It’s still too early to say for sure, but initial trends suggest spikes in some parts of the world and declines in others. Broadly speaking, birthrates should continue to drop in many higher-income countries and climb in many poor and middle-income nations, where the U.N. Population Fund (UNFPA) projects that pandemic-driven disruptions in access to contraception could lead to millions of unplanned pregnancies.
In March, India implemented one of the world’s strictest shutdowns — which meant millions of women were cut off from access to contraception, abortions and other family planning services. Between March and May, about 1.85 million women were probably unable to gain access to abortions they otherwise would have sought, according to an estimate by the Ipas Development Foundation, which focuses on safe abortion and contraception in India. Another study by the Delhi-based Foundation for Reproductive Health Services India calculated in May that about 25 million couples could have been cut off from contraception access during the country’s shutdown.
“Unfortunately, it’s too early to have empirical evidence of any large-scale upticks in pregnancies,” UNFPA spokesman Eddie Wright said of the agency’s global data. “We won’t see any covid-caused births for several months yet.”
The pandemic also poses maternal health risks. Women who give birth during the pandemic “must prepare to bring a life into the world as it has become — a world where expecting mothers are afraid to go to health centers for fear of getting infected, or missing out on emergency care due to strained health services and lockdowns,” Henrietta Fore, the executive director of UNICEF, said in a statement.
Even before India’s health-care system came under the strain of the pandemic, the country had a maternal mortality rate more than seven times higher than that of the United States, according to UNICEF data.
Health-care providers in Indonesia are also bracing for more births in coming months. About 10 million married couples across the world’s fourth-largest country stopped using contraception in April amid shutdown measures, according to the country’s national population and family planning agency, the New York Times reported.
The pandemic has been a blow to Indonesia’s efforts to provide free contraception, part of a push to prevent childhood malnutrition by promoting smaller families. Condoms, though available, are relatively unpopular compared with hormone injections, administered either monthly or four times a year. Birth control pills are the second choice.
As the coronavirus spread, the family planning agency began making door-to-door visits and distributing larger supplies of pills.
Globally, efforts like these remain the exception. For every three months a shutdown lasts, 2 million women may lose access to contraception, according to a UNFPA estimate.
In addition to disrupting local services, the pandemic has posed obstacles for the global supply chain for condoms and other forms of birth control, the Atlantic reported. Backlogs at factories in Asia, where production slowed in response to the coronavirus, have created procurement difficulties in large import centers in the developing world, such as Lagos, Nigeria.
The United States
In the United States, analysts are watching a different trend emerge: Many women say they are likely to hold off on having children during the pandemic. Some companies have seen growth in the sale of contraceptives.
In June, the Brookings Institution estimated that birthrate in the United States would drop by 300,000 to 500,000 over the coming year, based on fertility trends during past recessions and crises. That same month, the digital health clinic Nurx told USA Today that it has had a 50 percent rise in birth control requests and a 40 percent increase in emergency contraception orders. (New demand for digital services during shutdowns could explain that increase.)
A study by the Guttmacher Institute found that more than 40 percent of more than 2,000 women surveyed in the spring reported they were changing their plan for when to have children (or how many to have) because of the pandemic. Thirty-four percent said they wanted to have fewer children and get pregnant later.
The results are no surprise: School closures and job losses have disproportionately affected mothers, with women on average bearing a greater child-care burden and more likely to lose or leave their jobs than their male counterparts.
The Guttmacher Institute study also found that women of color and poorer women were more likely to have lost jobs and access to health-care services, increasing the chances of unwanted or risky pregnancies.
Overall, one-third of respondents reported delaying a visit to a health-care provider or having trouble accessing contraception. Black and Hispanic women were more likely than white women to report encountering these difficulties, and queer women were more likely to than straight women.
In the survey, about 44 percent of black women and 48 percent of Hispanic women also reported wanting to delay or limit pregnancies, compared with 28 percent of white women.
Before the pandemic, Europe was already grappling with an aging population and declining birthrates and family sizes. That baby-bust trend looks likely to deepen during the crisis, according to a June study by the London School of Economics and Political Science.
The spring survey of people ages 18 to 34 in France, Germany, Italy, Spain and the United Kingdom found that the pandemic has had “a strong and negative” effect on fertility choices.
“One of the consequences of this particular health emergency has been one of the most severe economic crises of the last century, with such events always being followed by a decline in fertility rates,” Francesca Luppi, Bruno Arpino and Alessandro Rosina, the co-authors of the report, said in a statement.
Fifty percent or more of respondents in France, Germany and Spain said they would postpone having children. In the United Kingdom, 58 percent said they would postpone, and 19 percent said they would abandon childbearing altogether. Respondents in Italy, where the birthrate is already low, were the most likely to say they would abandon their plans to have a child.
“Supporting young people, and women in particular, through employment is necessary to strengthen the economic recovery of the countries most affected by the health emergency, to reduce the risk of poverty among young families, and consequently to support fertility choices,” the co-authors wrote.
An earlier version of this article misstated the amount of time that had elapsed since the WHO declared the coronavirus a pandemic.