, major morbidity, and blood transfusion during vaginal delivery in mothers with at least one prior C-section.{{cite journal | vauthors = Stamilio DM, DeFranco E, Paré E, Odibo AO, Peipert JF, Allsworth JE, Stevens E, Macones GA | title = Short interpregnancy interval: risk of uterine rupture and complications of vaginal birth after cesarean delivery | journal = Obstetrics and Gynecology | volume = 110 | issue = 5 | pages = 1075–82 | date = November 2007 | pmid = 17978122 | doi = 10.1097/01.AOG.0000286759.49895.46 | s2cid = 71406865 | doi-access = free }}

Complications of a short inter-pregnancy interval are lower after an abortion or miscarriage compared to a full-term pregnancy.

An inter-pregnancy interval of greater than five years is associated with an increased risk of pre-eclampsia.

In one study taking place in Saudi Arabia, children born after a short birth interval (under 17 months) were more likely to have poorer performance at school and poorer cognitive development.{{Cite journal |last1=Dhamrait |first1=Gursimran |last2=Fletcher |first2=Tess |last3=Foo |first3=Damien |last4=Taylor |first4=Catherine L. |last5=Pereira |first5=Gavin |date=2022-11-25 |title=The effects of birth spacing on early childhood development in high-income nations: A systematic review |journal=Frontiers in Pediatrics |volume=10 |doi=10.3389/fped.2022.851700 |issn=2296-2360 |pmc=9732574 |pmid=36507145 |doi-access=free}}{{Cite journal |last1=Bella |first1=Hassan |last2=Al-Almaie |first2=Sameeh M. |date=2005-10-01 |title=Do Children Born Before and After Adequate Birth Intervals Do Better at School? |url=http://academic.oup.com/tropej/article/51/5/265/1690120/Do-Children-Born-Before-and-After-Adequate-Birth |journal=Journal of Tropical Pediatrics |language=en |volume=51 |issue=5 |pages=265–270 |doi=10.1093/tropej/fmi009 |pmid=16144794 |issn=1465-3664|url-access=subscription }}{{Cite journal |last1=Bella |first1=Hassan |last2=Khalil |first2=Mohamed S. |last3=Al-Almaie |first3=Sameeh M. |last4=Kurashi |first4=Nabil Y. |last5=Wahas |first5=Saeed |date=May 2005 |title=The effects of birth interval on intellectual development of Saudi school children in Eastern Saudi Arabia |url=https://pubmed.ncbi.nlm.nih.gov/15951861 |journal=Saudi Medical Journal |volume=26 |issue=5 |pages=741–745 |issn=0379-5284 |pmid=15951861}} Risk of accidental injury also increases with decreasing birth interval. Long IPIs greater than 24 months were associated with language deficits, and greater than 60 months were associated with an increased risk of deficits in communication skills and less general knowledge.

The global public health burden of short inter-pregnancy intervals is substantial. In developing countries, children born two years or earlier after an older sibling were at a 60% increased risk of death in infancy, while those born between two and three years had a 10% increase, compared with those born after intervals of four to five years.{{cite journal | vauthors = Rutstein SO | title = 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 | journal = International Journal of Gynaecology and Obstetrics | volume = 89 Suppl 1 | pages = S7–24 | date = April 2005 | pmid = 15820369 | doi = 10.1016/j.ijgo.2004.11.012 | s2cid = 37743580 }} Various organisations, including the World Health Organization have identified birth spacing as an important area of public health intervention. Evidence for causality of these associations in high-resource environments is weak.{{cite journal |author1=Katherine A. Ahrens |author2=Heidi Nelson |author3=Reva L. Stidd |author4=Susan Moskosky |author5=Jennifer A. Hutcheon |title=Short interpregnancy intervals and adverse perinatal outcomes in high-resource settings: An updated systematic review |journal=Paediatric and Perinatal Epidemiology |date=2019 |volume=33 |issue=1 |pages=O25–O47 |doi=10.1111/ppe.12503 |pmc=7379643 |doi-access=free|pmid=30353935 }}

In one study, the average birth interval across all countries was 32.1 months (2.7 years). The region with the greatest percentage of short interbirth intervals was central Asia, where a third of children were born less than 24 months apart. The region with lowest burden was Sub-Saharan Africa, with 20% of births having an interval of less than 24 months.Rutstein, Shea O. 2011. [https://dhsprogram.com/pubs/pdf/CR28/CR28.pdf Trends in Birth Spacing]. DHS Comparative Reports No. 28. Calverton, Maryland, USA: ICF Macro.

Birth intervals have been found to be higher in traditional hunter-gatherer societies. The median birth interval of the Gainj people of the New Guinea Highlands has been reported as 3.6 years (43 months),{{Cite journal|last1=Galdikas|first1=Biruté M. F.|last2=Wood|first2=James W.|date=1990|title=Birth spacing patterns in humans and apes|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/ajpa.1330830207|journal=American Journal of Physical Anthropology|language=en|volume=83|issue=2|pages=185–191|doi=10.1002/ajpa.1330830207|pmid=2248378|issn=1096-8644|url-access=subscription}} and that of the !Kung people of Africa as 3.7 years (44 months).{{Cite journal|last=Konner|first=M.|date=April 1978|title=Nursing frequency and birth spacing in Kung hunter-gatherers|url=https://pubmed.ncbi.nlm.nih.gov/12278620/|journal=IPPF Medical Bulletin|volume=15|issue=2|pages=1–3|issn=0019-0357|pmid=12278620}}

The inter-birth intervals in wild apes are reported to be significantly longer than those in humans, with median birth intervals at 3.8 years for gorillas, 5.6 years for chimpanzees and 7.7 years for orangutans.

• Weaning

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Category:Childbirth

Category:Human pregnancy

Category:Public health