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Birth Spacing


Shortened interpregnancy interval occurs more often when pregnancies are unintended and in women less than 18 years of age at the time of conception. In Delaware, this is impacting not only our youth but also women from 18-34 years of age. Helping women plan and space their pregnancies is an important strategy to support healthy outcomes for mothers and babies. Delaware launched an Optimal Birth Spacing campaign, which educates women and families on waiting at least 18 months from the time a baby is born to the time a woman gets pregnant again. For each month that the interpregnancy interval (IPI) was shortened below the recommended 18 months birth outcomes (preterm birth increased (PTB) by 1.9%; low birth weight increased by 3.3% and small for gestational age (SGA) increased by 1.5%) are negatively impacted.


Delaware Division of Public Health in collaboration with DHMIC launched an aggressive educational initiative “Give Them Some Space” whose overarching aims are to:

  • REFRAME the postpartum visit as the beginning of the next stage of the woman’s life rather than the END of a health care event (pregnancy);
  • Increase the number of women who attend their postpartum visit;
  • Shorten the time interval from time of discharge until postpartum visit by scheduling at 2-6 weeks;
  • Identify/Address health concerns;
  • Discuss desires about future pregnancies and, if desired, the expected inter-pregnancy interval;
  • Promote interconception health (emotional wellness, substance and tobacco use, chronic conditions, and healthy weight); and
  • Remind patient that this is their time to take care of themselves.


DHMIC partnered with Worldways Social Marketing to create a Birth Spacing Implementation Toolkit for providers. The toolkit includes a provider letter, implementation letter, reproductive life plan, brochure/poster, worksheet, and checklist flyer (in English and Spanish). These materials are located in the resource section.


Helping women plan and space their pregnancies is an important strategy to support healthy outcomes for mothers and babies in Delaware. Birth spacing remains an integral part of DPH’s overall focus and strategy to improve maternal and child health outcomes.  The birth spacing initiative’s key messaging is cross pollinated within the framework of its ongoing major public health initiatives which include the Well Woman and the Delaware Contraception Access Now (DE CAN) initiative.  Both projects rely upon the power of prevention services, education, and counselling to improve optimal health outcomes.