How can contraception cut child deaths?

July 10, 2012

LONDON (TrustLaw) – It’s well known that good family planning vastly reduces the risk of women dying from pregnancy complications and helps prevent miscarriages and still births.

What is far less recognised is the effect that spacing out pregnancies has on the survival of children way beyond birth.

A report published by the Lancet medical journal on the eve of an international summit on family planning says improving access to contraceptives in developing countries could reduce deaths in young children by 20 percent.

This is largely because increasing the interval between births reduces the chance of babies being low-weight or premature – a major cause of mortality in under-fives.

For anyone in any doubt about the importance of investing in family planning, here are some compelling figures cited by Professor John Cleland, an expert in medical demography at the London School of Hygiene and Tropical Medicine.

  • In developing countries, children born within two years of a sibling are 60 percent more likely to die before the age of one than those born following a bigger gap
  • More surprisingly, they are also 40 percent more likely to die between the ages of one and five
  • And most surprising of all, the older sibling’s chance of survival is also compromised. When a child acquires a younger sibling within two years the risk of the older child dying between the age of one and two is also raised by about 40 percent.

Why should this be? Close spacing of births may mean a mother can give less time to the older child, it might increase competition between siblings for food and it may make disease transmission more likely. A new pregnancy may also affect how long the mother breastfeeds the older child.

“In high-fertility countries where most children born have both older and younger siblings there’s a double jeopardy that hugely raises the risk of under-five mortality,” Cleland said.

“Indeed it has been estimated that in high-fertility countries, if all births were spaced by at least two years, infant mortality in the general population would fall by 10 percent and child mortality between the age of one and five would fall by 20 percent.”


Cleland was speaking ahead of the London Summit on Family Planning on Wednesday, which will launch an initiative to give 120 million more women access to voluntary family planning methods by 2020.

He said family planning had been “horrendously neglected” for 15 years.

Cleland believes the role of contraception on improving the health of women, babies and children has been overlooked because much of the evidence is produced by demographers and published in non-medical journals and medics regard family-planning as boring and would rather be involved in more glamorous, high-tech interventions.

Writing in the Lancet, Cleland said another problem is that emphatic advocacy of family planning had also been linked to population control – a highly sensitive subject which had become “deeply unfashionable”.

But one result of the long silence on these issues has been a steep drop in international funding and vocal support for family planning programmes.

“In terms of maternal and child health, a heavy price has been paid for this neglect, particularly in Africa. We believe that redress of this imbalance is long overdue,” he concludes.

See also:

Lack of contraception costs over 100,000 lives a year – expert

One man’s mission to prevent unwanted pregnancies in Africa

The Word on Women – Family planning and the romance of a better life in India’s Bihar state

(Editing by Katie Nguyen)

Photo: Afghan mothers visit a health clinic in Eshkashem district of Badakhshan province, northeast of Kabul, April 23, 2008. REUTERS/Ahmad Masood

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