Vacation for the stork. When to give birth to the second?
The number of children in the family is determined by the desire of the spouses, their level of health, material possibilities, religious upbringing and other social and biological factors. The gap between the birth of children is a matter of choice, but couples should know that the term of 2.5-5 years is optimal. It has a beneficial effect on the health of both the child and the mother, and also gives social and economic benefits to the whole family.
Oksana Bolotova obstetrician-gynecologist
A little physiology
During pregnancy, the restructuring of the woman's body affects all organs and systems, beginning with the endocrine and central nervous system and ending with the locomotor apparatus. All kinds of a metabolism change. The vital activity of the pregnant woman's body is aimed at creating and providing optimal conditions for fetal development. Since the implantation of a fertilized egg (inserting it into the uterine wall), the requirements of the embryo (fetus) are constantly increasing, causing the mother's body to improve the adaptive-compensatory mechanisms that ensure its proper development. From the mother the fetus receives the necessary amount of oxygen, proteins, fats, carbohydrates, vitamins, minerals and other vital substances. In turn, the products of the life of the fetus enter the mother's body and are excreted by its excretory system. These constantly changing processes determine a new level of the internal state of the body, characteristic for each trimester of pregnancy and different from the internal state of the organism of a healthy non-pregnant woman.
All these changes occur gradually, and so does the body gradually recover after delivery. The period of complete recovery from the time of previous births, according to the World Health Organization, is 2 - 2.5 years. This interval between births is recognized as optimal for better development of subsequent pregnancy and least harm to the female body. This interval consists of 12 months, the minimum required for breastfeeding, 9 months - to restore the strength of the woman after childbirth and breastfeeding, the next pregnancy lasts 9 months.
Do not hurry and do not be late ...
Scientists have several hypotheses about why shorter intervals between births have a negative impact on children. One of them is that a woman who becomes pregnant shortly after birth does not have time to restore the reserves of her body (lack of vitamins, blood loss and stress associated with a previous pregnancy and childbirth). Pregnancy, childbirth and breastfeeding are a huge burden for the body. There is an assumption that the psychological problems associated with the frequent occurrence of children can affect the health of women and children.
Too short a period between births can lead to complications of pregnancy such as miscarriage (miscarriage, premature birth), circulatory failure in the placenta (the consequence of this - hypotrophy - slowing the growth of the fetus, the birth of small children), placental attachment pathology (low placental attachment - placenta location almost at the exit from the uterus), anemia.
Too long a period between births (10 years and more), especially if a woman is 35-40 years old by this time, can cause a high risk of violations in the development of the fetus, as the conditions of the blood supply to the uterus at this age are significantly deteriorating, resulting in increased risk of miscarriage and development of chromosomal abnormalities in children (for example, Down syndrome).
The optimal interval between births, from the doctor's point of view, is determined not only by the woman's health and her psycho-emotional readiness for a new pregnancy, but also by the way the previous pregnancy and childbirth took place. Operational delivery is the topic of a separate conversation. But it is necessary to know that the uterus after cesarean section is an anatomically and functionally inferior organ. It is extremely important to evaluate the processes of healing in the seam area, since the time of onset of subsequent pregnancy and the forecast of the forthcoming births are determined precisely by the condition of the formed scar on the uterus.
Restoration of the pristine anatomical integrity of the uterus after cesarean section occurs after 1.5 - 2 years, when the scar, consisting of connective tissue, is replaced by muscle fibers, which determines its functional consistency. The lowest risk of complications such as scarring (formation of a defect in the uterine wall - openings at the site of the scar) is observed with the development of pregnancy in the period from 1 year to 4 years after cesarean section. After cesarean section, the next pregnancy is recommended no earlier than in 2 years.
The process of restoration of the uterus tissue after the operation depends not so much on the technique of "execution" of the latter, as on the features of the course of the postoperative period and possible complications (inflammation of the uterus). At the same time, it should be noted that abortions performed after cesarean section seriously worsen the prognosis of subsequent pregnancies.
It is also recommended to increase the interval between pregnancies for women whose first pregnancy was complicated (gestosis, threatened miscarriage, threat of premature birth), because in these cases the body needs more time to recover.
Pregnancy of a woman soon after childbirth is often a consequence of the lack of information about the possibility and necessity of using contraceptives. According to some data, if women are not protected, then about 3 months after the first postpartum menstruation, about 50% of them become pregnant again. In addition, pregnancy can occur before the first postpartum menstruation.
Among young mothers there is a popular belief that in the first months after childbirth, while a woman is breastfeeding and menstruation has not yet recovered, it is impossible to conceive. In general, moms are right. However, in order for pregnancy to not exactly occur, four conditions must be observed:
- A woman should only breastfeed her baby without breastfeeding.
- The child should take the breast at least every 3 hours in the daytime and 1 time at night, and the interval between night feedings should not exceed 6 hours. The more frequent the feeding, the more effective the method.
- Menstruation for the time being should be absent.
- After delivery, no more than 6 months have passed.
If at least one of these conditions is not met, quite unexpectedly for a woman can again be "in position". And there is little good here: a new pregnancy will prevent the baby from breastfeeding.
Summarizing, I want to say that repeated pregnancy in this or that period of life is first and foremost a responsible step, beyond which - a huge human joy and anew experienced wonderful sense of motherhood!