COVID-19 pandemic could cause US births to drop by half a million next year, report shows

There could be 300,000 to 500,000 fewer U.S. births next year, a report by the Brookings Institution estimates.

The prediction is based on economic studies of fertility behavior as well as data from the Great Recession of 2007-2009 and the 1918 Spanish flu pandemic.

Researchers from Brookings point to a wide array of studies showing that the decision to have children, and how many children a parent decides to have, is dependent on economics, among other factors. A 2019 study shows that places that experienced a reduction in employment and earnings had lower birth rates. Two studies from 2013 and 2014 also show that increases in housing wealth also resulted in increases in births.

The researchers also said that recessions usually correlate to fewer births. An analysis of the Great Recession shows that it led to a decrease in birth rates. In 2007, the birth rate was 69.1 births per 1,000 women, aged 15 to 44 years, and in 2012, that rate was 63 births per 1,000 women.

The researchers also analyzed the 1918 Spanish flu pandemic and found that the public health crisis also led to fewer births. Specifically, large spikes in deaths were matched by large decreases in births. The decline in births "was likely due to the uncertainty and anxiety that a public health crisis can generate," the researchers wrote.

During the current coronavirus pandemic, the monthly unemployment rate jumped from 3.5 percent to 14.7 percent in April and to 13.3 percent in May. The researchers forecasted the 2020 annual unemployment rate as ranging from 10.6 to 13.6 percent, which would imply a 7 to 10 percent drop in births next year. Given there were 3.8 million births in 2019, that would result in a decrease of between 266,000 and 380,000 births in 2020.

Analysis of the 1918 Spanish flu pandemic shows there was an approximately 15 percent decline in annual births. It is important to note that the Spanish flu pandemic was not accompanied by a major recession and no modern contraception existed at the time, researchers said.

Combining predicted effects of both the recession and pandemic, "we could see a drop of perhaps 300,000 to 500,000 births in the U.S.," researchers wrote.

Add to this the brewing rural health crisis adversely affecting pregnant women, and births could see an even greater drop. A 2019 report by The Commonwealth Fund outlined the barriers to maternal care that pregnant women living in rural areas in America face, including rural hospitals closing at alarming rates. In addition, many rural hospitals have closed their obstetric units, resulting in fewer than 50 percent of rural counties having OB units.

Also, less than half of all rural counties have a practicing obstetrician or gynecologist, which means women in these areas have scarce access to prenatal and postpartum care. This could contribute to higher rates of infant mortality.

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