AIIMS Delhi NO- 2019: The minimum recommended distance between two births according to WHO is?

AIIMS Delhi NO- 2019

Obstetrics & Gynaecology

Medium

Appeared in: AIIMS Delhi NO- 2019

Explanation

The World Health Organization (WHO) recommends a birth-to-conception interval (the time between a live birth and the start of the next pregnancy) of at least 24 months.
The question asks for the 'distance between two births,' which is the birth-to-birth interval.
This is calculated by adding the recommended waiting period (24 months) to the average duration of a pregnancy (9 months).
The resulting minimum birth-to-birth interval is 33 months (24 + 9).
Among the given options, 36 months (3 years) is the closest and most appropriate answer, aligning with public health guidance that recommends spacing births by at least 3 years.

Option A: This interval is significantly shorter than the WHO recommendation and is associated with a high risk of adverse outcomes like preterm birth, low birth weight, and maternal anaemia.
Option B: While better than 12 months, an 18-month interval is still considered short and carries increased risks for both mother and child. The WHO explicitly recommends waiting longer.
Option C: This represents the recommended minimum time to wait before conceiving the next child (the inter-pregnancy or birth-to-conception interval), not the total time between the two births.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain WHO recommendations on birth spacing as background academic context rather than a clinical decision trigger.
As a community health nurse, advising families on adequate birth spacing is a key part of maternal and child health (MCH) counseling to reduce morbidity and mortality.
Proper spacing allows the mother's body to fully recover nutritional stores (especially iron and folate) and for the uterus to heal, which reduces the risk of complications in the next pregnancy.
What if? If a woman had a caesarean section, the recommended inter-pregnancy interval might be even longer to ensure the uterine scar has healed sufficiently, making the advice for a 3-year gap even more critical for preventing uterine rupture.

How to Approach the Question

First, identify the precise term used in the question: 'distance between two births,' which means the birth-to-birth interval.
Differentiate this from the 'inter-pregnancy' or 'birth-to-conception' interval, which is the waiting time before the next pregnancy.
Recall the specific WHO recommendation for the waiting period, which is at least 24 months.
Perform the necessary calculation: Add the waiting period (24 months) to the average duration of a pregnancy (9 months).
The result is 33 months. Compare this calculated value to the given options.
Select the option that is the closest and most logical fit, which is 36 months (3 years), a common public health guideline.

Concept Tested & Keywords

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2822-2824