Benefits of Healthy Timing and Spacing of Pregnancies
HTSP is an intervention to help women and families delay or space their pregnancies to achieve the healthiest outcomes for women, newborns, infants, and children, within the context of free and informed choice, taking into account fertility intentions and desired family size. Individuals and couples should consider health risks and benefits along with other circumstances such as their age, fecundity, fertility aspirations, access to health services, child-rearing support, social and economic circumstances, and personal preferences in making choices for the timing of the next pregnancy.
Recommendation for Spacing after a Live Birth
After a live birth, in order to reduce the risk of adverse maternal, perinatal, and infant outcomes, the recommended interval before attempting the next pregnancy is at least 24 months.
The basis for this recommendation is that, after a live birth, waiting 24 months before trying to become pregnant will help avoid the short birth-to-pregnancy intervals associated with the highest risk of poor maternal, perinatal, neonatal, and infant health outcomes. In addition, this recommended interval is considered consistent with the WHO/UNICEF recommendation of breastfeeding for at least two years, and is also considered easy to use in programs: “two years” may be clearer than 18 months or 27 months.
HTSP Messages that Promote Healthy Outcomes
Evidence indicates that birth-to-pregnancy intervals of at least two years (almost three years between births) are associated with:
- Decreased risk of neonatal and perinatal mortality, low birth weight, small for gestational age, and preterm delivery.
- Decreased stunting or underweight; allows children and mothers to experience the benefits of optimal breastfeeding for two years.
The evidence indicates that:
- When birth-to-pregnancy intervals are more than six months or less than five years apart, there is a reduced risk of maternal mortality, pre-eclampsia, premature rupture of membranes, puerperal endometritis, third-trimester bleeding, anemia, high blood pressure, and induced and frequently unsafe abortion.
- Waiting until at least the age of 18 years before a first pregnancy helps young mothers reduce the risk of pregnancy-induced hypertension and associated complications.
- FP reduces abortions by preventing unintended pregnancies, for an added impact on maternal mortality.
Key Resources for HTSP:
- Healthy Timing and Spacing of Pregnancies Toolkit (K4Health, 2012)
- Healthy Timing and Spacing of Pregnancies: A pocket guide for health practitioners, program managers and community leaders (ESD). Available in English and French.
- HTSP Counseling Pathways: A counseling tool for health care providers (ESD)
- HTSP: A Trainer’s Reference Guide (ESD, 2008)
 ESD. 2008. HTSP 101: Everything you wanted to know about healthy timing and spacing of pregnancy. http://www.esdproj.org/site/DocServer/HTSP_101_Brief_Final_corrected_4.9.08.pdf?docID=1761
 WHO. 2005. Technical Consultation on Birth Spacing. http://whqlibdoc.who.int/hq/2007/WHO_RHR_07.1_eng.pdf