State fertility rates during COVID-19 and associated factors


In a recent study, investigators found changes in fertility rates during the COVID-19 pandemic varied, with differences in states’ political leanings and social distancing efforts linked to this variety in impact.

Fertility rates declined in the United States throughout the COVID-19 pandemic, with greater declines seen in some states compared to others, according to a recent study conducted by researchers from NYU Grossman School of Medicine.

In the United States, births were reduced by 18 per 100,000 women of reproductive age a month 9 months following the onset of the pandemic. This reduction has been attributed to anxiety, stay-at-home restrictions, and economic challenges.

A decrease in fertility by 9 births per 100,000 women was observed following the second wave of COVID-19 in 2021. This rate is similar to the rate of decline in fertility seen before the pandemic began.

In the recent study published in Human Reproduction, data was analyzed from the CDC’s Bureau of Vital Statistics, the 2020 US Census, and the University of Virginia 2021 population estimates. This data was used to measure state fertility rates following waves of COVID-19, after which investigators determined whether COVID-19 factors or other factors changed these rates.

State-specific outcomes show a massive decline in fertility in New York after the first wave. The pre-pandemic rate was a reduction of 4 births per 100,000 women, but this fell to about 76 less births per 100,000 women monthly. 

Steep declines were also seen in other states, with Delaware seeing about 64 less monthly births per 100,000 women and Maryland about 55 per 100,000. In comparison, Idaho, Utah, and Montana saw increases of up to 56 additional monthly births per 100,000 women, despite these states seeing reduced pre-pandemic rates.

Rather than COVID-19 severity, demographic factors such as economic factors and racial composition had the largest impact on state fertility rates. Negatively impacted rates were linked to large drops in employment when the pandemic began, greater income inequality, and greater rates of individuals receiving college degrees.

Social distancing index (SDI) and political leaning were also examined, and investigators saw greater reductions of fertility rates after the first wave of the pandemic in states with stronger social distancing efforts. Higher SDIs were seen in states with stronger liberal political leanings.

“These results suggest that changes in a state’s fertility rates were not driven by COVID-19 cases themselves but rather by existing social, economic, and political disparities,” said co-lead author Mia Charifson, MA, a doctoral student in the Department of Population Health at NYU Langone.


Impact of coronavirus on states’ fertility rates tracked with economic, social, and political divides. EurekAlert. April 11, 2023. Accessed April 12, 2023.

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