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When pop star Rihanna revealed her new pregnancy to the world wearing radiant red during her Super Bowl halftime performance Sunday night, it reignited a question that has been discussed before and studied: How long should women wait between pregnancies?
Rihanna’s diehard fans knew she had given birth to her first child in May, which meant she was pregnant with her second child in less than a year. Some people took to social media to criticize her for not waiting at least a year, citing medical risks they’d learned from their doctors.
Rihanna’s defenders argued that women of advanced maternal age or who struggle with fertility don’t have the luxury of waiting. Plus, fans say, it’s none of anybody’s business. Furthermore, some pregnancies are “surprises,” which was apparently the case with Rihanna, who is 34, and her partner A$AP Rocky, according to media reports. Also, it’s important to remember that no form of birth control is 100% effective.
Is there a clear “answer?” Obstetrician Dr. Chris Danner, of Novant Health Mintview OB/GYN, took note of the debate this week and decided to research the question a little deeper.
“It’s something we don’t focus on probably enough,” Danner said.
Citing articles published in the American College of Obstetricians and Gynecologists, the March of Dimes and the Journal of the American Medical Association, Danner said studies confirm it’s better to wait.
“(JAMA) did a meta-analysis and it showed that there was an increased risk of adverse perinatal outcomes if the spacings were much shorter (than a year),” Danner said. “And that included premature birth, low birth weight, and even preeclampsia (a high blood pressure disorder.)”
Danner said women should consider avoiding pregnancy less than six months after giving birth and speak with the doctors about the risk and benefits of intervals less than 18 months.
One concern raised by fans on social media was the potential increased risk of autism in closely-spaced pregnancies. Danner said he’s hesitant to make that connection.
“It’s been mentioned, but I don’t know if it’s been proven,” he said. “I think it’s more about having mom get to her optimal health mentally and physically because obviously, that’s going to give you the best outcome with less risk for a small baby when you’re back to your normal thing. Even breastfeeding moms are depleted of a lot of nutrients and they’re not sleeping well still. There is something to be said about that.”
Danner said the studies suggest it is not only best to wait at least six months between pregnancies but as long as 18 months. The advantages he said he sees in his daily practice for women who wait center around time to heal and to adjust to raising their first child.
Letting your previous baby grow for a while “is a little bit easier,” on moms, he said. “(And) your body is fully recovered. If you had a bad (vaginal) tear or a C-section, all that inflammation is resolved. You’ve replenished a lot of the nutrients that you’ve lost from pregnancy and from breastfeeding, like folic acid.”
Another important point he made is that a greater time gap allows for improved mental health, including time for women to work through postpartum depression.
“If you have a baby close, that can lead to stressors financially and stressors in relationships,” Danner said.
That’s not to say Danner doesn’t understand why patients want children close in age. And, he noted, countless women have given birth without waiting a year with no complications.
“There are potential advantages in a sense that parents think kids closer in age have a greater bond with their siblings,” he said. “They can share items like clothing, toys, bottles, you name it. And especially people who have children later in life, they don’t want to wait – certainly with the risks with advanced maternal age for chromosomal challenges and Down syndrome.
“Everybody’s situation is unique,” he said. “At the end of the day, only an individual family knows what’s best for them.” And, he said, it’s no one’s place to judge any woman on when she chooses to have a baby.
All debates aside, Danner said he always makes two points clear with his patients:
1. He recommends women who delivered via caesarean section need more time than women who deliver vaginally.
“With a C-section, you want to wait at least a year in between to let the scar from the uterus heal,” Danner said. “Because studies show if you have a shorter interpregnancy interval, there’s a higher risk for uterine rupture.”
2. Women who have had miscarriages can start trying again after one normal menstrual cycle.
“We used to wait three months, but the newest data suggest this isn’t necessary,” Danner said. “The key is making sure the patient is mentally ready after a difficult event. “
Novant Health
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