What you need to know about birth spacing

When and how to add another member to your family is one of the most personal decisions you can make, but there are a few general medical guidelines that can be helpful to keep in mind when you’re deciding. Most notably, the American College of Obstetricians and Gynecologists (ACOG) strongly recommends waiting at least 6 months after giving birth before becoming pregnant again.  For the best outcomes for parent and baby, ACOG recommends waiting 18 months or longer between pregnancies. 

How can birth spacing impact health?

A pregnancy that begins too soon after the previous one faces a higher risk of preterm delivery. Preterm birth, or having a baby before 37 completed weeks of pregnancy, carries its own set of risks for babies, including problems with breathing and lung health, infections, feeding problems, and other complications. Pregnancy and delivery of a baby shortly after another pregnancy also carries the potential for health risks for the birthing parent. Pregnancies spaced less than 18 months apart can put you at a higher risk of a number of health complications.

Some potential health complications include

  • Anemia during pregnancy
  • Preterm rupture of membranes (water breaking early), which often causes preterm birth or infection in the parent or baby
  • Placental abruption, or early separation of the placenta from the uterus (for spacing less than 6 months apart)
  • Higher risk for maternal death (for spacing less than 6 months apart)

Healthy birth spacing techniques

For those able to conceive through intercourse, the most effective way to prevent short interval pregnancies is to start a birth control method before you start to have sex again after recovering from birth. With a range of birth control options to choose from, take a moment to explore your options. Birth control options vary in price, insurance coverage and also vary widely in terms of how they’re used and hormone content.

If you have health insurance, look up the options covered by your plan (some might have co-pays, while others are free). If you need to pay out of pocket, call up a local community health clinic (for example, Planned Parenthood) to see if they can help you find an affordable option. Access to birth control is harder for some, including for people of color and those who are low-income, for various reasons, including racism. According to ACOG, “The unintended pregnancy rate for poor women is more than five times the rate for women in the highest income bracket.”

So what’s the best way to protect yourself and your family in an inequitable world? Think ahead about what matters most to you about your contraception. Then advocate for yourself by voicing your needs with confidence. For example, IUDs are safe, effective, and in many cases, are completely free to you. Everybody has the right to make their own choices. If you’ve given birth in the past 18 months, may want to consider a longer-acting birth control method that gives your body more time to recover. In fact, OB providers are encouraged to start talking about your birth control plans before you give birth. Since they see you at so many prenatal visits, it makes sense to form a plan and discuss the risks or benefits of getting pregnant again soon. Some providers even place IUDs before you leave the hospital with your baby.

We know growing your family involves so many unique decisions. But if you’re not quite ready to get pregnant again, talk to your healthcare provider about the type of contraception that’s right for you.


  • Grady, Cynthia D et al. “Racial and ethnic differences in contraceptive use among women who desire no future children, 2006-2010 National Survey of Family Growth.” Contraception vol. 92,1 (2015): 62-70. doi:10.1016/j.contraception.2015.03.017 
  • Kossler, Karla et al. “Perceived racial, socioeconomic and gender discrimination and its impact on contraceptive choice.” Contraception vol. 84,3 (2011): 273-9. doi:10.1016/j.contraception.2011.01.004
  • Committee Opinion. “Access to Contraception.”American College of Obstetricians and Gynecologists(ACOG). ACOG. January 2015. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/01/access-to-contraception
  • Fingar KR (IBM Watson Health), Mabry-Hernandez I (AHRQ), Ngo-Metzger Q (AHRQ), Wolff T (AHRQ), Steiner CA (Institute for Health Research, Kaiser Permanente), Elixhauser A (AHRQ). Delivery Hospitalizations Involving Preeclampsia and Eclampsia, 2005-2014. HCUP Statistical Brief #222. April 2017. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb222-Preeclampsia-Eclampsia-Delivery-Trends.pdf.
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