Medical experts in maternal health have raised concerns over increasingly short intervals between pregnancies, warning that the trend poses serious risks to both mothers and newborns.

The doctors, who spoke to a health publication, said women—especially those who delivered via caesarean section (CS)—are at higher risk when they conceive too soon after childbirth, stressing that the body needs sufficient time to recover before another pregnancy.

They recommended a minimum spacing of 24 months before conception after childbirth, noting that inadequate recovery time can lead to complications such as uterine scar rupture, anaemia, excessive bleeding, premature birth, poor foetal growth and, in severe cases, stillbirth.

The experts explained that women who have undergone CS are medically classified as high-risk, even when they appear healthy after delivery, due to the possibility of internal complications that may not be immediately visible.

They also warned against the growing influence of unverified health advice circulating on social media, urging women to rely strictly on guidance from qualified medical professionals.

The concern comes amid the emergence of a growing trend popularly referred to as “two-under-two,” where women have children in very rapid succession. According to the experts, such patterns may contribute to Nigeria’s already high rates of maternal and infant mortality if not properly addressed.

A Professor of Obstetrics and Gynaecology at the University of Uyo, Aniekan Abasiattai, explained that the uterus must fully heal after a caesarean section before another pregnancy is attempted.

He warned that if the surgical scar is not fully healed, it may rupture during labour, creating a life-threatening emergency for both mother and child.

He further noted that women who do not observe adequate spacing after CS are often advised against vaginal delivery in subsequent pregnancies, meaning repeat surgical delivery becomes necessary.

Beyond scar-related risks, he said short birth intervals increase the likelihood of anaemia, gestational diabetes, placenta complications and postpartum haemorrhage, particularly among women who are already medically vulnerable.

Another expert, Abubakar Panti, described short birth spacing as a major public health concern in Nigeria, warning that it continues to contribute to preventable maternal and infant health complications.

He advised that women should maintain at least a 24-month gap between childbirth and the next pregnancy, which translates to about three years between successive births for optimal health outcomes.

Panti added that closely spaced pregnancies place significant physical strain on breastfeeding mothers and increase risks such as preterm birth, low birth weight, and newborn complications.

He identified poor contraceptive use, cultural expectations for rapid childbearing, and late marriages as key drivers of unsafe birth spacing practices.

While acknowledging concerns about declining fertility among some women, he stressed that the medical risks of rapid successive pregnancies far outweigh such fears.

Both experts called for stronger integration of postpartum family planning into maternal healthcare services, as well as intensified public awareness campaigns to educate women on safe pregnancy spacing and its importance for maternal and child survival.

The World Health Organisation (WHO) has raised fresh concerns over the worsening Ebola outbreak in the Democratic Republic of the Congo (DRC), warning that ongoing violence and humanitarian challenges are hampering efforts to contain the disease.

WHO Director-General, Tedros Ghebreyesus, disclosed on Sunday in a post on X that more than 900 suspected Ebola cases have so far been identified in the DRC, including 101 confirmed infections and 220 suspected deaths.

The latest outbreak, caused by the Bundibugyo strain of the Ebola virus, has also spread beyond the DRC, with neighbouring Uganda recording two additional confirmed cases among healthcare workers, bringing its total to seven confirmed cases and one death.

WHO had declared the outbreak a Public Health Emergency of International Concern (PHEIC) following confirmed cross-border infections.

Emergency funds

The WHO had earlier announced the release of $3.9 million from its Contingency Fund for Emergencies to strengthen response efforts in the DRC and neighbouring Uganda.

It also said it is setting up a continental Incident Management Support Team with the Africa Centres for Disease Control and Prevention to coordinate and scale up the outbreak response.

Mr Ghebreyesus said the national risk level in the DRC had been raised to “very high” because of rapid transmission and the absence of approved vaccines or therapeutics for the Bundibugyo strain.

He added that the health agency is finalising a multi-agency Strategic Preparedness and Response Plan aligned with national response plans for DRC and Uganda, while expanding contact tracing, treatment centres, laboratory capacity and community engagement.

Disease in conflict zone

Mr Ghebreyesus said the outbreak is centred in Ituri Province, a conflict-ridden region where nearly five million people are living amid insecurity and a humanitarian crisis.

He added that “1 in 4 people are in need of humanitarian assistance, and 1 in 5 are internally displaced.”

“The violence is forcing people to flee, including health and humanitarian workers. This is severely impeding efforts to scale up Ebola contact tracing and identify infections early enough to provide supportive care,” he stated.

He added that ongoing insecurity and fear are also “fueling mistrust within communities,” a development that could further complicate containment efforts.

Providing an update on the outbreak, Mr Ghebreyesus said 101 Ebola cases had been confirmed in the DRC, including 10 confirmed deaths.

Health interventions

Despite the challenges, Mr Ghebreyesus said WHO and its humanitarian partners are maintaining operations across Ituri, including in “some of the hardest-to-reach and most insecure areas.”

He said health partners are also supporting the delivery of maternal, newborn, child and adolescent healthcare; treatment for severe acute malnutrition; mental health services, wound care and support for survivors of sexual violence; medical supplies; routine immunisation; community health services.

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“Delivering a comprehensive package of healthcare services is essential,” he said, adding that such interventions were necessary “not only to meet urgent health needs, but also to build the trust that is critical for an effective Ebola response.”

More cases expected

Mr Ghebreyesus said response efforts are being intensified in collaboration with health partners, but warned that more infections are likely to be detected in the coming days and weeks.

“The sooner we can trace people with infections and identify their contacts, the sooner we can provide the care they need and bring this outbreak under control,” he said.