'Gore mwana' practice raises risk of birth complications

Zimbabwe's leading family planning expert with the Zimbabwe National Family Planning Council (ZNFPC), Thandekile Munemo, has cautioned women against closely spaced pregnancies, warning of serious health risks for both mothers and children.

Munemo raised concern over the practice commonly referred to as "gore mwana," a Shona term describing a pattern where a woman conceives again soon after giving birth, sometimes before the previous child reaches one year or stops breastfeeding.

While the practice remains culturally familiar in some communities, health experts say it places significant strain on a woman's body, increasing the likelihood of complications such as maternal anaemia, pregnancy-related disorders and poor infant health outcomes.

Speaking in an interview, Munemo emphasised that although childbearing is a personal decision, couples should consider medical guidance on birth spacing.

"We are not prescribing when to have a child, but we are saying give yourself the recommended time to rest and the recommended time is two years, which is 24 months, for one to recover from a previous pregnancy," she said.

She warned that falling pregnant before the recommended interval increases the risk of anaemia due to haemodilution, pre-term labour, and complications for women who previously underwent caesarean sections.

"If a woman has had a caesarean section and then falls pregnant before the two-year interval, there is a risk of uterine rupture and also bleeding after delivery, also known as postpartum haemorrhage," Munemo explained.

She added that the uterus requires adequate time to heal after pregnancy.

"The uterus would have been stretched during the previous pregnancy less than two years ago, and now it is stretching again. For it to return to normal tone after delivery becomes difficult, and someone might experience postpartum haemorrhage. We are not saying it will definitely happen, but you are at greater risk," she said.

Experts also note that closely spaced pregnancies can negatively affect newborn health, with babies more likely to be born prematurely, have low birth weight or face developmental and immunity challenges. In addition, shorter intervals may reduce breastfeeding duration for the older child, affecting nutrition and growth.

Health specialists attribute the persistence of closely spaced pregnancies to a combination of cultural expectations, limited access to contraception and misconceptions about breastfeeding as a reliable family planning method. In some cases, women face pressure from partners or relatives to have children in quick succession.

Recent data from the Zimbabwe Demographic and Health Survey (ZDHS) shows that maternal anaemia is on the rise, increasing from 27 percent in 2015 to 41.8 percent among women aged 15 to 49. The report also estimates that one in every 125 women faces the risk of dying from pregnancy or childbirth-related complications in their lifetime.

Medical experts say leading causes of maternal deaths in Zimbabwe include hypertensive disorders such as eclampsia, severe obstetric haemorrhage, infections like sepsis, and complications from miscarriages or unsafe abortions.

Anaemia has also been linked to fatigue, reduced productivity and increased risks during childbirth, particularly where pregnancies are closely spaced and the body has not fully recovered.

Against this backdrop, health professionals are calling for increased awareness around birth spacing as a key component of safe motherhood, urging improved access to family planning services and stronger postnatal counselling to reduce preventable complications for both mothers and their children.