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If you’re planning to start a family — or want more kids — you might be wondering how far apart to space your children. While it depends on your situation, there are some general guidelines that are good to know. These can help keep you and your future babies healthy.

How Long Between Pregnancies?

There are many different terms to describe the time between pregnancies. These include interpregnancy interval, birth spacing, and pregnancy spacing.

How soon can you get pregnant after giving birth? It’s possible to get pregnant just weeks after giving birth — but it’s not optimal.

The American College of Obstetricians and Gynecologists recommends waiting at least 18 months after giving birth before conceiving again. There’s even stronger evidence to space your pregnancies by at least six months. This will help ensure your body has recovered enough to support another pregnancy.

Why Wait Between Pregnancies?

When your pregnancies are less than 18 months apart, you’re at greater risk for harming your health. Short interpregnancy intervals can also affect your developing fetus. They may experience:

• Premature birth: This is when your baby is born before 37 weeks of gestation. Babies born early are more likely to suffer from health problems.
• Low birthweight: Smaller babies can struggle with health issues. This is defined as less than 5 pounds, 8 ounces.
• Small gestational size: Your baby may not reach the typical size milestones while in utero.

If you’ve previously had a C-section, short birth spacing has been associated with uterine rupture and blood transfusion.

How Does Spacing Your Pregnancies Help?

There’s still more research to do on birth spacing. But it’s clear that the body needs time to recover after the act of carrying and delivering a baby. By waiting, you may be giving your body a chance to:

• Heal from infections and swelling. Your body can become inflamed during pregnancy. If you conceive again before fully healing, you may experience more swelling with the next pregnancy. There’s some evidence that inflammation plays a role in preterm premature rupture of membranes (PPROM). This is when the sac around the baby breaks before 37 weeks, causing labor to start early.
• Build back its supply of nutrients. The vitamins and minerals in your body get depleted during pregnancy. These are important for your baby to have, and back-to-back pregnancies may leave fewer nutrients for the next child and you.
• Reset the birth canal microbiome. Your body is filled with microorganisms that affect you. More research is needed, but it’s possible that a vaginal microbiome that’s out of balance could lead to premature birth. It may take up to a year to reset after a pregnancy.

Using Family Planning

Considering that 45% of pregnancies in the U.S. aren’t planned, how can you space them apart the way you want? Talk to your health care provider about your options. You might use birth control such as:

• Intrauterine devices (IUDs)
• Hormonal implants
• Birth control pills, patches, or shots
• Condoms, diaphragms, sponges, or cervical caps

An IUD or implant are the most effective because they’re low-maintenance. They are typically good for three to 10 years after being placed. They can also usually be inserted while you’re still in the delivery room for maximum convenience.

After you’ve given birth, wait three weeks before using birth control that contains both estrogen and progestin. Examples include the pill and patch. Avoiding these in the early postpartum weeks will decrease your risk of blood clots.

If you delivered by C-section, it’s best to wait six weeks to use birth control that has both estrogen and progestin.

There are pros and cons to each family planning method, so talk to your doctor about what’s right for you.

Can I Get Pregnant If I’m Breastfeeding?

Yes, surprisingly, you can get pregnant even if you are exclusively breastfeeding and even prior to return of your period. Some people use a family planning technique known as the lactational amenorrhea method. To protect from unplanned pregnancy, this requires three parts:

1. Your period has not yet returned (known as amenorrhea).

2. You are exclusively or nearly exclusively breastfeeding (no intervals of more than 4 to 6 hours between feeding or pumping).

3. You are less than six months’ postpartum.

If all these conditions are met, you typically will not get pregnant, but utilization of supplementary forms of birth control will improve your chances of not becoming pregnant. The lactational amenorrhea method is about 98% effective, but only when done perfectly.

This can be challenging, though, especially if you go back to work. If you plan to supplement with some formula or miss pumping sessions while away from the baby, this method won’t work as a form of birth control.

Spacing Pregnancies for Lifelong Health

Your body isn’t the only thing that changes with a pregnancy — your whole life does. It can be a big mental shift to have a child. In fact, depression and anxiety during and after pregnancy affect one in seven women.

Spacing your pregnancies gives you a chance to devote time to one baby before becoming pregnant with the next. And paying attention to your well-being in between pregnancies isn’t just important now. It’ll set you up for improved health for the rest of your life.

If you have questions about spacing your pregnancies, contact us at UPMC Magee-Womens Hospital, a National Center of Excellence in Women’s Health. What’s right for you will depend on factors like your age, pregnancy history, and health history. We can talk through the scenarios of how long between pregnancies makes the most sense for your situation.