Longer birth spacing healthier for mothers and babies

Posted: 17 October 2002

New research finds that the ideal time for a mother to have another child is between three to five years after her last birth. Waiting longer than the previously recommended two-year gap between births gives infants and children through age five a better chance of survival, according to a new study.

Children born 3 to 5 years after the previous child are about 2.5 times more likely to survive to age five than children born less than 2 years after the previous child, according to the report, Birth Spacing: Three to Five Saves Lives.

In Nigeria, for example, if all couples space births between 3 to 5 years, deaths of children under the age of five could fall by 23 per cent. Similarly in Pakistan, death of under-five children in Pakistan could fall by as much as 46 per cent, if all women spaced their births 3 to 5 years apart, according to the Hopkins report. Unfortunately, in many countries, spacing births beyond three years is far from the current practice and as a result many lives are still being lost.

The findings are based on a study of more than 430,000 pregnancies in 18 countries. The study accounted for many demographic factors also known to affect infant survival and health. Thus researchers can have greater confidence that the effect of birth spacing is real and not a reflection of some other factor, according to the report. A year 2000 study of 450,000 women and over a million pregnancies in 19 Latin American and Caribbean countries reinforces the findings.

Why are short birth intervals riskier for mothers and children? The biological and behavioral mechanisms that make short intervals riskier are little understood, but researchers suspect that mothers who give births frequently may not have time to restore their own nutritional reserves or breast milk. Also, children close in age are more likely to compete for food and other resources.

The Hopkins report points out that in many developing countries women would prefer to wait longer between births than they actually do due to lack of access to contraception. A 1998 survey in Kenya, for example, found that median intervals were 35 months compared with preferred intervals of 49. If Kenyan women could achieve the 49 month interval, an additional 17 per cent of children under five would survive.

In view of the findings, the report's authors, Vidya Setty-Venugopal and Ushma Upadhyay, call for reproductive health programs to help women space their birth by extending family services and campaigns. Communication campaigns in several countries have already begun promoting 3-year spacing to raise awareness of the benefits of birth spacing.

The report was prepared by for Population Reports published quarterly by the Population Information Program at the Johns Hopkins Center for Communication Programs.