How Long After Childbirth Can You Get Pregnant Again

For older mothers, it can feel similar there'due south trivial time to waste matter before trying for some other child. But in that location are real risks linked to getting pregnant again too soon. Lauren Bates/Getty Images hide caption

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Lauren Bates/Getty Images

For older mothers, it can feel like there'south little time to waste material before trying for another child. But there are real risks linked to getting meaning again too shortly.

Lauren Bates/Getty Images

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Many older first-time moms face a dilemma when it comes to infant No. two. The clock is ticking louder than e'er. But doctors advise waiting at least a yr and a half after giving nativity before conceiving again.

This is the standard advice, based on multiple studies and public health guidelines. Simply deciding when to effort again can be a difficult determination — weighing medical gamble against infertility risk. Now there are some new information points to cistron in. A paper published Monday in the journal JAMA Internal Medicine analyzed medical records from almost 150,000 Canadian pregnancies to tease out how a mother's historic period influences the effects of a shorter-than-recommended interval between pregnancies.

For older moms in a hurry, the bad news is that the report adds show that conceiving inside 12 months of a nativity does mean heightened health risks for both mother and child. But epidemiologist Laura Schummers, who led the research while at Harvard and is now a mail-doctoral fellow at the University of British Columbia, says there's good news for y'all here as well:

"The optimal spacing window that nosotros found was one to two years after the delivery of one child until the conception of the side by side pregnancy," she says. "That'due south when we plant the lowest run a risk for both mothers and babies." And, she adds, that's short compared to some previous studies that had suggested the optimal wait was between xviii months and up to v years.

Past enquiry has establish a clear link between short "interpregnancy intervals" and increased risk of health bug for mother and baby, including premature birth. But why? The debate, Schummers says, revolves around whether the short interval is a direct biological crusade of the risks, or whether it it is itself a result of other forces at work in the mother'south life — for example, a lack of access to health care and unintended pregnancies.

Because older women are likelier to program their pregnancies and have better access to intendance, Schummers and colleagues hypothesized that those mothers would non incur as much risk as younger women do if they had babies close together.

They found out they were wrong.

"In fact," Schummers says, "we found that at that place were risks of agin infant outcomes for women of all ages.

"The risks to the babies were higher among younger women, which was consistent with the team's hypothesis. But risks to the mothers were college among older women — indeed, only older mothers incurred higher risks to their ain wellness by getting pregnant again so soon.

Later on bookkeeping for other factors that could bulldoze these numbers, Schummers says, the stats shake out like this:

• For women 35 years or older who conceived just six months after a birth, six.2 per chiliad experienced serious illness or injury, including decease. Expect eighteen months and that risk dropped to ii.half-dozen per per grand. Then, pocket-sized absolute numbers merely a dramatic difference.

• A "severe adverse infant outcome" includes stillbirth and being born very early on or very small. Among women ages twenty to 34, those who conceived after just 6 months had xx babies per thousand with those severe outcomes; the take chances drops to 14 per thousand amongst those who waited eighteen months.

• Among women 35 years or older, there were 21 severe infant outcomes per thousand amidst those who waited just six months; the risk drops to 18 per m among those who waited 18 months.

"This shows you both the human relationship between pregnancy spacing and the increased risk," Schummers says, "merely also that older women tend to have a higher baseline take a chance of many of these outcomes at all pregnancy spacing lengths."

The research turned upwardly a similar pattern for premature birth: A short pregnancy interval raises the risk for all women, just particularly for younger women. The risk for them dropped from 53 per one thousand at a six-month interval to 32 per thousand at an eighteen-month interval. For women over 35, the take a chance dropped from 50 per chiliad at six months to 36 per g afterward 18 months.

It seems similar common sense that a woman's torso may need more than six months to fully recover from building a babe and giving nascence, but the bodily machinery behind the risks of short pregnancy intervals is non fully articulate.

The leading theory, Schummers says, is that nutrients like atomic number 26 or folate could be depleted in the mother's trunk. Just more inquiry is needed to see if that theory holds in developed countries like the United States and Canada, or if there are other mechanisms that accept not even so been identified.

For at present, she says, her team hopes these new findings can help women make decisions within their own personal contexts, and in consultation with their medical teams. The data may be specially helpful for older women, she says, because they more often determine to have short pregnancy intervals on purpose.

"And so if y'all're making that kind of decision on purpose," she says, "information technology'south easier to say, 'You lot know, let'south expect another iii months.' "

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Source: https://www.npr.org/sections/health-shots/2018/11/01/663181674/how-long-should-older-moms-wait-before-getting-pregnant-again