Interconception, or interpregnancy care, can be defined as the care provided to women and their partners between pregnancies in order to improve outcomes for both women and infants.^1,2 The interconception period presents an opportunity to address medical issues (both physical and mental, including intimate partner violence) that have arisen in the preceding pregnancy/pregnancies or postpartum period , provide education regarding optimal pregnancy spacing, provide contraception and consider and address lifestyle risk factors.² Implementation of this in reality can be challenging due to the competing priorities brought about by new parenthood.

Given the potential risk of adverse outcomes in both the mother and child, interpregnancy interval is a modifiable risk factor.² Interconception care is particularly important given the increasing rates of chronic disease in people of childbearing age.² GPs can prepare for interconception care during pregnancy by developing a postpartum plan that includes the patient’s wishes for future pregnancies.¹

The following recommendations should be considered alongside those provided in Preconception care.

Research has shown that many women are unaware of the risks of short interpregnancy intervals, and this should be discussed with the woman as part of reproductive planning and/or postpartum care.² 

Potential adverse outcomes due to a shorter (six months) interpregnancy interval

Women with shorter interpregnancy intervals are more likely to experience:^2,7–9

• placental abruption
• placenta praevia
• uterine rupture (for women who previously had a caesarean section)
• gestational diabetes.

Potential adverse outcomes for neonates include:^2,10–12

• increased risk of stillbirth
• small size for gestational age
• preterm delivery
• neonatal death. 

The UK medical eligibility criteria for contraceptive use provides guidance on the possible methods of contraception that can be used by patients with specific health conditions or characteristics.

GPs should be aware that contraceptive implant soon after childbirth or the insertion of IUC at the time of either vaginal or caesarean delivery is convenient and highly acceptable to women. This has been associated with high continuation rates and a reduced risk of unintended pregnancy.³ An intrauterine device (IUD) can be safely inserted at time of delivery, or within 10 minutes of delivery of the placenta, or within the first 48 hours after uncomplicated caesarean section or vaginal birth. After 48 hours, insertion should be delayed until 28 days after childbirth.³

There are no specific interconception recommendations for Aboriginal and Torres Strait Islander peoples.