Pittsburgh Post-Gazette

When pandemic began, some reconsider­ed getting pregnant

- By Tara Bahrampour

Kat Athanasiad­es and her husband had planned to have a second child right around when their daughter turned 2, which meant trying to get pregnant in March or April 2020. But then the world turnedupsi­de down.

When the coronaviru­s pandemic hit, the couple, who live in Washington, began to reassess. Both had switched to remote work, and the social network on which they relied had receded. The prospect of giving birth in a hospital during the pandemic also felt daunting; Ms. Athanasiad­es recalled stories of women “delivering solo with masks or being separated from your baby if you were positive.”

“We were isolating,” she said, “so we didn’t have any support at all. We furloughed our nanny, so it was my husband and I doing all the care for an active 18-month-old. Putting our daughter to bed one night, I said, ‘I don’t think we can have another right now. ... I don’t think I can do it when I’m so uncertain of what our future’s going to look like.’ ”

She was not the only one. A recent Brookings Institutio­n study shows 60,000 fewer births than expected between October 2020 and February 2021 in the United States, correspond­ing with fewer conception­s earlier in 2020. The largest number of missing births were in January 2021, which roughly correspond­s to conception­s in April 2020, when many Americans began to process the magnitude of the pandemic.

“Uncertaint­y is not good for fertility,” said Phillip Levine, a professor of economics at Wellesley College and co-author of the report. “You want to know that when you’re bringing a child into the world, you’re going to be bringing the child into an environmen­t that’s safe and secure, and if you can’t forecast that, that’s when things will

be, ‘Maybe now is not the right time.’ ”

The dip correspond­s with declines in births during past recessions and public health crises, such as the Great Recession and the 1918 flu pandemic, which came in waves, Mr.Levine said.

“What was interestin­g about Spanish Flu is there were three significan­t spikes indeath rates, and there were significan­t dips in births nine months after each of these spikes.”

By the summer of 2020, conception­s had returned to expected levels but did not rise enough to compensate for the missing births earlier in the year. Once additional data becomes available, the researcher­s plan to measure the effects on births of the coronaviru­s spike from the winter of 2020-21 and those related to the delta variant; the impact of the current omicron surge could follow.

The study found that the decline was not the same across the board. Births fell 3.7% on average across states, but in states such as New York, Massachuse­tts, New Hampshire and Delaware, the dip was much sharper. Births to residents of New York City, which was hit particular­ly hard early in the pandemic, saw a 23.4%

decline nine months later, theresearc­hers estimated.

States with larger spikes in unemployme­nt rates early in the pandemic tended to have larger decreases in birth rates nine months later, as did states with more COVID-19 cases per capita, thestudy found.

But the missing births were not necessaril­y directly related to personal hardship; for some, the general state of affairs was worrying enough, Mr.Levine said.

“Psychology is an important factor,” he said. “You might not be a front-line worker, you might not have lost your job, yet you still are scared. You could be more worried about the health implicatio­ns of being pregnant and being exposed to COVID, or the ability of the medical care system to handle the demand and tend to your needs.”

The biggest birthrate declines were among more highly educated women, women who already had at least one child, and women in their late 30s and early 40s.

Women in that age category are more likely than youngerone­s to need assisted reproducti­ve technology to conceive and stay pregnant, and many fertility clinics suspended operations for a period after the pandemic began.

But those using ART make up a small minority of pregnancie­s, Mr. Levine said, adding that even though the rate of decline was highest among older women, those in their early 30s accounted for three times as many missing births as those in their early 40s because the younger age group accounts for a larger share of total births.

The other group that saw a significan­t decline in births was teens, for whom “separation from peers [likely] reduced opportunit­ies for sexual encounters,” the report found.

By February 2021, the birth rate had bounced back to expected levels, and in June, the latest month included in the data, there was even a spike, suggesting that by September 2020 people werefeelin­g more optimistic.

The rebound correspond­ed with a reduction of the unemployme­nt rate from a high of 14.5% in April 2020 to 7.8% by September, and a reduction in daily cases and deaths before the winter spike later that year, the report said.

Economic hardships associated with the coronaviru­s pandemic have been shorter-lived than those associated with the Great Recession, Mr. Levine said, adding that government assistance was far more robust during the pandemic. Stimulus checks, increased unemployme­nt insurance benefits and expansions to the child tax credit probably helped keep the birthrates from plummeting even further, he said.

“In the COVID recession we basically used every weapon in our arsenal, and that seemed to have worked.

To the extent that women have fewer children when times are tough, if we implement strategies to lessen the impact that would limit the reductioni­n births.”

However, he cautioned that any decline in births because of the pandemic should be viewed in the context of the greater long-term and continuing decline in birthrates underway before coronaviru­s hit.

The birthrate in America fell 4% last year, marking the biggest annual decrease in decades. About 3.6 million babies were born in the United States in 2020, compared with about 3.75 million in 2019. It was the lowest number of births since 1979 and the largest one-year drop in percentage terms since 1965, the year the baby boom ended. The United States now has about 700,000 fewer births annually than it did in 2007.

 ?? Bill O'Leary/The Washington Post ?? Kat Athanasiad­es plays with her daughter, Tala, 3, at their home in Washington. At left is her husband, Rajan Kapoor.
Bill O'Leary/The Washington Post Kat Athanasiad­es plays with her daughter, Tala, 3, at their home in Washington. At left is her husband, Rajan Kapoor.

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