Women's  Healthcare Topics is a website about pregnancy and your newborn baby.

Back to Back Pregnancies

Reviewed by James Brann, M.D.

Back to Back Pregnancies

There are risks to having back to back pregnancies, learn them before conception.

During pregnancy, your body is constantly working to support your growing baby. Everything gets thrown out of whack—from your abdominal muscles to your breasts. After you've delivered your bundle of joy, your body must recover and heal from your pregnancy, labor, and delivery.

Recovery doesn't happen overnight. It may take time before your body goes back to normal and your nutritional stores are replaced. That is one of the reasons that many doctors recommend that you wait at least two years before you get pregnant again.

What is the Optimal Interval between Pregnancies?

  • For women under 35 years of age who have had a previous normal birth, the World Health Organization (WHO) and the United States Agency for International Development (USAID) recommendation that the interval between pregnancies should be greater than 2 years and less than 5 years

  • For women 35 years of age and older who have had a previous normal birth, an interval of 12 months is a reasonable approach for women with advancing age.

  • After miscarriage, a six-month minimal interval is recommended

  • Women with previous preeclampsia or previous preterm birth should wait 12 months between pregnancies

What are the Risks Associated with Back to Back Pregnancies of Less than Six Months?

  • Maternal nutrients (especially folic acid) may not be replenished sufficiently to protect the growing baby

  • The inflammation of the genital tract that develops in a previous pregnancy has not completely resolved and can give rise to pre-term or premature rupture of membranes and early delivery.

  • Incomplete healing of a previous cesarean section scar.

  • The inflammation of the genital tract that develops in a previous delivery has not completely resolved and can give rise to pre-term or premature rupture of membranes and early delivery.

  • Incomplete healing of a previous cesarean section scar.

  • The cervix may have not have gained all of its strength and may lead to an incompetent cervix and miscarriage.

  • Increase risk of maternal anemia, which may increase the risk of third trimester bleeding from placental abruption or placenta previa.

  • Increased risk of congenital anomalies up to 14 to 20 percent.

  • Low-birth weight infants (less than 2500grams) and small for gestational age babies (less than 10% of growth).

  • Autism have been associated with a short interval between pregnancies.

  • A trial of labor after cesarean delivery has been associated with about a three-fold increase in risk of uterine rupture among women with a short interval between deliveries.
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