1. Healthy Timing and Spacing of Pregnancy (HTSP): For healthy babies, healthy mothers, and healthy communities
Adapted from presentation by May Post, ESD Project
Consultation on Faith, Family Planning, and Family Well-being, Georgetown University, April 2011

2. The technical experts concluded that closely spaced pregnancies can lead to the following:
Babies may be:
Born too early
Of low birth weight
Too small
More likely to die
Mothers may be:
More likely to die in childbirth
More likely to miscarry a pregnancy
More likely to seek an unsafe abortion
Source: Report of a Technical Consultation Report on Birth Spacing (WHO)

3. Pregnancy Timing
Women under the age of 18 are twice as likely to die, and women under the age of 15 are five times more likely to die of complications compared to women over18 years of age.

4. Recommendations from WHO, UNICEF and UNFPA on early age pregnancy
Delay first pregnancy until at least 18 years of age.
WHO, UNICEF and UNFPA all recommend that women delay their first pregnancy until they are at least 18 years of age.
Source: UNICEF, Facts for Life 3rd edition, New York, United nations Children’s Fund , 2002; WHO/UNFPA Pregnant Adolescents: Delivering on Global Promises of Hope, WHO, 2006
Kenyan mother, 2006 Mike Wang, Courtesy of Photoshare

5. HTSP Concept HTSP helps women: space pregnancies
better time pregnancies
become pregnant and give birth when it is healthiest and safest for mother and child.
Therefore, in addition to helping women space, we also need to help them time their pregnancies, so they are becoming pregnant and giving birth when it is healthiest and safest for both mother and child.
Together, these make up the concept of Healthy Timing and Spacing of Pregnancy.

6. Benefits of HTSP
Progress in FP’s role in helping women avoid unintended pregnancies.
Focus on lowered fertility
FP’s role in achieving healthy fertility – much less recognized
The focus on healthy fertility encourages couples to use FP - to time and space pregnancies – for improved mother and child health

7. Benefits of HTSP: For Women
Spacing
A reduced risk of pregnancy- related complications
Gives mothers two years to fully prepare for her next pregnancy
Timing:
Physically and psychologically prepared to become mothers
Allows time for school and education

8. What role does education play?
Girls’ secondary school is associated with:
Higher immunization rates
Improved household nutrition
Lower rates of domestic violence
Delayed childbearing
Increased use of family planning
Ian Diamond et al., “Female Education and Fertility: Examining the Links,” in Critical Perspectives on Schooling and Fertility in the Developing World, ed. Caroline H. Bledsoe et al. (Washington DC: National Academies Press, 1999):

9. Women’s Education & Total Fertility Rate

10. Benefits of HTSP: For Children
A reduced risk of:
Pre term birth
Low birth weight
SGA (small baby)
Death
Breastfed for a full 2 years
Undivided attention from the mother

11. Benefits of HTSP: For Men
Involves men in making decisions about family planning, child spacing, and the health of the family. Gives men a feeling of satisfaction when they can guarantee the well being of their families Allows men time to emotionally and financially prepare for the birth of the next child

12. Benefits of HTSP: For Communities
Communities will see:
Less illness and death among mothers, babies, and children
Improvements in the quality of life
Men and women have more educational opportunities
More time to contribute to community development
Less stress
Reduced poverty

13. HTSP Messages
Support men and women practice healthy timing and spacing of pregnancy.
This means that:
After a live birth, couples should wait at least 24 months before trying to become pregnant again.
After a miscarriage or abortion, couples should wait at least six months before trying to become pregnant again.
Adolescents should delay pregnancy until at least 18 years of age.
Women and men should use a family planning method of their choice to delay and space their pregnancies.

14. What can we do?
Advocacy: Reaching decision makers with data and evidence Leadership: Informed leaders ensuring an enabling environment Training: Training health workers in HTSP counseling BCC: Producing educational materials to support HTSP BCC Smart integration Community education: Educating communities about HTSP benefits in churches, mosques, schools, workplace, community events.
Smart integration: adding HTSP information and messages to on-going FP services, MNCH services, nutrition services – to reach women at multiple points of contact

15. Annual Global Burden of Disease
>500,000 maternal deaths (70,000 abortion-related; 60,000 eclampsia related)
8 million women suffer complications
5.5 million adolescent girls give birth
4 million newborn deaths (28% linked to pre-term births)
18 million LBW infants (98% in developing countries)
Here is the annual global burden of disease. This is not a happy picture.

16. HTSP: A Small Change that Produces Big Results
Reducing closely spaced pregnancies
Timing pregnancies at the best age possible
Contributes to the healthiest outcomes for mothers, babies, families and communities.

17. Final Thoughts
“No woman should die bringing life into the world and no child should die when we know how to save them” UN Secretary General Ban-Ki Moon