What's the Ideal Spacing Between Pregnancies?

I get asked the question a lot: “How long is best to space out pregnancies?”

Or, for some women, “How soon can we start trying for another?”

The simple answer?

Well, your body, your choice. Your life, your decision. It’s ultimately up to you (and whoever is making that baby, too).

Oh, if only it were that easy.

This decision and the ultimate achievement of another pregnancy is often a tough decision to make. I also have a feeling you’re not here for such an oversimplified take on this question.

There are actually a lot of factors to consider when it comes to having a baby whether it’s your first or fifth. So that’s what this post is going to explore- particularly through my unique lens of functional nutrition + women’s physiology + metabolic & mental health.

What does society say?

Well firstly, we know that our modern and especially patriarchal and capitalist society doesn’t really place much emphasis on mom’s true health. (This is apparent by our lack of sufficient postpartum care, mental health support, paid leave, proper nutrition education, and more). Call me jaded, but I often look through things through this lens when it comes to this season of life especially.

It is very common to space children around 2 years apart. The average pregnancy spacing between the first and second child in the U.S. has been found to be 26.5 months. However, research has found that almost 30% of mothers become pregnant with their second child before the first is 18 months old (1).

Pregnancy spacing nowadays is often based primarily on other factors like women starting to have children later and/or after establishing their careers, financial reasons, and of course, what the societal norms are.

Not surprisingly, shorter interpregnancy intervals- or the time between the birth of a baby and the conception of the next) have been found to be more common among mothers aged 35 and over (1).

What does the research say?

There’s a well-established relationship between shorter interpregnancy intervals (or IPIs) and high infant and child mortality. But closely-spaced pregnancies also have other health impacts and affect mothers, too (2).

Studies show that waiting at least 18 months between birth and conception of the next baby helps improve outcomes for both mom (i.e. decreased 3rd trimester bleeding, cervical insufficiency, preeclampsia, abnormal healing, and rates of maternal death) and baby (i.e. decreased risks of preterm birth, neural tube defects, developmental delays, and intrauterine growth restriction or IUGR) (2, 3).

Based on the research, the American College of Obstetrics and Gynecology recommends women avoid interpregnancy intervals (IPIs) shorter than 6 months but also be advised on potential risks of another pregnancy sooner than 18 months post-birth (4).

However, many other organizations suggest women wait at least 24 months before trying for another baby to reduce health risks for both mom and baby (5). This is primarily due to pregnancy and breastfeeding depleting women’s energy and micronutrient stores, which need to be replenished before another pregnancy (2, 3).

And while research has mostly focused on intervals between live births, the research that has been done on interpregnancy intervals that begin with non-live births (miscarriages, abortions, and stillbirths) have shown that waiting to conceive for at least 6 months is ideal. However, this does depend on the length of the pregnancy (6).

Research has also shown that closer spacing can also be difficult due to decreased ability to give a new baby adequate attention as well as increased competition between children for parental time or resources (7).

Lastly, similar negative health outcomes have also been shown when spacing is 5 years or longer (8) but shorter intervals are more commonly associated with adverse effects (9).

Now… if you want the full answer that considers the whole picture of women’s health and well-being… If you prefer more of an answer to the question “How do I support my body in preparation for another baby and when do I know I’m ready?”:

Here’s my take on pregnancy spacing from my unique functional nutrition + women’s physiology + metabolic & mental health perspective.

Because what everyone else is doing, what society deems to be “normal,” and even scientific research all do not dictate your body, your health, your experience, or your readiness.

And we know that preventing negative outcomes for mama and baby is not the same as supporting optimal health for both!

(Plus… How in depth has research truly gone on metabolic health and mental health especially in the face of the stressful lives most women lead?! How in depth has research truly gone on following infants through adulthood to determine health outcomes based on pregnancy spacing or better yet, their mother’s health?)

The truth is that most women today need at least 2-3 years to fully heal, recover, and- the big one no one talks about- REPLENISH their bodies after pregnancy.

Dr. Weston Price’s observations showed this back in the early 1900s! Amongst the healthiest and most nourished indigenous cultures he studied, pregnancies were spaced at least 2-3 years apart. In many cultures, it was even frowned upon to have a child more than once every 3 years (10).

These primitive cultures intuitively knew that it took time for a mother’s nutrient stores to replenish and that adequate bonding time between mom and baby and family was important. And they took great care to adequately nourish mothers to both properly prepare for pregnancy and support postpartum healing (11).

It may take less time for you. And it could take more. It depends on a lot, like:

Your physical health:

Particularly considering markers like your energy, body temperatures, menstrual cycle, sleep, and libido. Factors like postpartum healing, breastfeeding duration and frequency, return to work, sleep, stress, and more can impact our physical health after giving birth.

The most basic factor is ovulation, which is suppressed for varying amounts of time after giving birth. Breastfeeding typically extends the body's return to fertility, and this will be different for each woman. But even if it’s been a year or more and you want to get pregnant again, you’ll need to be ovulating in order to get pregnant!

Libido is also an important, yet often overlooked factor. Sure you can get pregnant without one, but it helps! It’s also a clear sign of overall metabolic health.

Secondly, nourishment and nutrient stores are key. Growing (and caring for) a baby takes a lot of energy! In fact, having an adequate supply of nutrients has been considered to be the most important environmental factor impacting pregnancy outcome (6).

Did you know each pregnancy takes about 10% of a mother’s mineral stores? (12). These minerals- like magnesium, copper, sodium, potassium, and iodine- need to be replenished to not only support another pregnancy, but help revitalize the mom’s health, too. Minerals operate in our bodies like spark plugs, and are important for so many different functions like energy production, thyroid hormone use, blood sugar control, and more.

Vitamins are also in higher demand during pregnancy and stores can become easily depleted- especially fat-soluble vitamins. For example, it’s been shown that one-third of women with short pregnancy intervals were more deficient in vitamin A. The American Pediatrics Association cites vitamin A as one of the most critical vitamins during pregnancy and breastfeeding. If a mom’s vitamin A supply is not sufficient, her supply to her growing baby as well as future breastmilk will be, too (13).

Adverse consequences of shorter pregnancy intervals have been attributed to what’s often called “maternal depletion syndrome.” This simply means that a woman has not fully recovered from one pregnancy before supporting the next one.

But there’s another term I prefer using- postpartum or postnatal depletion. This term, which was coined by Dr. Oscar Serrallach, is a syndrome marked by a “constellation of symptoms affecting all spheres of a mother’s life after she gives birth” (14). It commonly arises in new moms due to all the new stressors they experience without getting enough time to properly recover on top of the lack of support and nutrient depletion they suffer (14).

Postpartum depletion looks beyond the bare essentials of recovery to also encompass replenishment of nutrient stores, hormone rebalancing, mental health, social support, environmental factors, and more (14).

And the symptoms of postpartum depletion- including fatigue, anxiety, brain fog, low libido, depressed mood, and decreased ability to handle stress- can actually affect moms for a decade or more after giving birth (14).

Working to replenish your body goes far beyond taking a prenatal vitamin. Factors like dieting history, chronic under-eating, intake of refined foods, hormonal birth control usage, stress, and more can also deplete nutrient stores. You can begin replenishing your body by building a foundation through prioritizing nutrient-dense foods, consuming balanced meals, eating regularly and more are a great strategy to help recover from pregnancy and prepare for another. (Learn more here: How to Replenish Your Body Postpartum).

Within this realm, your body’s “structural” health, particularly your core and pelvic floor are important, too! Tightness, weakness, and poor coordination of these muscles are all common after giving birth and especially if not addressed, these issues can worsen and be tested even further with future pregnancies. Problems like prolonged ab muscle separation (called diastasis recti) and pelvic organ prolapse are common. Symptoms like leaking urine or stool, pelvic pain, low back pain, and more can be a sign that your core and pelvic floor health need some attention.

Your mental and emotional health:

Including your current stress levels but also any postpartum mental health issues you may have experienced, and any unresolved trauma around preconception, pregnancy, birth, and postpartum and/or possible pregnancy or infant loss.

Society doesn’t like to acknowledge some of the tougher components of pregnancy, birth, and motherhood. We’ve normalized postpartum depression and anxiety to an extent, but I feel we may be sweeping a lot under the rug, too and even gaslighting women and band-aiding without proving real solutions.

The reality is that while the experience is so beautiful, it’s hard. And for so many women, this majorly impacts their mental and emotional health, including their capacity to handle stress, mood, drive, emotional stability, and more. And it can even be so intense that it impacts the ability to simply function day-to-day and care for their baby/children and themselves.

Many other factors are important, too- like your partner’s readiness, your parental leave options, your financial readiness, your living situation, your career goals, your childcare access, and more. What’s going on in your life, especially your stress levels, matters a lot!

Pregnancy spacing intervals shouldn’t just be about societal pressure to have another in a certain time frame.

Just because everyone else has 2 under 2, has baby fever before their child is even walking, or “bounced back” so fast that they feel ready to go again ASAP doesn’t mean you need to, too.

Pregnancy spacing needs to consider the mom’s health and the family unit’s well-being as a whole.

(And side note: just as it’s not right to ask someone when they’re going to have their 1st baby, it’s not right to ask someone when they’re going to have their 2nd.. 3rd… etc.!)

So now, with all of that being said…

Do you feel ready for another baby? Physically? Mentally? Financially?

Do you have a unique situation that calls for closer spacing?

Do you just really want your kids to be close in age?

If you answered yes to any of these, go for it!

Already have children that are closer in age than what’s recommended? Don’t panic! It’s never too late to work on healing and properly nourishing your body. And especially if you’re planning on it, focusing on this now can help you prepare for any future pregnancy.

The reality is that now, many women are waiting a little later to start having babies and so, in order to have more children, they may not want to wait 2-3+ years between. (Which just further proves the importance of a proactive approach to help moms be fully nourished and supported).

And let’s be honest: Does anyone ever feel 100% ready to have a baby whether it’s #1, #2, or #10? I’ll take a wild guess and say no!

For some women, it’s a quick and easy decision. For many others, it’s a more calculated one that requires checking in with oneself, having important conversations, taking specific steps to prepare, and more in order to determine and support readiness.

Ultimately, it’s important to listen to your gut and follow your heart when it comes to future pregnancy(ies), but it’s also important to acknowledge different factors, understand the difference between feeling ready and feeling pressured, and most importantly, recognize that you’re on no one’s timeline but your own!

Whatever you decide (or maybe don’t, because your family may be complete OR you may get pregnant unexpectedly or the hundreds of other possible scenarios), please don’t stress it. Use this information to help guide and most importantly, empower you. Be intentional about nourishing, resting, and moving your body, pursuing joy, getting a handle on stress, and asking for help when you need it. Taking care of YOU is crucial- even if you’ve decided another baby isn’t in your near future or at all.

If you are wanting to learn how to nourish yourself fully, especially replenish your body postpartum and/or prepare for pregnancy, you’ve come to the right place. You can start with learning how to build a strong foundation for optimal metabolic function and hormonal health with my online program, Nourished Roots. Or, you may want to dive in deeper, run some functional testing, and get more personalized guidance and support by working 1:1 with me.

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