Preventing or delaying pregnancy in adolescents is one way to reduce preterm birth rates.

Why Family Planning Matters: Healthy Timing and Spacing of Pregnancy to Achieve Optimal Birth Outcomes

Photo: Suzanne Lee/Save the Children

Sadma Khan, 19, plays with her daughter Madheeha, 18 months, at her shared house in her mother’s extended family’s compound is Rajasthan, India. Sadma was married at 17 to another underaged teenager. Sadma is now 3 months pregnant with her second child and plays to use contraceptives after this pregnancy. "After one month of marriage I got pregnant. There is one an a half year’s difference between my first and second child. After that I don’ want another child."

This summer during a trip to Uganda, I visited a Kangaroo Mother Care unit at a district hospital in central Uganda.  Several mothers were patiently lying on their beds, with their preterm babies on their chest.  The nurses were providing tremendous support to the mothers, whose concern was expressed in their eyes as they held their preterm babies.  As I looked up from one baby to see her mother’s face, I was struck by how young she was. I then looked at all the women in the ward and realized most were adolescents.

We are learning new ways to care for preterm babies and manage complications associated with preterm birth to increase their survival rate. The importance of healthy timing and spacing of pregnancy to achieve optimal birth outcomes has never been clearer than when looking at these young women.

Preventing or delaying pregnancy in adolescents is one way to reduce preterm birth rates. Adolescent girls are not physically prepared for pregnancy and childbirth and studies have shown that adolescent girls are at increased risk for preterm birth compared with women ages 20 to 35.

It is also essential that all women who wish to delay or prevent unintended and poorly spaced pregnancies have access to family planning. We can do this by improving access to a wide range of methods that are acceptable and affordable to women.  Evidence has shown that waiting at least 24 months after giving birth before trying to become pregnant again reduces the risk of poor outcomes for mother and infants, including preterm birth. The postpartum period or period soon after birth provides a window of opportunity to counsel women and couples on their family planning options and offer contraceptive methods.

Currently, there are more than 200 million women with an unmet need for family planning. This summer, several organizations and donors including the Department for International Development, UK (DfID) and the Bill & Melinda Gates Foundation hosted the London Summit on Family Planning, during which support was galvanized to reach 120 million women and girls in the world’s poorest countries with family planning services by 2020. Commitments were made from donor and developing countries, international agencies, civil society, foundations and the private sector all agreeing to the idea that there is no controversy in contraception.

Ensuring those commitments translate into better access to contraceptives for women and girls will go a long way in improving the lives of women and improving birth outcomes including preterm births. 

This blog is part of a series on HNN marking World Prematurity Day, November 17, that discusses preterm birth and highlights the actions needed to prevent and reduce preterm birth, the leading cause of newborn deaths. Join us as we discover that everyone has a role to play. To get involved and learn more, please visit


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