Baby bust: How the COVID-19 pandemic reshaped family planning

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Samara Perez and her husband Joe Brier were planning for a second child when the World Health Organization declared a global pandemic in March, 2020.

As the crisis intensified, the couple’s fears mounted: If Prof. Perez, 34, were to give birth during a spike in COVID-19 infections, would her husband be shut out of the delivery room? What would parental leave look like in lockdown with the mother and father, their three-year-old daughter and a newborn isolated at home in Montreal? After thinking it through, the spouses hit pause on their plans.

“I just didn’t feel like I needed to have a baby tomorrow,” recalled Prof. Perez, a psychologist at McGill University Health Centre and assistant professor of oncology at the school.

With Montreal locked down, the social pressures of having another child melted away further: “I wasn’t going to communions and brises and meeting my friends’ second kids,” Prof. Perez said of her experiences in the first wave. “I didn’t see babies. It created less of an urgency.”

The spouses joined many Canadians whose family planning took a detour when the pandemic deepened last spring.

In the first wave, some observers mused that couples locked down together at home would spell a pandemic baby boom nine months into the crisis. Those early, giddy predictions never materialized.

Instead, Canada saw a baby bust: 13,434 fewer children were born in 2020 than in 2019 – the lowest number since 2006, according to preliminary birth data released late last month by Statistics Canada. In a report from the agency, statisticians surmised that the onset of the global pandemic in the early months of 2020 likely contributed to steep fertility declines in the final months of that year, as families delayed having children amid rising case counts, economic insecurity, job loss, school and daycare closures. They also pointed to travel restrictions limiting international migration, leading to fewer births among newcomer parents.

Canada’s birth-rate decline mirrors similar trends internationally, with France, England, Wales and the United States reporting notably fewer babies born in 2020 compared to 2019. Nearly one in five Canadians ages 25 to 44 said they plan to postpone having children because of the pandemic, with 14 per cent saying they now want fewer kids than before, according to a separate survey published by Statistics Canada this fall.

At the same time, births to women ages 40 to 49 increased last year from 2019, the only age cohort to show an upward fertility swing, according to data from the agency. “When you are on a short timeline, you don’t choose to delay for a year,” said Marina Adshade, a faculty member at the University of British Columbia’s Vancouver School of Economics who took an early interest in fertility rates in the pandemic.

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Mere days into the crisis, Prof. Adshade cast doubt on a COVID baby boom, predicting a bust instead. While she views 2020′s decrease as a blip, she believes it could affect birth rates over the next several years.

“Some people will age out of their fertility in this time. Those births will never be reclaimed,” Prof. Adshade said. “It’s not just a delay in, ‘Should I have a baby this year or next?’ For people who are at the stage of their life where they are starting to look for partners to form families with, this will be a multiyear delay for them.”

A drop in unplanned pregnancies helped drive declining birth rates around the country, Prof. Adshade said. The number of babies born to women ages 15 to 19 plummeted to 5,682 last year, its lowest point in decades. “Social distancing and shelter in place orders make for extremely good birth control. Teens can’t get pregnant on Zoom,” Prof. Adshade pointed out in a March, 2020, Twitter thread on the coming baby bust. Here, she noted that stoppages of fertility treatments during the pandemic would also contribute to a decline in births.

The economist is keen to see the next round of birth numbers for early 2021, to determine how living through lockdowns shaped Canadians’ childbearing decisions further into the crisis.

“We’ll see the effect of people who have children being home with those children, trying to balance work and family life. Some were disappointed with their partners’ contribution,” said Prof. Adshade, who wrote the book Dollars and Sex: How Economics Influences Sex and Love. “What we will start seeing are the people who say, ‘You know what? We’re good with one kid.’ People will start reducing their family size in expectation that things don’t always proceed as planned.”

Ten months into the pandemic in Montreal, Prof. Perez and her husband decided to move ahead with their plans for a second baby. With vaccines and hope on the horizon, she conceived in December, 2020, delivering a boy in August.

While she feels fortunate, Prof. Perez noted that mothering a pandemic-era baby involves frequent quieting of fear. When strangers peer into her stroller at the park, she worries about whether they are double vaccinated. And when her uninoculated toddler touches the newborn, she wonders how many times she’s washed her hands.

“I try to balance between realism and risk,” Prof. Perez said. “And I try to recreate some of those prepandemic feelings of trust, confidence and resilience.”

She is not alone in her apprehension as a mother of an infant in the pandemic. Nearly 69 per cent of pregnant women surveyed during the first wave reported feeling distressed, according to a study of nearly 1,500 women published last month by researchers at St. Michael’s Hospital in Toronto.

Women were anxious about getting infected while pregnant, being alone in the delivery room, getting no visits or support from family and friends, and being denied access to in-person prenatal classes and hospital tours. Second-time parents worried about their older, unvaccinated children bringing the virus home from school.

“I could see the fear on my patients’ faces when the pandemic was declared,” said Tali Bogler, the study’s lead author and chair of family medicine obstetrics at St. Michael’s Hospital.

“Many, many questions at the beginning of the pandemic were, ‘Should I delay?’ ” Dr. Bogler said. “People were going through a significant amount of stress economically and socially, with fears of what COVID-19 would involve in pregnancy. Many people were worried about entering the medical system at that time.”

Dana Ramler, a design consultant on Vancouver Island, was set to welcome her first child in the spring of 2020, expecting “the usual hospital birth experience.” Then the pandemic hit, sending her and her husband into a panic.

“We had this Amazon cart full of emergency home-birth supplies that we could press ‘purchase’ on if we needed to at the last minute,” Ms. Ramler recalled of those early days in the pandemic.

Though her baby was born healthy in hospital, the mother grew anxious about infection: “There was grief about, this isn’t how it was supposed to go,” she said. “We were supposed to be sharing this with people, not afraid of the air they breathe.”

Cautiously weathering months of surges and lockdowns with her new family, Ms. Ramler, 37, began contemplating a second child: “I knew it wasn’t the optimal time to be having a baby but I’m getting older.”

After conceiving this April, her optimism turned to worry in the third wave. The climate crisis amplified her fears, as the family suffered through June’s heat dome and temperatures soared to the 40s where they live.

“I’m growing this human while the Earth is burning and everyone is dying,” the mother said. “What kind of a world is this child going to enter?”

Toronto’s Dr. Bogler warned that distress levels remain high among new mothers and pregnant women. She and her study co-authors urged health care providers to prioritize mental-health support for these women, now and in future large-scale crises. To help them, Dr. Bogler co-created the popular Instagram account Pandemic Pregnancy Guide, which offers evidence-based information about the virus and vaccines, plus free resources including yoga classes and lactation seminars.

Rivanna Segal relied heavily on the online resource after becoming pregnant in the second wave. She watched the trepidation on women’s faces at her prenatal classes, now held via Zoom, the video-calling app. The pandemic had done away with the community, camaraderie and shared knowledge exchanged at face-to-face classes and moms’ groups.

“It felt like there was a lot of fear and hysteria – which was completely reasonable – but there wasn’t a lot of data to say, ‘Don’t,’ ” said Ms. Segal, a Toronto dietician. “Babies kept being born in April, May, June and July, and they were okay.”

After marrying in November, 2019, Ms. Segal and her husband Adam began trying for a baby in April, 2020, one month after the pandemic was declared. She was 41, and they decided not to wait. “I also knew there were delays with IVF, if we needed IVF,” said Ms. Segal, whose son was born this past May.

She and friends in her age group are predicting a late-stage pandemic baby boom, as people play catch-up. Some 7 per cent of Canadians ages 25 to 44 said they now want to build their families sooner, with 4 per cent saying they’d like to have more children than they did before the crisis, according to a Statistics Canada survey.

As the third wave receded this past summer in Toronto, the Segals began taking their newborn outside. They noticed how powerfully people reacted.

“He was like a little celebrity in the street. It was as if people had never seen a baby before,” Ms. Segal said, describing women and men of all ages stopping them in public. “It was a spark of optimism.”

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