What Couples Want to Know: When Is the Best Time to Become Pregnant?

Healthy babies, healthy moms, healthy families – for couples, these are priorities. But many are not quite sure about how and when to have those babies or what effect the timing of a pregnancy has on everyone else in the family.

According to WHO, qualitative studies conducted by USAID in Pakistan, India, Bolivia and Peru showed that women and couples are intensely interested in the healthiest time to become pregnant.

Healthy Timing and Spacing of Pregnancies (HTSP) is an intervention to help women and families delay or space their pregnancies in order to achieve the healthiest outcomes for women, newborns, infants and children.

HTSP differs from previous birth spacing approaches that refer only to the interval after a live birth and when to give birth. HTSP provides guidance on the healthiest age for the first pregnancy, as well as the age when a woman may be too old to risk becoming pregnant. Thus, HTSP encompasses a broader concept of the reproductive cycle, starting from the healthiest age for the first pregnancy in adolescents, to spacing subsequent pregnancies following a live birth, still birth, miscarriage or abortion – capturing all pregnancy-related intervals in a woman’s reproductive life.

Why HTSP?

Multiple studies have shown that adverse maternal and perinatal outcomes are related to closely spaced pregnancies. As shown in the table to the right, taken from the above-mentioned WHO report, the risks are particularly high for women who become pregnant very soon after a previous pregnancy, miscarriage or abortion.

HTSP and Life Stages

For women ages 15-29, spacing or delaying pregnancies is the main reason for an increase in demand for family planning. Data from developing countries show that younger, lower-parity women have the highest demand and need for delaying and spacing births.

For postpartum women, unmet need for spacing among this group is very high: 95-98 percent of postpartum women do not want another child within two years, yet only 40 percent are using family planning. In short, 60 percent of postpartum women who want to space their pregnancy have an unmet need.

• The core messages of HTSP are:
  • For your health and your baby’s health, wait until you are at least 18 years of age before trying to become pregnant.
    • Consider delaying pregnancy by using a family planning method of your choice without interruption until you are 18 years old.
• For couples who desire another pregnancy after a live birth, the messages are:
  •  Wait at least 24 months, but not more than five years, before trying to become pregnant again. Consider using a family planning method of your choice without interruption during that time.
• For couples who decide to have a child after a miscarriage or abortion, the messages are:
  • For the health of the mother and the baby, wait at least six months before trying to become pregnant again.
  • Consider using a family planning method of your choice without interruption during that time.

​As for the main interventions suggested for promotion of HTSP, they are:

• Advocacy at the policy level
• Education and counseling of women and families, including linkage to family planning at the service delivery level
• Monitoring and evaluation

The latest Health COMpass Trending Topic offers a wide selection of tools and project examples for SBCC professionals working in HTSP. If you know of some other material that should be included, please contact susan.leibtag@jhu.edu.