Patients ask me at their postnatal visits, from time to time: ”How long should I wait before having another baby?”

While there are no set rules, there are considerations that you should think about before trying again.

My personal opinion is that about 18 to 24 months is good interval between births. It is long enough for you to recover physically from your pregnancy and childbirth, enjoy giving your baby lots of attention and love before your are pregnant again with the pregnancy symptoms such as nausea and fatigue and for your baby to be less dependent and yet close enough that your children will be similar in age to have a good relationship with each other.

I  have had many women over the years who have conceived only a few months after a full-term pregnancy and my recollection is there has never been an adverse development in the subsequent pregnancy which has been caused by not waiting longer.

Some considerations that you should think about are…

If you are older (especially if in your 40’s) then your eggs are older and so the risk of chromosome problems such as Down Syndrome is increasing. In your 40’s the incidence is increasing exponentially. I suggest you conceive soon, to minimise the risk as much as possible. As well, there can be delays in conceiving with reducing ovary function as you get older. But if your next pregnancy will be through IVF and stored frozen embryos this is not a problem as the embryos are not getting any older.

Some studies have suggested a short interval between pregnancies is associated with increased risks of preterm birth, low birth weight, and maternal anaemia, as the mother’s body may not have fully recovered from the previous pregnancy. I have never seen these issues becsue of a shorter interval between births.

Exclusive breastfeeding can act as a natural form of contraception which can delay the return of ovulation and menstruation. However, the effectiveness of breastfeeding as a contraceptive method depends on various factors including frequency of breastfeeding, duration of breastfeeding sessions, and whether the baby receives any supplementary feedings. Breastfeeding can also influence the timing of ovulation and conception, potentially affecting the interpregnancy interval.

Contraception use. Couples who wish to have another baby soon are wise to choose a contraceptive method that does not prevent ovulation. Such methods include condoms, a progesterone pill, a Mirena IUCD or natural family planning. If a contraception method that suppresses ovulation is chosen then there could be extra delay after ceasing contraception before ovulation resumes.

Caesarean section. Sometimes women are told not to get pregnant within two years of a Caesarean section. The concern is about healing and increasing the risk of uterine rupture next time if the interval is short and especially if attempting a VBAC. I have never had this concern. I suggest it relates more to surgical technique with close of the uterus at a Caesarean section operation. I am extremely careful and thorough with uterus and abdominal wall closure and so have never had a problem. Even though I have done many thousands of Caesarean sections, I have never had a patient who has had a ruptured uterus.

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