The stories beneath the data: pregnancy spacing

At Cradle Cincinnati, improving data around pregnancy is absolutely central to our work. This is the fourth in a series of posts about how data can help drive healthy change for Hamilton County.THE DATA:A Cradle Cincinnati analysis of 2007-2012 data for Hamilton County shows that:

• A pregnancy conceived less than 12 months after a previous pregnancy is nearly twice as likely to result in preterm birth.
• A pregnancy conceived less than 6 months after a previous pregnancy is nearly three times as likely to result in an infant death.

THE STORY BENEATH THE DATA:The amount of time between a woman’s pregnancies matters. An elite marathoner needs to let her body rest after a long race.  Similarly, a woman’s body needs to time to recover after a pregnancy. There are many factors that contribute to infant deaths.  But, local data shows that the single most important modifiable risk factor is pregnancy spacing - or the amount of time from the birth of one child to the conception of the next. Families should wait at least one year before trying to get pregnant again in order to reduce their likelihood of having a preterm birth.In 2011, 19.2% of births to non-first time moms in Hamilton County were the result of a pregnancy that began less than one year after the birth of a previous child¹. The neighborhoods with the highest rates of short pregnancy spacing are also neighborhoods where we see very high rates of infant deaths including Winton Hills, Lower Price Hill, Walnut Hills, North Fairmount and Northside. If we want to improve infant mortality in these neighborhoods, we must first track and improve their rate of short pregnancy spacing.Several published studies show the increased risk associated with short pregnancy spacing even when accounting for socio-economic status. For a complete look at our local analysis, see this summary table of odd ratios related to pregnancy spacing.A DEEPER LOOK:Of course, the fact that not every pregnancy is intentional complicates the problem of short spacing. More than half of the live births in Hamilton County in 2011 were the result of pregnancies that were either unwanted or were wanted later².  And, of the 250 women that we recently surveyed at the Center for Closing the Health Gap’s annual Health Expo, only 38% agreed or strongly agreed that the timing of their own children was something they had “planned for or had control over.” As we pursue an increased awareness about the importance of waiting at least one year between pregnancies, we must keep in mind this broader context.¹2011 Vital Statistics²2010-2012 Pregnancy Risk Assessment Monitoring System