How the Pandemic Affected U.S. Birth Rates—and What Comes Next

When the COVID-19 pandemic hit the U.S. in March of 2020, speculation began about how this would affect births. With activities outside the house severely limited, would more people decide to stay home and make a baby with their partner, leading to a baby boom? Or would worries about health and money lead people to delay or avoid getting pregnant, leading to a baby bust? In full disclosure, we were firmly on Team Baby Bust. Now, with enough passage of time, we can look at the data and evaluate what really happened to birth rates in the U.S. and why. The short answer: at first there was a bust, then there was a boom, and now U.S. birth rates are back on their long-term, downward trend.

Here are five ways birth rates changed in the U.S. during the Covid-19 pandemic:

In the early months of the pandemic, pregnancies dropped. The onset of the pandemic in the U.S. in March and April of 2020 led to a drop in pregnancies resulting in live births, as compared to what would have been expected otherwise based on pre-existing trends. Two major factors explain the decrease. First, it is a well-established fact that when unemployment rises, births fall nine months later. Some families avoid having a child when economic times are tough. Between January 2020 and May 2020, the unemployment rate jumped from 3.5 percent to 13.2 percent. Pregnancies fell the most in states where the spike in unemployment was largest. Second, COVID generated widespread health concerns that contributed to the decline. Pregnancies fell the most in those areas that experienced the largest outbreaks. For instance, the largest drop in pregnancies occurred in New York City, the epicenter of the pandemic at the outset.

Pregnancies fell the most for older women and women with children. The largest drops in birth rates occurred among women in their late 30s and early 40s, and those who already had at least one child. This suggests that pandemic-related factors and pressures beyond economic challenges were important drivers of the decline associated with the early months of the pandemic. There are a variety of potential explanations for this. For instance, among women in their 30s and 40s, reduced access to fertility specialists and services during this period might reduce pregnancies among this group. In addition, having a child at home while schools and daycares were closed might have made this time an especially challenging one for parents, leading them to delay or cancel plans to expand their family.

Births started falling in the spring and summer of 2020. This pattern cannot be explained by a fall in pregnancies associated with pandemic conditions, which would not affect birth rates until later that fall. Researchers have identified two reasons that births fell so quickly: First, medical access was restricted during the initial months of the pandemic and that led to a reduction in inductions and c-sections, causing an immediate drop in births. Second, fewer pregnant women entered the U.S. in those months due to travel restrictions, contributing to an immediate fall in births. Births started falling faster late in the fall of 2020, when the reduction in post-pandemic conceptions started showing up as fewer births.

In summer and fall 2020, pregnancies rebounded. The drop in pregnancies did not last long. The rebound, though, did not simply reflect an increase in pregnancies among the same women who delayed earlier that year; the states in which births fell the most are not the same as where births subsequently increased the most. Families’ greater economic security contributed to the rebound. During summer 2020, the unemployment rate steadily declined, and the federal government transferred trillions of dollars of income assistance to families, through enhanced unemployment insurance benefits and direct household payments. Pregnancies rebounded the most in those states with relatively larger improvements in the labor market and a greater resumption of household spending. Pandemic-related anxiety also waned by summer and fall of 2020, more so in some parts of the country than others, leading to more pregnancies. One way we can see this is that pregnancy rates rose more in states that did not have ongoing mask mandates. The rebound in conceptions in summer and fall of 2020 led to baby boom in 2021, offsetting the initial COVID baby bust.

U.S. birth rates are now back on their longer-term downward trend. The COVID initial baby bust and subsequent boom did not change the long-term trajectory of births in the U.S. In the second quarter of 2022, the U.S. had 889,000 births, as compared to 919,000 births in the second quarter of 2019. In other words, the number of annual U.S. births post-COVID are 3.3 percent lower than pre-COVID. This is right in line with the downward trend in births going back to 2007, the year in which births peaked in the U.S. after three decades of relative stability. The COVID baby bust and rebound were just blips on a much more significant trend for the country – the long-term substantial decline in childbearing. Will this decline continue, stall out, or reverse? And what that will that mean for our country? That is what we will be watching to see.