Essential Knowledge

© 2003 Georgina Cranston, Courtesy of PhotoshareEducating women, men, youth, and communities about the benefits of using family planning to practice healthy timing and spacing of pregnancy (HTSP) is an effective way to strengthen and revitalize family planning programs in sensitive settings. HTSP focuses on health for both the mother and baby, and it highlights how family planning can prevent maternal and child illness and death. 


Healthy timing and spacing of pregnancy is an approach to family planning that:

  • Helps women and families delay, space, or limit their pregnancies.
  • Helps achieve the healthiest outcomes for women, newborns, infants, and children.
  • Works within the context of free and informed contraceptive choice.
  • Takes into account fertility intentions and desired family size. 
The HTSP approach is grounded in research. USAID supported a series of six studies on pregnancy spacing and health outcomes, and the findings were reviewed in 2005 by a panel of technical experts. These experts made two recommendations to the World Health Organization (WHO) on pregnancy spacing intervals following a live birth, abortion, or miscarriage, which were later issued in a WHO Policy Brief from the Department of Reproductive Health and Research and the Department of Making Pregnancy Safer, titled Birth Spacing – Report from a WHO Technical ConsultationThese recommendations are as follows:  

  • After a live birth, the recommended interval before attempting the next pregnancy is at least 24 months in order to reduce the risk of adverse maternal, perinatal, and infant outcomes.
  • After a miscarriage or induced abortion, the recommended minimum interval to the next pregnancy is at least six months in order to reduce risks of adverse maternal and perinatal outcomes.
  • In addition, USAID, WHO, UNFPA, and UNICEF all recommend that women should delay their first pregnancy until at least age 18
This section of the HTSP Toolkit is intended to provide users with an overview of the evidence base for HTSP, including Frequently Asked Questions about HTSP. To access peer-reviewed journal articles and grey literature on HTSP, please visit POPLINE, where you can access papers on a range of topics related to HTSP, including:

Do you have a comment about this section of the Toolkit or a resource you'd like to suggest for inclusion? To share your thoughts, please visit the feedback form.