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Infant Mortality Awareness Month :: How Birth Spacing Can Help

Happy interracial family in enjoying a day in the park

A mother’s health is one of the most impactful and most controllable predictors of a baby’s health. The basics of a healthy pregnancy are widely known — eat right, exercise appropriately, and maintain good general health. But there’s one factor that’s often overlooked, yet it can play a significant role in the health of a child: timing.

Interconception, or birth spacing, refers to the time between when a woman gives birth and when she becomes pregnant again. Generally, evidence shows that a span of at least 18 months between birth and a subsequent pregnancy is best for the health of moms and babies. Providing enough time between births is important since close spacing creates significant risk for both the mother and child, the most significant of which is the higher likelihood for preterm births. For births spaced less than 18 months, there are other less common complications, which may include risks such as maternal anemia, low birth weight, and even maternal or fetal death.

I’m a mother working in maternal and child health, so I see these issues through both a personal and professional lens. As a data specialist at NICHQ (National Institute for Children’s Health Quality), an independent, nonprofit organization working to improve children’s health, I’m interested in the intersection of health between moms and babies. However, becoming a parent has underscored for me how difficult it is to be a mom in our society. There is so much pressure to get it right, and so much blame for anything that goes wrong.

In my group of friends, there were some families who were already expecting a second baby before their first child had turned one. I had to wonder, with all the things we do talk about when it comes to motherhood and our kids, is ideal birth spacing something people simply don’t know much about because it’s not part of the conversation among ourselves and our healthcare providers? There are also many misconceptions around pregnancy spacing, such as some women not realizing they can still become pregnant while they are breastfeeding.

Ideal birth spacing is very attainable if you foster an open conversation with your healthcare provider about your pregnancy plans, and discuss the use of the most effective forms of contraception, including long-acting reversible contraception (LARC). LARCs have had a bad rap in the past, but the new versions of LARCs are recognized to be safe, even for women to use immediately after birth, and they can be a great option in family planning. In addition, with rising concerns over the introduction of the Zika virus into the U.S., LARCs can empower women to plan their pregnancies when they feel it is optimal and safe for them and their babies. Using the most effective forms of contraception will help to ensure access to appropriate care and the right support for a healthy pregnancy and good birth outcomes.

Practicing good interconception care is a critical factor in reducing health risks to both mother and children, yet it’s something we don’t talk about enough. Women have to make the right choices for their families. It’s our goal to ensure all women have the information they need to do just that.


sabrina-selkSabrina Selk is a mother of three and the associate director of applied research and evaluation at National Institute for Children’s Health Quality (NICHQ), which is currently in the midst of a campaign to promote Infant Mortality Awareness Month. Her focus is on infant and maternal health, with previous work at Dana-Farber Cancer Institute and Harvard School of Public Health. When she’s not at work, you can find her reading, traveling, watching movies, or trying new things with her family.

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