PETALING JAYA: Couples have been advised to ensure a gap of at least two years between the birth of a child and the next to avoid miscarriages, premature births and even death, said Universiti Putra Malaysia obstetrician and gynaecologist Dr Nurul Iftida Basri.
She added that she encounters at least five cases of short-interval pregnancies each month, which carry risks of various health conditions for expectant mothers, which is a cause for concern.
“While the number of short interval cases is still low when complications occur, these women are at risk of death, especially those who have undergone previous Caesarean sections and have heart disease to boot.
“When low-risk patients become pregnant again within short intervals, some experience miscarriages or premature births, while high-risk patients face an increased risk of death.”
A short pregnancy interval is defined as less than six months between childbirth and the next pregnancy, or the time between births of 18 months or less.
Nurul Iftida said effective family planning allows women to manage their reproductive health by spacing pregnancies while lowering the risk of complications such as premature births and postpartum depression.
She said signs of complications from a short pregnancy interval include bleeding – with or without abdominal pain – which could indicate a miscarriage or preterm birth, depending on the stage of pregnancy.
“Any vaginal loss such as leaking or abnormal vaginal discharge may indicate early membrane rupture or an infection,” she said.
Nurul Iftida stressed that short intervals between pregnancies lead to inadequate recovery from childbirth, potentially worsening conditions such as anaemia or gestational diabetes.
It can also increase the risk of postpartum depression and may further deteriorate the mother’s health.
Nurul Iftida said women with heart diseases are usually advised to space their pregnancies between three and five years, depending on the type of heart issue, and to reduce stress and ensure heart function is returned to normal before the next pregnancy.
She advised women with hypertension to space their pregnancy longer than two years until the optimum level of blood pressure and kidney function is achieved.
“Women with medical conditions such as anaemia or gestational diabetes during pregnancy might not fully recover, or return to their pre-pregnancy health, which could also potentially worsen.
“Mothers who breastfeed their babies postpartum are at risk of anaemia and being anaemic when embarking on a new pregnancy will affect both the mother’s and baby’s health.”
Nurul Iftida said women who conceive within a short interval after a previous pregnancy are at risk of multiple pregnancy complications such as miscarriage, premature rupture of membrane and premature birth.
She said women who previously delivered through a Caesarean section are specifically at risk of uterine rupture and placenta praevia, which is a problem during pregnancy when the placenta completely or partially covers the opening of the uterus (cervix).
“Women who deliver their next child too close to the previous pregnancy are at risk of massive bleeding during delivery, which can be potentially fatal.
“Mothers with unplanned pregnancies may not be taking folic acid adequately to prepare their bodies for another pregnancy. This risks their babies being born underweight.
“Some studies reveal an increased risk of foetal distress, which may lead to a Caesarean delivery. The use of instruments such as a vacuum or forceps could also lead to stillbirth,” she said.
Nurul Iftida urged spouses to discuss family size and spacing, as family planning requires cooperation from both partners to ensure the health and well-being of both mother and children.
