The COVID-19 pandemic led to an initial decrease in birth rates in the U.S. followed by a partially offsetting rebound, as we documented in our December 2021 Brookings post (based on birth counts through June 2021). A similar pattern of an initial, substantial decline in births followed by a rebound in births occurred in many other high-income countries as well. Now, three years after the declaration of the COVID public health emergency in the U.S. and with the benefit of many additional months of data, we take a final look at aggregate birth counts over the course of the pandemic and put that in the context of the long-term decline in U.S. births.
Birth certificate data on all births in the U.S. through the end of 2021 reveal that the early months of the U.S. pandemic were associated with a drop in births, leading to an overall baby bust on the order of 100,000 fewer births than would have occurred based on pre-pandemic trends. We show in a longer research paper that births fell by more in states where COVID caseloads were (initially) relatively high and unemployment rate spikes were relatively large, consistent with a behavioral response to public health and economic conditions. Some of the drop in births came in the summer and early fall of 2020, too soon to reflect behavioral changes leading to fewer conceptions. This reduction is partially explained by a modest drop in the number of pregnant immigrant women entering the country.
This period of a baby bust was followed by a period of elevated birth rates; over the next several months, in early 2021, there were roughly 30,000 more births than would be predicted by pre-pandemic trends, partially offsetting the earlier bust. In our longer research paper, we show that births rebounded most rapidly in places with relatively quick improvements in the unemployment rate and household spending, regardless of ongoing COVID caseload counts.
Recently released provisional data on births from the U.S. CDC through the end of 2022 reveals that following the bust and rebound cycle, birth counts are back down below 2019 levels. It seems that U.S. births have returned to a downward trend—albeit one that might be slowing relative to the pace of decline seen in U.S. births after the Great Recession.
A Downward Trend, with a COVID Disruption
Figure 1 plots total birth counts in the U.S. from 2016 through 2022, separately by quarter. We distinguish births by quarter because of the strongly seasonal pattern in birth rates: Births tend to be relatively higher during the summer (reflecting elevated conception rates during the fall) and lower during the winter (reflecting fewer babies conceived in the spring).
Quarterly births have been steadily trending downward between 2016 and 2022, with significant deviations from trend during the years of the U.S. COVID pandemic. The existence of a “baby bust” period during the earlier part of the pandemic is obvious in the figures. For instance, births in 2021 Q1 are noticeably below the trendline. These births would have been conceived in 2020 Q2, when the pandemic first hit. Births in Q4 of 2020 are also well below the downward trend; some of these births were conceived around the time of the pandemic’s onset. We note, though, that births also fell in the third quarter of 2020. Those births almost certainly were conceived before the onset of the pandemic, a point we return to below.
An initial Baby Bust
There were around 100,000 “missing births” in the 7 months associated with the COVID baby bust, spanning from August 2020 through February of 2021 (conceptions between November 2019 and May of 2020). We estimate that roughly half of those can be attributed (in a timing sense) to a reduction in conceptions after the pandemic began. This would be consistent with a behavioral fertility response to economic and public health conditions. The other half are attributable to conceptions occurring prior to the start of the pandemic that did not result in a live birth. Some of these missing births conceived in late 2019 may have resulted from a shift in birth timing due to restricted health care access, or an increase in miscarriages, still births, or abortions. It could also be the case that there were fewer conceptions in late 2019 for reasons unrelated to the pandemic, and some conception dates could be assigned in error.
Changing migration patterns also account for some of the reduction in births soon after COVID’s onset. To gauge the magnitude of this effect, we use data from the American Community Survey (ACS) to tabulate the number of children born in the U.S. to mothers who immigrated in the preceding year. We see that in 2020, there were roughly 20,000 fewer children born to recent immigrants than there were between 2015 and 2018. This represents around 20% of the overall baby bust and 40% of the missing births that were conceived prior to the pandemic. That leaves an additional 30,000 missing births unaccounted for that would have been conceived before the pandemic.
A Subsequent Rebound
The data shown in Figure 1 also reveal a rebound in aggregate births. In each quarter after the COVID birth bust period of August 2020 through February 2021, birth counts are above the trend line. In our longer research paper, we documented 30,000 “excess” births in the 7-month rebound period of March through September of 2021 (reflecting likely conceptions in June through December of 2020). Here we augment these data with an additional 3 months of official CDC birth counts for October through December of 2021 and an additional 12 months of provisional CDC birth data from calendar year 2022.
While birth counts are above levels predicted by pre-pandemic trends, they are still below pre-pandemic levels.
Using these updated data, we focus on births in the 7-month window between October 2021 through April 2022, which follows the previously identified baby bust and initial periods (also defined as 7-month periods) and corresponds to likely conceptions in January 2021 through July 2021. We estimate that there were an additional 50,000 excess births during this time beyond what pre-pandemic trends would have predicted, though this estimate is not statistically significant. Monthly birth counts throughout the remainder of 2022 are similarly erratic (in a statistical sense), though generally above the level predicted based on declining pre-pandemic trends.
It is unclear to what extent the above-predicted birth counts further away from the pandemic reflect a recovery of births delayed during the COVID baby bust period or whether they are a more stable reflection of “post-pandemic” fertility intentions. What the data do indicate clearly is that while birth counts are above levels predicted by pre-pandemic trends, they are still below pre-pandemic levels. In each quarter of 2022, birth counts are below the pre-pandemic level of births in the corresponding quarter of 2019.
The Longer-Term Perspective
Before the pandemic, births had been steadily declining for many years. There were almost 600,000 fewer annual births in 2019 relative to 2007—a 13% reduction. The size of the COVID-related baby bust and subsequent rebound were meaningful in that context, but they also represent short-term deviations from an ongoing trend of considerably greater importance. Birth counts in 2022 are still below what they were in 2019.
In other work, we have investigated the causes of the longer-term decline in U.S. births. That line of research has led us to tentatively conclude that “shifting priorities” about family, careers, and how to allocate one’s time and resources is the most likely explanation for the dramatic reduction in rates of childbearing seen among more recent cohorts of young adults. We have not found compelling data support for more readily observed (and potentially altered) policy or economic factors, like the price of childcare or rent. Whether the experience of the COVID pandemic—and how it shifted people’s thinking about their life choices and priorities—will ultimately lead to a sustained rebound in births, a further decline, or simply fade into memory is yet to be seen. For now, the recent data suggests that births remain below 2019 levels.
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 See our NBER working paper for a detailed description of how we calculate these numbers: https://www.nber.org/system/files/working_papers/w30000/w30000.pdf.
 Births in May 2022 through October 2022 are also somewhat higher than predicted levels, but are not statistically different. Births in November and December of 2022 are considerably higher than the predicted levels and are statistically different.