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Seasonally adjusted births and deviations from prepandemic trends, by mothers' nativity. Subtitles: (A) Births to US-born women. (B) Births to foreignborn women. (C) Percent deviations among US-born women. (D) Percent deviations among foreign-born women, by mothers' region of birth. (E) Absolute deviations among US-born women. (F) Absolute deviations among foreign-born women, by mothers' region of birth. Legend: (A) Births to US-born women. 1. US-born TFR (US) -green dot. 2. US-born birth counts (78% of all US births) -solid blue. 3. US-born TFR (California) -dashed green. (B) Births to foreignborn women. 1. Foreign-born TFR -green dot. 2. Foreign-born birth counts (22% of all US births) -solid blue. 3. Foreign-born TFR (California) -dashed green. (C) Percent deviations among US-born women. 1. Birth count (US) -solid blue. 2. TFR (US) -green dot. 3. TFR (California) -dashed green. (D) Percent deviations among foreign-born women, by mothers' region of birth. 1. All foreign born -solid gray. 2. Latin America (53%) -green dot. 3. China (5.1%) -dashed blue. 4. Africa, Europe, Middle Eastern, and Other Countries (22%) -teal square. 5. Asia & Pacific (not China) (20%) -long dashed purple. (E) Absolute deviations among US-born women. 1. Birth count (US) -solid blue. 2. TFR (US) -green dot. 3. TFR (California) -dashed green. (F) Absolute deviations among foreign-born women, by mothers' region of birth. 1. All foreign born -solid gray. 2. Latin America (53%) -green dot. 3. China (5.1%) -dashed blue. 4. Africa, Europe, Middle Eastern and Other Countries (22%) -teal square. 5. Asia & Pacific (not China) (20%) -long dashed purple. Notes: Calculations use all births occurring in the United States and stratify by whether the mother was born in or outside the United States. The legends in A and B indicate in parentheses the percent of all births in the United States in 2019 that occurred to US-born women (A) or foreign-born women (B). The legends in D and F indicate in parentheses the percent of all births in the United States to foreign-born women in 2019 occurring to women in the indicated region of birth grouping. See Materials and Methods for more details.
Source publication
We use natality microdata covering the universe of US. births for 2015 to 2021 and California births from 2015 through February 2023 to examine childbearing responses to the COVID-19 pandemic. We find that 60% of the 2020 decline in US fertility rates was driven by sharp reductions in births to foreign-born mothers although births to this group com...
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Citations
... Since January 2022, many European countries have shown a marked decline in birth rates, continuing a negative trend that may have begun before the Covid-19 pandemic ). In the United States (US), birth rates declined from 2020 to early 2021 (Bailey et al. 2023), especially after the first and second waves of Covid-19 (Adelman et al. 2023), followed by a surge in births later in 2021 (Bailey et al. 2023). ...
... Since January 2022, many European countries have shown a marked decline in birth rates, continuing a negative trend that may have begun before the Covid-19 pandemic ). In the United States (US), birth rates declined from 2020 to early 2021 (Bailey et al. 2023), especially after the first and second waves of Covid-19 (Adelman et al. 2023), followed by a surge in births later in 2021 (Bailey et al. 2023). ...
... Importantly, the opposite GFR trends in 2021 and in 2022 were driven by different subgroups of the population: while the increase in births in 2021 occurred mostly among Swiss women aged 30+, the subsequent 2022 decrease disproportionately affected non-Swiss women aged <30. In the US, similar trends have been found: foreign-born women accounted for the majority of the 2020 fertility decline, while US-born women experienced a baby bump in 2021 (Bailey et al. 2023). The authors explained that pandemic aid from the government may have increased childbearing among US-born women. ...
... Initial findings out of Australia revealed an immediate increase in birth rates in the first year versus the pandemic, which align with the trends in the USA and various North European countries. [11][12][13][14] It was suggested that this upward trend may have resulted from low infection rates alongside extensive income support programmes that mitigated economic strains. 15 Data from low-and middle-income countries suggest similar trends to those of many developed countries, with short term declines in births and subsequent recoveries. ...
Introduction: The COVID-19 pandemic has brought about unprecedented global health, economic, and social crises, which has had a significant impact on the world’s population, with a surge in maternal deaths in both developing and developed countries. However, there remains a paucity of data on the impact of the pandemic on fertility and reproductive function, especially among low- and middle-resource countries. Methods: This retrospective study examines the impact of the pandemic on birth rates in Trinidad and Tobago and Barbados, two middle-resource countries. Birth data was gathered from three major hospitals in these countries, covering a period of nine years (2015-2023), Findings: Our analysis of birth data reveals a significant decline in births during the pandemic, with an 11.7% decrease in mean births per year (11,063.0 vs 9,846.7); p < 0.001. The decline in births was more pronounced in Barbados, with a 13.7% decrease, compared to 10.3% and 10.2% at the two hospitals in Trinidad. Conclusion: The greatest impact on birth rates resulted from the peak of the Omicron variant in Trinidad and the Delta variant in Barbados. Furthermore, this study suggests that the pandemic has had a negative impact on fertility, with the decline in births persisting even after the pandemic. The findings are consistent with historical crises, such as the Great Depression and the 2008 economic downturn, which also had a negative impact on fertility rates.
... The initial shock was linked in most countries to a short-term decrease in the number of births around December 2020 to January 2021, followed by an equally brief recovery around March 2021 and a more differentiated development in the subsequent months that varied across countries (e.g. OECD, 2021a,b;Gray et al., 2022;Nis� en et al., 2022;Pomar et al., 2022;Bailey et al., 2023;Fallesen and Cozzani, 2023;Gietel-Basten and Chen, 2023;Kearney and Levine, 2023;Lappegård et al., 2023;Plach et al., 2023;Sobotka et al., 2023). Some countries, including the Nordic countries, the Netherlands, Switzerland, Germany, Israel, and the USA, even experienced a minor 'baby boom' during the second pandemic year, 2021. ...
... While birth trends during the early stages of the COVID-19 pandemic have been extensively researched (e.g. Pomar et al., 2022;Bailey et al., 2023;Kearney and Levine, 2023;Plach et al., 2023;Sobotka et al., 2023), the majority of studies have focused on single countries and conceptions in the first year of the pandemic. The most recent birth declines and their drivers are not yet well documented and understood. ...
STUDY QUESTION
What are the factors influencing the decline in the birth rates observed in higher-income countries in the later phase of the COVID-19 pandemic?
SUMMARY ANSWER
Our results suggest that economic uncertainty, non-pharmaceutical policy interventions, and the first wave of the population-wide vaccination campaign were associated with the decline in birth rates during 2022.
WHAT IS KNOWN ALREADY
During the COVID-19 pandemic, birth rates in most higher-income countries first briefly declined and then shortly recovered, showing no common trends afterwards until early 2022, when they unexpectedly dropped.
STUDY DESIGN, SIZE, DURATION
This study uses population-wide data on monthly total fertility rates adjusted for seasonality and calendar effects provided in the Human Fertility Database (HFD). Births taking place between November 2020 and October 2022 correspond to conceptions occurring between February 2020 and January 2022, ie, after the onset of the pandemic but prior to the Russian invasion of Ukraine. The data cover 26 countries, including 21 countries in Europe, the United States, Canada, Israel, Japan and the Republic of Korea.
PARTICIPANTS/MATERIALS, SETTING, METHODS
First, we provided a descriptive analysis of the monthly changes in the total fertility rate (TFR). Second, we employed linear fixed effects regression models to estimate the association of explanatory factors with the observed seasonally adjusted total fertility rates. Our analysis considered three broader sets of explanatory factors: economic uncertainty, policy interventions restricting mobility and social activities outside the home, and the progression of vaccination programmes.
MAIN RESULTS AND THE ROLE OF CHANCE
We found that birth trends during the COVID-19 pandemic were associated with economic uncertainty, as measured by increased inflation (p < 0.001), whereas unemployment did not show any link to births during the pandemic (p = 0.677). The stringency of pandemic policy interventions was linked to a postponement of births, but only in countries with lower institutional trust and only in the early phase of the pandemic (p = 0.003). In countries with higher trust, stricter containment measures were positively associated with birth rates, both for conceptions in the first year of the pandemic (p = 0.019) and, albeit only weakly significant, for conceptions later in the pandemic (p = 0.057). Furthermore, we found a negative association between the share of the population having received the first dose of the COVID-19 vaccination and total fertility rates (p < 0.001), whereas the share of the population having completed the primary vaccination course (usually consisting of two doses) was linked to a recovery of birth rates (p < 0.001).
LARGE SCALE DATA
N/A
LIMITATIONS, REASONS FOR CAUTION
Our research is restricted to higher-income countries with relatively strong social support policies provided by the government as well as wide access to modern contraception. Our data did not allow analyses of birth trends by key characteristics, such as age, birth order and social status.
WIDER IMPLICATIONS OF THE FINDINGS
This is the first multi-country study of the drivers of birth trends in the later phase of the COVID-19 pandemic. In the past, periods following epidemics and health crises were typically associated with a recovery in births. In contrast, our results show that the gradual phasing out of pandemic containment measures, allowing increased mobility and a return to more normal work and social life, contributed to declining birth rates in some countries. In addition, our analysis indicates that some women avoided pregnancy until completion of the primary vaccination protocol.
STUDY FUNDING/COMPETING INTEREST(S)
This study did not use any external funding. The authors acknowledge funding from their home institution, the Vienna Institute of Demography of the Austrian Academy of Sciences, and from the Open-Access Fund of the Austrian Academy of Sciences. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript versions arising from this submission. All authors declare that they have no conflicts of interest.
... A substantial decline prior to November 2020 was only reported in the United States. 2,6 Many studies of birth rates in the intervening months (March-November 2020) have focused on preterm births [11][12][13][14][15][16][17][18][19] and stillbirths. 16,[19][20][21] Preterm births and stillbirths constituted 10% and 0.5% of all deliveries, respectively, during the pre-pandemic period. ...
... We obtained complete data on live births (ie, excluding stillbirths) by month from January 2016 to December 2021 for the United States, Canada, and 37 European countries from national statistical agencies. [24][25][26] Compared to previous studies on birth rates, for the United States, our data source was the same as that of Bailey et al. 6 For Europe, we had a different source than that used by Pomar et al., 9 but the number of births in each country in their data matched ours. ...
... The COVID-19 pandemic was associated with substantial changes to birth rates in the United States 2,6 and in Europe. 9,10 Bailey et al. 6 reported that the reduction in births in the United States was 76 000 for all 12 months of 2020, and Kearney and Levine 2 estimated a reduction of 97 000 births in the United States in the period from August 2020 to February 2021. Our ITS estimate of 60 000 (95% CI, 30 000-90 000) fewer births between March and November 2020 overlapped with these results. ...
Birth rates in Canada and the USA declined sharply in March 2020 and deviated from historical trends. This decline was absent in similarly developed European countries. We argue that the selective decline was driven by incoming individuals, who would have travelled from abroad and given birth in Canada and the USA, had there been no travel restrictions during the COVID-19 pandemic. Furthermore, by leveraging data from periods before and during the COVID-19 travel restrictions, we quantified the extent of births by incoming individuals. In an interrupted time series analysis, the expected number of such births in Canada was 970 per month (95% CI: 710-1,200), which is 3.2% of all births in the country. The corresponding estimate for the USA was 6,700 per month (95% CI: 3,400-10,000), which is 2.2% of all births. A secondary difference-in-differences analysis gave similar estimates at 2.8% and 3.4% for Canada and the USA, respectively. Our study reveals the extent of births by recent international arrivals, which hitherto has been unknown and infeasible to study.
... The COVID-19 pandemic of 2020-2022 contributed to distinct swings in birth rates. The initial shock was linked in most countries to a short-term decrease in the number of births around December 2020 to January 2021, followed by an equally brief recovery around March 2021 and a more differentiated development in the subsequent months that varied across countries (e.g., Bailey et al., 2023;Fallesen & Cozzani, 2023;Gietel-Basten & Chen, 2023;Gray et al., 2022;Kearney & Levine, 2023;Lappegård et al., 2023;Nisén et al., 2022;OECD, 2021aOECD, , 2021bPlach et al., 2023;Sobotka et al., 2023). Some countries, including the Nordic countries, the Netherlands, Switzerland, Germany, Israel and the United States, even experienced a small "baby bump" during the second pandemic year, 2021. ...
... While fertility trends during the early stages of the COVID-19 pandemic have been extensively researched (e.g., Bailey et al., 2023;Kearney & Levine, 2023;Plach et al., 2023;Sobotka et al., 2023), the majority of studies have focused on single countries and on conceptions in the first year of the pandemic. The most recent fertility declines and their drivers are not yet well documented and understood. ...
BACKGROUND: During the COVID-19 pandemic, birth rates in most higher-income countries first briefly declined and then shortly recovered, showing no common trends afterwards until early 2022, when they unexpectedly dropped.
STUDY FOCUS: We analyse monthly changes in total fertility rates in higher-income countries during the COVID-19 pandemic, with a special focus on 2022, when birth rates declined in most countries. We consider three broader sets of explanatory factors: economic uncertainty, policy interventions restricting mobility and social activities outside the home, and the role of vaccination programmes.
STUDY DESIGN, DATA: This study uses population-wide data on monthly total fertility rates adjusted for seasonality and calendar effects provided in the Human Fertility Database (HFD, 2023). Births taking place between November 2020 and October 2022 correspond to conceptions occurring between February 2020 and January 2022, i.e., after the onset of the pandemic but prior to the Russian invasion of Ukraine. The data cover 26 countries, including 21 countries in Europe, the United States, Canada, Israel, Japan and the Republic of Korea.
METHODS: First, we provide a descriptive analysis of the monthly changes in the total fertility rate (TFR). Second, we estimate the effects of the explanatory factors on the observed fertility swings using linear fixed effects (within) regression models.
MAIN RESULTS: We find that birth trends during the COVID-19 pandemic were associated with economic uncertainty, as measured by increased inflation, the stringency of pandemic policy interventions, and the progression of the COVID-19 vaccination campaign, whereas unemployment did not show any link to fertility during the pandemic.
LIMITATIONS, REASONS FOR CAUTION: Our research is restricted to higher-income countries with relatively strong social support policies provided by the government as well as wide access to modern contraception. Our data do not allow analysing fertility trends by key characteristics, such as age, birth order and social status.
WIDER IMPLICATIONS OF THE FINDINGS: This is the first multi-country study of the drivers of birth trends in a later phase of the COVID-19 pandemic. In the past, periods following epidemics and health crises were typically associated with a recovery in fertility. In contrast, our results show that the gradual phasing out of pandemic containment measures, allowing increased mobility and a return to more normal work and social life, contributed to declining birth rates in most countries. In addition, our analysis indicates that some women avoided pregnancy during the initial vaccination roll-out.
... economic insecurity, leading to a decreased desire for pregnancy 16,17 . However, emerging evidence suggests that the 'baby bust' seen in 2020 was followed by a smaller "baby bump" in 2021, though this increase in fertility was largely concentrated among US-born mothers 3,18 . ...
The immediate, direct effects of the COVID-19 pandemic on the United States population are substantial. Millions of people were affected by the pandemic: many died, others did not give birth, and still others could not migrate. Research that has examined these individual phenomena is important, but fragmented. The disruption of mortality, fertility, and migration jointly affected U.S. population counts and, consequently, future population structure. We use data from the United Nations World Population Prospects and the cohort component projection method to isolate the effect of the pandemic on U.S. population estimates until 2060. If the pandemic had not occurred, we project that the population of the U.S. would have 2.1 million (0.63%) more people in 2025, and 1.7 million (0.44%) more people in 2060. Pandemic-induced migration changes are projected to have a larger long-term effect on future population size than mortality, despite comparable short-term effects.
... From January 2022, many European countries show a marked decline in birth rates, continuing a negative trend that may have started before Covid-19 (Sobotka et al., 2023). In the US, the pattern of birth rates was slightly different, first falling in 2020 to early 2021 (Bailey et al., 2023), and especially after the first and second waves of Covid-19 (Adelman et al., 2023), followed by a smaller than expected upswing in 2022. ...
We follow population trends in the birth rate in Switzerland almost up to the present day and place the latest developments during the Covid-19 pandemic in a historical context. The birth rate in 2022 was the lowest it has been since the 1870s, and it seems the trend is continuing in 2023. The latest decline had already begun 1-2 years before Covid-19. Previous pandemics (1890, 1918, 1920, 1957) had each led to a temporary decline in the birth rate around 9 months after the peak of these outbreaks. With Covid-19, this appears more complex. The immediate shock of the global outbreak has not left a nega-tive mark on births in Switzerland. However, during and shortly after the first two pandemic waves and partial shutdowns in 2020, there were more conceptions and thus significantly more births in 2021, in all available subgroups except Italian-speaking Switzerland, and somewhat more pronounced among >30-year-old mothers and second parities. The subsequent decline in births from January 2022 was stronger than the increase in births in 2021. The first part of the 2022 decline falls on conception months in the first half of 2021, when the vaccination campaign started in Switzerland. However, given that the proportion of young people vaccinated by summer was still small, vaccination cannot by itself explain the decline in birth rate. The second part of the 2022 decline is associated with conceptions during the large Omicron wave in winter 2021/2022. The decline appears to continue in 2023, albeit not substantially.
... Many previous surveys only focus on women's intentions (Tan, Ryan, and Lim-Soh 2021;Afshari, Abedi, and Beheshtinasab 2022;Akinyemi et al. 2022;Chen et al. 2022;Zimmerman et al. 2022). Moreover, it is the first study that systematically investigates the heterogeneity across genders, locations (rural versus urban), and social classes, while other studies have only briefly touched this topic (Fostik and Galbraith 2021;Manning, Guzzo, and Kamp Dush 2021;Akinyemi et al. 2022;Zimmerman et al. 2022;Bailey, Currie, and Schwandt 2023). Finally, it is also the first comprehensive study on the case of Iran and the first on this scale from a lowermiddle income country. ...
... Existing studies also reveal that there are differences among population subgroups, for example, the location (urban versus rural), household income level, or ethnicity (Fostik and Galbraith 2021;Manning, Guzzo, and Kamp Dush 2021;Akinyemi et al. 2022;Zimmerman et al. 2022;Bailey, Currie, and Schwandt 2023). ...
... More precisely, respondents who are concerned about the continuation of the pandemic have a 3.2 pp lower probability of childbirth during the pandemic. This refers to Hypothesis 1 and supports the community influence theory and empirical studies from other countries (Luppi, Arpino, and Rosina 2020;Lima, Ferreira Soares, and Monteiro da Silva 2021;Afshari, Abedi, and Beheshtinasab 2022;Pomar et al. 2022;Sobotka et al. 2022;Wang, Gozgor, and Lau 2022;Bailey, Currie, and Schwandt 2023). As presented in the interaction terms in Table 4, when taking into account the gender, location, and social class of the respondents, we can see that the effect is driven by female respondents, urban respondents, and respondents who consider themselves lower-middle class. ...
With a representative survey of 1,214 participants conducted in early 2022, this study investigates the impact of the COVID-19 pandemic on marriage and childbirth in Iran. The results of the empirical investigation using logistic regressions suggest that the experience of unemployment due to the pandemic is positively associated with marriage during the pandemic and the experience of losing a close relative or family member is negatively associated with marriage. In addition, concern about the persistence of the pandemic and vaccination status show negative associations with childbirth during the pandemic. We found heterogenous effects depending on gender, location, and social class; for example, the negative effects of the concern about a prolonged pandemic and vaccination status are driven by female respondents. Overall, the results have implications for the development of the fertility rate and population in post-pandemic Iran.
Background
Fetal echocardiography is the mainstay of prenatal diagnosis of congenital heart disease. The COVID‐19 pandemic led to shifts in triage of prenatal services. Our objective was to evaluate the impact of COVID‐19 restrictions on prenatal diagnosis, surgical outcomes, and disparities in neonatal critical congenital heart disease (CCHD) management in the United States during the pandemic's first year.
Methods and Results
A multi‐institutional retrospective cohort study compared neonatal CCHD outcomes (requiring surgery within 60 days of birth) 1 year prior (prepandemic era) and during the peak pandemic era, supplemented by a Fetal Heart Society survey assessing regional practice changes. Data on prenatal diagnosis, demographics, outcomes, and 2020 state Area Deprivation Index were analyzed using Wilcoxon rank sum and χ ² tests. The survey, completed by 72 fetal cardiologists from 9 US census regions, showed 75% of institutions implemented restrictions by March 2020, affecting triage, referrals, and number of prenatal cardiology visits. Compared with CCHD neonates born prepandemic (n=4637), those born during the pandemic (n=1806) had a higher proportion of prenatal diagnosis (66% versus 63%, P <0.05). There were no significant differences in complications or mortality, but pandemic‐era neonates had longer hospital stays. During the pandemic, CCHD neonates had a more disadvantaged Area Deprivation Index and had surgery at hospitals located in more advantaged regions.
Conclusions
Although pandemic‐driven care delivery adjustments affected perinatal cardiology referrals and triage, prenatal diagnosis, perioperative outcomes, and survival remained robust. The management of CCHD demonstrates health care resilience, maintaining core prenatal and perioperative care. Regional variations highlight the need for targeted strategies to address disparities during health care crises.
Although other studies have utilized demographic variables to characterize pet owners, this study incorporates a demographic framework that considers different family structures—couples and singles, with or without children—to better understand the place of pets within families. This article explores the extent to which pets fit into families in either substitute or complementary family roles, whether the inclusion of pets in families is subject to resource constraints or cultural proclivities. Data are from the 2023 Pew Research Social Trends study, a nationally representative telephone survey of 5073 respondents, analyzed using bivariate and multinomial models. Results indicate that couples without children are just as likely to be a dog-only household as are the traditional pet-owning families of couples with young children. They are also more likely to have cats, with or without dogs, compared to couples with young children. Homeownership makes pets, especially dogs, more feasible for families. The results suggest that pets are considered as substitutes and/or complements for other family members. Pets may be more affordable and attainable substitutes and/or complements for human family members, provided there are both human and spatial resources, filling a niche created by changes in family formation patterns, while providing affection, companionship and a sense of home.
