This blog post is published in conjunction with the Child Survival Call to Action, which was convened June 14-15 by the Governments of the United States, India, and Ethiopia, and organized in close collaboration with UNICEF.
On a recent visit to northeast Bangladesh, I had the opportunity to visit rural postpartum women in their homes. My colleagues and I were undertaking site visits to a USAID program that provided integrated newborn, maternal and family planning services at the community level. After we entered the home of our first visit, we congratulated the new mother, who was holding her newborn wrapped in a blanket in her arms. We asked her how many children she had. She replied quietly, “This was my twelfth pregnancy — it is my fifth living child.” She explained that three children died as newborns, two were stillborn, and she had two miscarriages. The woman was only 32 years old. We heard similar stories from other women whom we interviewed.
The first step to ensure that a child reaches their 5th birthday starts even before they are born. USAID promotes Healthy Timing and Spacing of Pregnancy as a vital family planning intervention that helps ensure that pregnancies occur at the healthiest times in a woman’s life. Mothers and children are then more likely to survive and stay healthy.
A USAID analysis found that, by preventing closely spaced births, family planning could save the lives of more than 1.6 million children under five annually.
We recommend three key programmatic actions to strengthen family planning as an essential intervention for child survival
- Educate families on the use of family planning to ensure that pregnancies occur at the healthiest times of a woman’s life. Healthy times for a pregnancy are:
- After age 18
- Before age 34
- At least 24 months after a live birth
- Six months after a miscarriage
When pregnancies occur before the age of 18, after the age of 34, and when they are too closely spaced, they are called high risk pregnancies. Family planning helps women avoid high risk pregnancies.
- Expand the mix of available contraceptives, including long-acting, reversible methods, to help couples effectively delay, time, space, and limit pregnancies, to achieve their fertility intentions.
- Enact policies to reap the benefits of the demographic dividend – especially policies that support job creation for women as well as girls’ education. In this way, women are empowered to become more involved in health decision-making.
Family planning can also improve infant survival by delaying the age at which a woman has her first pregnancy. About 16 million girls ages 15 to 19 give birth every year. Babies born to young mothers under age 18 are more likely to be premature, have low birth weight, and suffer from complications of delivery.
When a mother dies, her children are less likely to survive. In the developing world, an estimated 90 percent of infants whose mothers die in childbirth will die by their first birthday. Family planning could prevent up to 40 percent of the 287,000 maternal deaths that occur each year.
More than 215 million women worldwide want to delay or avoid pregnancy but are not using a modern method of contraception. Increasing access to family planning is essential to help women like those I met in Bangladesh and their children survive and stay healthy.
Read the Healthy Timing and Spacing of Pregnancy issue brief (pdf) to learn more about family planning’s role in child survival.