The Consequences of the COVID19 Pandemic for Fertility and Birth Outcomes: Evidence from Spanish Birth Registers

Abstract

Demographic change almost never happens fast, except during wars, natural disasters, and pandemics. We ask what the joint consequences of the COVID-19 pandemic for fertility and birth outcomes are by drawing on full population administrative data from Spain. We find a surprising improvement in birth outcomes in November and to a less extent in December 2020 (8–9 months after the first wave of the pandemic) compared with monthly trends in the ten previous years (2010-2019). The improvement in birth outcomes was shortly followed by a decline in the total fertility rate (TFR), especially among women at the beginning and the end of their reproductive age. These findings are consistent with the idea that the pandemic selectively affected conception, which showed up first as a birth-outcomes improvement due to the missing conception of frail-children-to-be (including pre-term children) and then as a lowered fertility rate due to the missing conception of at-term children.

Partial Fertility Recuperation in Spain Two Years After the Onset of the COVID-19 Pandemic

“…Spanish fertility saw the largest fertility decline in Europe during the pandemic, with the total fertility rate (TFR) reaching an unprecedented low of 1.0 in December 2020, 9 months after the onset of the COVID-19 pandemic. Given the previous finding of a stratified effect of the pandemic in Spain (Cozzani et al 2022), this study provides evidence on recuperation from a substantially affected low-fertility setting.…”

“…Using ARIMA time series analysis (see Materials and Methods), we modeled trends in monthly TFR and age-(ASFR) and parity-specific fertility rates (PSFRs) for the period January 2016 to September 2021 [the last month where fertility appeared unaffected by the pandemic (Cozzani et al 2022)] and forecasted the expected FRs for the pandemic period of October 2020 to December 2021. Figure 1 displays the FRs for all births, by parity groups (first vs. second or higher order), and by age groups (15-49; 25-34; 35-49).…”

“…The pandemic has also been an accelerator of demographic change, with research showing its profound impact on life expectancy (Aburto et al 2021), migration (González-Leonardo and Spijker 2022), and fertility (Aassve et al 2021;Arpino et al 2021;Berrington et al 2022;Cohen 2021;Cozzani et al 2022;Hamilton et al 2021;Nitsche et al 2022;Sobotka et al 2021Sobotka et al , 2022. Several studies have documented the immediate fertility consequences of the pandemic, showing profound and sudden fertility declines across (Aassve et al 2021;Sobotka et al 2021) and within (Arpino et al 2021;Nitsche et al 2022) developed countries such as the United States (Cohen 2021;Hamilton et al 2021) , the United Kingdom (Berrington et al 2022), and Spain (Cozzani et al 2022). Whether these declines have been recuperated, and, if so, for whom, have been far less studied (Sobotka et al 2022).…”

Causes of ART‐related outcomes in the COVID‐19 era

“…In addition, the use of 2021 data could illuminate the relative contribution to perinatal outcomes of selection into ART conception and COVID‐19‐related stress during pregnancy. Emerging work in the US and elsewhere indicates substantial deviations from expected levels in perinatal outcomes in 2021 owing to both compositional shifts into fertility (including away from ART) and from a direct effect of COVID‐19 infection on particular subgroups 8,9 . In addition, some countries (e.g., Denmark and Norway) have registered pregnancy loss pre‐20 weeks, which could logically extend studies of pregnancy loss that rely on foetal death data ≥20 weeks.…”