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Child spacing is described as the interval between two births. Birth/Child spacing is an essential part of maternal and child health and primary health care. People have been spacing child births for thousands of years through withdrawal, abstinence, and breastfeeding and, in recent years, the use of barrier or contraceptive methods. In recent years, a great deal of attention has focussed on breastfeeding, which has the dual advantage of protecting the health of young children and delaying the return to fertility of new mothers although it is not totally a reliable method of child spacing. There are many ways to space child births. Child bearing patterns such as maternal age, birth order, and the Interval between births have an important influence on the probability that a child will survive Infancy and early childhood. Studies have shown that when the interval between two births in a family is less than two years, the new-born, on average, more than 50% possibility to die in infancy than a child born after a longer birth-interval. This applies not only to the first year of life, but adversely affects the child’s survival chances for at least the first four years of life. Babies born after a three-to-four year Interval have the best chances of survival.

Before the industrial revolution, when agricultural activities were strictly dependent on manual labour, many families engage in large number procreation. In other words, the size of the farm produce is dependent on the size of the family. The larger the family, the larger the farm produce. However, the birth of technological revolution gave rise to mechanized farming which had a corresponding reduction in manual labour. In developing world, women who give birth to lots of children without spacing, place themselves and their children at enormous health risk. This thus indicates the need for child/birth spacing.

Factors such as maternal age, birth order, and the interval between births have an important influence upon the possible chances of a child surviving infancy and early childhood. Studies have also shown that the length of time between two births in a family greatly influences survival of both children. When there is a short birth interval, both have a much greater chance of dying than do children with a longer birth interval. When the birth interval is less than two years, the pregnancy outcome is more dangerous than when it is about two years. Short birth intervals are associated with higher rates.
Impact of foetal, infant and child mortality, is particularly high if the inter-birth period is shorter than a year. In developing countries, children who are born after a birth interval of less than two years are, on average, have 50% chance of dying at infancy than children born after a longer interval. Such children have a 50% greater risk of dying between the ages of one and four than do children born after a longer birth interval. Kwashiorkor was named the disease of the suckling child because, while a child was still suckling, another was born, resulting in inadequate breast feeding of the children.
Data from numerous WHO collaborative studies indicate that in most communities babies had the best chance to survive infancy when they were born after a three-to-four year interval. When the birth interval is longer than five years, the chances of surviving infancy again become poorer irrespective of the wealth or poverty of the family, level of maternal education, rural or urban habitat.
In modern societies, various means of family planning to space child births are available. They must be made accessible and available in accordance with the religious, social, and cultural practices of the concerned society.

Dangers of Poor Family Planning

When the time interval between two births is short it can result in the following:
• Preterm birth
• Low birth weight
• Malnutrition of both the child and the mother
• Low immune system
• Poor education of the children in the family
• Poor mental status of the children
• Depression/emotional disturbance
• Abuse/domestic violence

Importance of Child Spacing on Maternal and Child Health

The importance of child spacing cannot be over-emphasized. Several studies conducted by World Health Organization (WHO) have pointed out that adequate spacing of pregnancies helps in ensuring proper development and survival of the children. Of the more than 42,000 women from Latin America, North Africa, and Asia who were interviewed in a WHO study, more than nine out of ten said that short birth intervals were harmful to child health.
The benefits of adequate child spacing may include:
• Giving each child adequate care and attention.
• Enabling the mother to have enough rest before the next pregnancy and regain her health.
• Helping the parent(s) to weigh the financial implication and plan properly for the future.
• Helping to prevent possible development of illness by the mother and child.
• Helping to also assist the woman in maintaining her physical beauty.
• Allowing the child to have proper education.
• Helps to reduce child mortality, especially in developing countries.
The reasons for birth/child spacing need to be understood and affirmed by the couples because it will go a long way in helping them to make the right choice and plan properly. Health professionals should give good counselling, not only by appearing as an expert but more importantly by active listening.

– DuBois, D. (2002). Qualitative research on providing culturally sensitive reproductive health care for Somali immigrants. Minneapolis, MN
– Filio Degni, Seppo Pöntinen & Mulki Mölsä (2006). Somali Parents’ experiences of Bringing up Children in Finland: Exploring Social-Cultural Change within Migrant Households; Qualitative Social Research, Volume7, No. 3, Art. 8 – May
– DeFranco EA, Seske LM, Greenberg JM, Muglia LJ. Influence of interpregnancy interval on neonatal morbidity. Am J Obstet Gynecol. 2015 Mar;212(3):386.e1-9.
– Mayer JP. Unintended childbearing, maternal beliefs, and delay of prenatal care. Birth 1997;24(4):247–252.
– Orr ST et al., Unintended pregnancy and preterm birth. Pediatric Perinatal Epidemiology. 2000; 14:309–313.
– Institute of Medicine. Preterm Birth: Causes, Consequences, and Prevention. The National Academies Press, Washington, DC, 2007.
U.S Department of Health and Human Services. Healthy People 2020: Topics and objectives: Family planning. Washington, DC. 2010. Accessed 7/2015 from: http://www.healthypeople.gov/2020/topics-objectives/topic/family planning/objectives

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