In the early days of the pandemic there were plenty of jokes about people stuck at home making lots of babies. But some economists predicted a different result as unemployment surged along with the coronavirus: roughly 10% fewer births. Initial state numbers suggest that forecast is about right.
From November 2020, when you might start to see the impact of pandemic-related decisions, through February of 2021, births in Massachusetts were down 9% as compared to the same period a year ago. They are up 2% in March.
Emily Boyle of Nahant has been hoping to add to her family. Growing up, Boyle wished she and her younger brother had been closer in age. So at the beginning of 2020, just after her son turned two, Boyle and her husband started talking about having another child.
“And we kind, just kept pushing things off,” Boyles says. “Every few months, [we’d say] let’s re-evaluate what’s happening with Covid and now a year later, we’re still doing that.”
Boyle’s main concern is isolation. Her parents live nearby but haven’t been coming inside for visits. Boyle’s husband travels for work.
“It was kind of a fear of, ‘what are we getting ourselves into,” Boyle recalls worrying. “I’m going to be alone and not have any help.”
Boyle’s fears echo the experience of many people considering pregnancy during the pandemic and many new parents. Rates of postpartum depression roughly doubled last spring and summer according to survey conducted by Brigham and Women’s hospital.
As of early April, both Boyle and her parents are vaccinated. To be extra cautious, Boyle will wait a couple of months and then start trying to get pregnant. She hopes another surge doesn’t interfere with that plan.
“I haven’t been watching the news a lot. I don’t know if that’s a good thing or ...” Boyle trails off with a nervous laugh. “I don’t want to listen to too much about any new variants or anything, cause, uh, yeah.”
Wellesley College economics professor Phillip Levine, whose work produced the 10% drop estimate, updated the forecast in December to an 8% decline. Levine says so far, it looks like he and his co-author are right.
“The numbers we’re seeing in Massachusetts, Florida and California are all about in that magnitude at the moment,” Levine says.
Levine says he does not expect to see a significant rebound this year or next.
“It’s not like, there will be fewer births this year, more births next year and everything will equalize out. I don’t think that’s what’s going to happen,” he says.
Several women interviewed for this story, who asked not to be named, seem to confirm Levine’s prediction. One woman who turns 39 next month is still worried about the pandemic’s effects on her family and is not sure when — or if — she’ll feel ready to start a family. Another had planned to start trying to get pregnant now, but her husband, who works in a restaurant, still doesn’t have much income.
In hospital labor and delivery wards across Massachusetts, the picture is mixed.
“I’m definitely seeing a surge, as are my partners,” says Dr. Katie Davis, an OB-GYN in Newton.
Davis tracked a significant dip in deliveries during the winter, but that changed in March. Davis says she isn’t sure what’s going on but has a theory.
“The summer saw a drop in the COVID numbers,” she notes. “I think that some people were feeling a little more secure about things like their employment, and they sort of got tired of putting their life on hold.”
Now, nine or 10 months later, Davis isn’t getting much sleep.
“I think that women and families realized that they had to continue living their lives and that this might be a long-standing pandemic"Dr. Nawal Nour, Brigham and Women’s Hospital
Dr. Nawal Nour, chief of obstetrics and gynecology at Brigham and Women’s, heard similar things from her patients after the first COVID surge.
“I think that women and families realized that they had to continue living their lives and that this might be a long-standing pandemic,” Nour says
The Brigham had a winter dip, but Nour doesn’t expect the pandemic will affect birth rates at the Brigham overall.
Infertility treatment clinics in the Boston area, which tend to have higher income patients, say they’ve never been busier. Some of that is because the clinics were closed during the first surge in Massachusetts and had to reschedule missed appointments. But Boston IVF’s medical director Michael Alper says demand is unexpectedly high.
“We were concerned that with the pandemic, many couples would put things on hold, but in fact it’s been the opposite,” Alper says. “Couples who’ve struggled, when they’ve been at home and thinking about priorities in life, have gravitated to treatment.”
It’s a very different picture at Boston Medical Center where births are down about 20%, more than double the statewide rate. The hospital’s OB-GYN chief, Dr. Aviva Lee-Parritz says that’s never happened before.
“If anybody said they weren’t unsettled they would be lying,” says Lee-Parritz about the impact on patients, hospital services and revenue.
“Maybe that damage is irreparable. Maybe it will be a long time before people in this community feel that families are a good idea. I don’t know.”Dr. Aviva Lee-Parritz, Boston Medical Center
Lee-Parritz says fewer babies is just the latest way COVID-19 is hammering her lower-income patients, some of whom have lost jobs, housing or loved ones.
“There are so many things that are at play in our community,” she says. “Maybe that damage is irreparable. Maybe it will be a long time before people in this community feel that families are a good idea. I don’t know.”
Deliveries are not down at all practices in distressed communities. Brockton Neighborhood Health Center, for example, has not seen much change in births during the pandemic. But Michelle Hoffman, the center’s lead nurse midwife says it’s still early.
“We’re not going to see a true change in the birth rate until the months to come,” she says. “2021’s birth data will be much more reflective of people intentionally delaying pregnancies.”
Where births are down, you might expect to see an increase in requests for birth control or abortions. Planned Parenthood says that’s not the case. But Dr. Jennifer Childs-Roshak, the CEO and president of Planned Parenthood of Massachusetts, says she is seeing some shifts.
Patients are more likely to request long-acting birth control like IUDs in the past 12 months and seek pills for medical rather than surgical abortions, she says. But requests for all family services are stable, not rising. Planned Parenthood is also seeing an increase in people seeking care after a miscarriage.
“The idea of whether to start a family, whether to add to your family, when to add to your family -- all of those things become very real decisions for people during times like this.”Dr. Jennifer Childs-Roshak, Planned Parenthood of Massachusetts
Childs-Roshak says she’s not surprised to see a drop in birth rates during a time of economic and social distress.
“The idea of whether to start a family, whether to add to your family, when to add to your family — all of those things become very real decisions for people during times like this,” she says. “COVID’s no different.”
Even a short term drop in births could have many ripple effects. Massachusetts Association of School Committees Executive Director Glenn Koocher says it might impact staffing and construction, issues districts are just beginning to discuss.
“It’s one of the things that will jump to the front of the agenda starting in September when they start coming out of COVIDd and think about what we’re going to do in the future,” he says, “and what the next five years is going to look like.”
This segment aired on April 20, 2021.