Healthy Timing and Spacing of Pregnancies (HTSP)

Maternal, Newborn, and Child Health (MNCH)

More than 303,000 women die annually from complications during pregnancy or childbirth. For every maternal death from these complications, at least 30 other women suffer serious illness or debilitating injuries. The millennium development goals seek to reduce maternal mortality by 75% by 2015, but the maternal mortality rate is declining only slowly. Almost all deaths from complications of pregnancy or childbirth—99%—occur in developing countries. In sub-Saharan Africa, a woman’s maternal mortality risk is 1 in 38, compared to 1 in 3,700 in developed regions.

In addition, a woman’s survival is critical to that of her children. Every year, more than 1 million children are left motherless; children who have lost their mothers are up to 10 times more likely to die prematurely than those who have not.

The situation is not hopeless. 80% of all maternal deaths are preventable through access to education and contraceptives, timely prenatal and postnatal care, skilled birth attendance during delivery, and emergency care to deal with post-partum complications.

Given the link between maternal and infant mortality, if we can save the life of the mother, we can likely save her child as well. Since 1990, we have cut child mortality rates in half. Even so, more than 5.9 million children die before the age of five; 44% of those children die in the first month of life. These children die of pneumonia, birth complications, diarrhea, malaria, and malnutrition. We can do better. We can halve these numbers again by 2030 with interventions like breastfeeding, vaccines, and oral rehydration.

Healthy Timing and Spacing of Pregnancies (HTSP)

What do we mean when we say we support the “healthy timing and spacing of pregnancies"? We mean enabling women and couples to determine the number and timing of their pregnancies, including the voluntary use of methods for preventing pregnancy, not including abortion, that are harmonious with their values and religious beliefs. The term “family planning” is often used synonymously with this concept.

More than 220 million women around the world who want to avoid pregnancy do not have access to effective contraceptives, counseling or services. The global partnership known as FP2020 was established in 2012 to guide the international effort to meet this need for 120 million women by the year 2020.

Healthy timing and spacing of pregnancies can dramatically improve the health and chances of survival of both women and children. In the words of journalist Michael Gerson, “family planning is a pro-life cause.”

The benefits include the following:

• Healthy Timing of Pregnancies

High-risk pregnancies include those of women under the age of 18 or over 34. The context of the developing world, with poor health systems, increases the risk. In many developing nations, child marriage is a common practice--in Ethiopia, one out of five girls is married by the time she is 15. Yet girls younger than 15 are five times more likely to die from complications during pregnancy or childbirth than women in their 20’s. At the other end of the spectrum, older women with five or more children are 1.5 to three times more likely to die from complications of pregnancy and childbirth than women with two to three children. With support, women and families in developing nations can make informed decisions about becoming pregnant in light of the risks.

• Healthy Spacing Between Pregnancies

When spaced two years apart, children are healthier and more than twice as likely to survive infancy. The time between pregnancies also allows the mother to provide the benefits of breastfeeding longer. It also allows her to spend more time with each child. Optimal spacing contributes to each child’s physical, mental, and emotional development.

• Reduction of Abortions

Every year, there are 210 million pregnancies worldwide. Of the women with those pregnancies, it is estimated that 85 million do not want to be pregnant. About half of those pregnancies, 42 million, end with an induced abortion. Among women who obtain abortions, more than 67,000 die because of abortion-related injuries, and millions more suffer complications and long-term injuries. Abortion-related injuries account for 13% of maternal deaths worldwide.

• Keeping Girls in School and Allowing Mothers to Work

Healthy timing and spacing of pregnancies result in families that are able to pursue education and to provide for their needs, making it one of the most cost-effective and powerful strategies to empower women and improve their lives. Women who are empowered to make choices about childbearing are more likely to get more education and job experience, and contribute to the economic health of their families and communities. Research has shown that personal savings and investments increase when working parents have a number of dependents that is more manageable, given their means.

Family Planning: Strategy Overview, The Bill & Melinda Gates Foundation

Countdown 2015 MNCH

Maternal, Neonatal & Child Health: Strategy Overview, The Bill & Melinda Gates Foundation

Family Planning and Reproductive Health Briefs, Christian Connections for International Health

Healthy Timing and Spacing of Pregnancy, World Vision

Preventing Mother-to-Child HIV Transmission through Family Planning in Maternal and Child Health Services: Kenya, Rwanda, and South Africa, fhi360

The Potential of Long-acting Reversible Contraception to Decrease Unintended Pregnancy, Association of Reproductive Health Professionals

Prevention of Unsafe Abortion, World Health Organization

Common Sense and Common Ground, New Evangelical Partnership for the Common Good

• Education for women in developing nations about healthy birth timing (pregnant women are at lower risk when mother is between 18-34 years old)
• Education for women in developing nations about healthy birth spacing (2-3 years between children)
• Voluntary use of modern contraception
• Fertility awareness-based methods (sometimes known as natural family planning e.g., using the Standard Days Method with cycle beads)
• NOT abortion:
  • Hope Through Healing Hands does not fund abortion.
  • The Helms Amendment bars the use of U.S. government funds to pay for abortion services worldwide.

• 220 million women worldwide want access to HTSP education and services but don’t have it.
• Less than 20% of women in Sub-Saharan Africa and barely a third of women in Asia use modern contraception.

• Every year, complications from pregnancy and childbirth claim the lives of nearly 303,000 women and permanently disable many more, mostly in developing countries.
• 99% of these deaths are in developing countries, and 80% are preventable.
• For every maternal death, at least 30 other women suffer serious illness or permanent debilitating injury.
• Girls younger than 15 are five times more likely to die from complications during pregnancy or childbirth than women in their 20’s.
• Pregnancy is among the leading causes of death for girls aged 15 to 19. 
• Women with five or more children are 1.5 to three times more likely to die from pregnancy complications.
• If 120 million women get access to HTSP resources, 200,000 fewer women and girls will die in childbirth by 2020.

• In developing countries, the risk of prematurity and low birth rate doubles when conception occurs within six months of a previous birth.
• Children born to women younger than 18 years have an excess mortality risk of about 40% and are more likely to be stunted and anemic than children born to women over 18 years of age.

• With the recommended two years spacing between birth and pregnancy, children are more than twice as likely to survive infancy.
• With recommended birth spacing, mothers can breastfeed their children longer and devote more time and attention to their infants.
• If 120 million women get access to family planning resources, 3 million fewer babies will die in their first year of life by the year 2020.

• Right now, up to 25% of girls in developing countries drop out of school due to unintended pregnancy.
• Moms empowered to make decisions on the timing and spacing of their pregnancies are more able to pursue their education and better their families’ lives.

• There are 85 million unplanned pregnancies each year, and about half end in abortion.
• For women who seek abortion, 67,000 will die because of abortion-related injuries and millions more suffer complications and long-term injuries.
• Abortion-related injuries account for 13% of maternal deaths worldwide each year.
• HTSP education and services in developing nations could result in more than 100 million fewer unintended pregnancies and over 50 million fewer abortions per year by the year 2020.

• Studies show that every dollar spent on HTSP can save governments up to six dollars that can be spent on improving health, housing, water, and other public services.

• Genesis 1:27-28
• Deuteronomy 15:7
• Psalm 41:2
• Proverbs 31:8-9
• Hosea 12:6
• Micah 6:8
• Matthew 22:37-40
• Galatians 6:2
• Hebrews 6:10
• 3 John 1:2

• A Call to Christian Common Ground on Family Planning and Maternal and Children’s Health, the New Evangelical Partnership for the Common Good
• Healthy Timing and Spacing of Pregnancy, World Vision