This Mother’s Day, let’s give women a wonderful gift: the luxury of enjoying motherhood and choosing when and if to have another pregnancy. In too many places around the world, women lack the access to contraception or the decision-making ability to make this a reality. As a result, 40% of the 186 million pregnancies in the developing world each year are unintended—either mistimed or not wanted at all—and one in four women in sub-Saharan Africa is unable to decide when and how many children to have.

The importance of healthy timing and spacing of pregnancies cannot be underestimated. According to the World Health Organization, short birth-to-pregnancy intervals—the time between the date of a live birth and the start of the next pregnancy—greatly affect maternal, newborn, and child health and mortality outcomes. The likelihood of miscarriages and stillbirths are much higher for extremely short birth-to-pregnancy intervals. Women who become pregnant 15 to 75 months after a preceding pregnancy are less likely to miscarry or have a stillbirth baby than those with shorter or longer inter-pregnancy intervals.¹

Family planning can help women ensure that pregnancy occurs at the healthiest times of their lives. Research shows that positive health outcomes for both mothers and newborns occur when pregnancy happens:

• 24 months after a live birth (an almost three-year birth-to-birth interval);
• 6 months after an induced abortion or miscarriage;
• To women who have had fewer than four live births; and
• To women between the ages of 18 and 34.

Family planning—including healthy timing and spacing of births—has been recognized as one of the most cost-effective global health interventions. At the cost of $1.55 per user annually, family planning alone can avert one of three maternal deaths and one in five child deaths. And with a better-spaced family, there are more opportunities for members to grow, remain healthy, and be better educated.

Bangladesh is an example of a country where family planning (healthy pregnancy spacing) has dramatically impacted health outcomes for women and babies. Maternal mortality in the country has declined by 40% in the last 9 years in large part due to fertility reduction that has decreased the proportion of higher risk, high parity births. And in India, due to fertility and maternal mortality ratio reductions between 1990 and 2008, an estimated 157,000 maternal lives were saved in the country during this period. Of these lives saved, an estimated 44% (70,000) can be attributed to fertility reduction.²

Here at MCHIP, we are working around the world to save and improve lives through increased use and understanding of family planning. In India, the Program has worked with the Ministry of Health to help prevent nearly 40,000 unintended pregnancies during the extended postpartum period through our work with the postpartum IUCD.  In Bangladesh, through the MaMoni Associate Award—a community-based approach to providing basic maternal and newborn health and family planning services—we have increased the contraceptive prevalence rate to 50% in just seven months. These are just two examples of MCHIP’s work in nearly 40 countries, but they are illustrative of our efforts to scale up results to reach as many women as possible.

This Mother’s Day, let’s remember the millions of women in developing countries who desire more time before becoming pregnant again, and who face the risk of death with every pregnancy. Healthy pregnancy spacing is a cost-effective intervention that can reduce both maternal and childhood mortality and excessive population growth.
Investing in women’s reproductive health and autonomy improves not only the health of the individual, but also the welfare of the whole family and, ultimately, the larger society. This investment is modest in relation to the dramatic returns it yields.


Koki Agarwal
MCHIP Director
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¹ J DaVanzo et al., An International Journal of Obstetrics and Gynaecology. 2007.
 ² Anrudh K. Jain. Studies in Family Planning. 2011.