Researchers Challenge Recommendation to Wait Two Years Between Pregnancies

Pregnant woman holding her stomach.

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Key Takeaways

  • Women are generally advised to wait at least two years after having a baby to try to conceive again.
  • A new study finds that this wait time may not be necessary for people in high-income countries.
  • Overall, experts say physicians now generally recommend that women wait at least a year before conceiving after having a baby.

Researchers are challenging widely accepted recommendations that advise mothers to wait at least two years after giving birth to become pregnant again. While these recommendations are designed to reduce the risk of complications like preterm birth and small birth weight, a new study finds that this wait time may not be necessary for all.

Researchers analyzed data from 5.5 million births to 3.8 million women in high-income countries including Australia, Finland, Norway, and the U.S. They found that the risk for negative birth outcomes was no different, whether the women waited six months to become pregnant again, or 18 to 24 months.

However, siblings that were spaced out more than 60 months, or five years, were at an increased risk of negative birth outcomes. The July study was published in the journal PLOS One.

“Current recommendations of waiting at least 24 months to conceive after a previous pregnancy, may be unnecessarily long in high-income countries,” the researchers concluded.

Women’s health expert Jennifer Wider, MD, tells Verywell that the results of the latest research are surprising.

“There has been much research that underscores the need for a ‘wait time’ between pregnancies," she says. "I think what this study highlights is that it's not a one size fits all equation.”

How This Fits in With Current Recommendations

Recommendations on wait time, which is formally known as healthy timing and spacing of pregnancy (HTSP), vary slightly by the organization.

The World Health Organization (WHO) recommends that women wait a minimum of 24 months before attempting another pregnancy after having a baby to reduce the risk of poor outcomes for the mom and baby. After a miscarriage, the WHO recommends that women wait at least six months before trying again.

Meanwhile, the American College of Obstetricians and Gynecologists (ACOG) recommends that women wait at least six months before trying to get pregnant after having a baby. They also suggest that women should be counseled about the risks and benefits of having a repeat pregnancy sooner than 18 months.

ACOG says that giving birth less than 18 months apart can result in a “modest increase in risk” and poor outcomes. However, there is a “more significant risk” of poor outcomes when getting pregnant less than six months after having a baby.

Overall, physicians now generally recommend that women wait at least a year before conceiving after having a baby, which would be about two years between births, Jennifer Lew, MD, an OB-GYN at Northwestern Medicine Kishwaukee Hospital, tells Verywell.

A study of 148, 544 pregnancies published in JAMA Internal Medicine in 2018 found that becoming pregnant less than a year after having a baby can lead to risks for women of all ages. After that time frame, however, the risks dropped.

“That time frame gives women a chance to recover from the changes pregnancy and birth caused,” she explains. “This time helps women return to pre-birth weight, nurse the infant, and return their blood count and likely other nutrient levels to baseline.”

Waiting six months to a year to conceive after having a baby also allows women to be treated for postpartum depression if they experience it, Lew says.

“Many women will wait, not just for health risks, but to heal properly and be able to manage the care of their infant,” Wider says.

Still, Lew says, “not every patient has two years to space their family. Some older women may need to space their family closer if they want to have their children before they experience a loss of their fertility.”

Ultimately, Wider says, it’s important for mothers who are interested in conceiving again quickly to talk to their doctors. “There’s not a one-size-fits-all recommendation,” she says. “If a woman has excellent prenatal and natal care, her options may be broader.”

What This Means For You

Choosing when to have another baby after giving birth is a personal decision. If you're thinking about conceiving make sure to reach out to a doctor to discuss what timing makes sense for you and your family.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Tessema GA, Marinovich ML, Håberg SE, et al. Interpregnancy Intervals and Adverse Birth Outcomes in High-Income Countries: An International Cohort Study. PLOS ONE. July 19, 2021. DOI: 10.1371/journal.pone.0255000.

  2. United States Agency International Development. HTSP 101.

  3. The American College of Obstetricians and Gynecologists. Interpregnancy Care. January 2019. 

  4. Schummers L, Hutcheon J, Hernandez-Diaz S et al. Association of Short Interpregnancy Interval With Pregnancy Outcomes According to Maternal Age. JAMA Intern Med. 2018;178(12):1661. doi:10.1001/jamainternmed.2018.4696

By Korin Miller
Korin Miller is a health and lifestyle journalist who has been published in The Washington Post, Prevention, SELF, Women's Health, The Bump, and Yahoo, among other outlets.