COVID-19 ‘baby bump’ brought an increased US fertility rate in 2021 — but also record high preterm births

By Deidre McPhillips, CNN

The number of babies born each year in the United States has been steadily dropping since the Great Recession of 2008. When the COVID-19 pandemic hit and brought another burst of uncertainty, many expected an even steeper dropoff.

But a new report from the US Centers for Disease Control and Prevention says that about 50,000 more babies were born in the US in 2021 than in 2020, marking the first major reversal of the downward trend.

This small uptick still leaves the US birth rate far below pre-pandemic levels. Registered births have dropped 1% or 2% nearly every year over the past decade and a half, according to the CDC data. They fell 4% in 2020 alone.

An earlier report from the National Bureau of Economic Research suggested that the 2020 drop may not have captured the pandemic’s effect on conception as much as it reflected trends in travel. Those researchers found that “childbearing in the US among foreign-born mothers declined immediately after lockdowns began.”

They instead found a small “baby bump” among US-born mothers.

Tracking birth trends gives a population-level perspective that can help plan things such as building schools and managing Social Security payments, said Sarah Hayford, director of The Ohio State University’s Institute for Population Research.

The total US fertility rate — about 1.7 births for every woman — was below “replacement” in 2021, as it generally has been for decades, according to the CDC report. That means there aren’t enough births for a generation to replace itself as people die.

But there’s also an important personal perspective to each birth, says Hayford, who was not involved in the CDC research but has published research on fertility goals and behaviors.

“Being a parent or not being a parent is a really important part of a lot of people’s identities. It’s a really important part of people’s social relationships and social networks,” she said. “So understanding who’s becoming a parent and when and in what family contexts helps us understand the kinds of lives people are living and if they’re reaching the goals they have for themselves.”

Nearly 3.7 million births were registered in the US in 2021, according to the report. The analysis of birth certificates doesn’t directly address intentions for each birth, but it did find notable differences in demographic trends.

Births increased among White and Hispanic women, but they fell among Black, Asian and American Indian women, according to the CDC report.

And experts agree that the pandemic probably played a major role — in more ways than one.

“People’s experience of the pandemic was really bifurcated, and that can affect people’s decisions around having children,” Hayford said.

“People who lost jobs, people who had to keep working even though they didn’t want to, people in high-risk professions may have experienced that as a very stressful and unstable time,” she said. “For people who were able to work from home and experience the pandemic as a time of more financial stability, that might have been a good time to have children without sort of the challenges of commuting or being in the office.”

But there’s been an undercurrent at play long before the pandemic, too.

“Part of the reason that birth rates have been going down is, people have been putting off childbirth,” Hayford said. “We’ve been sort of waiting to see if people are going to stop putting if off and have those kids or they’re going to stop putting it off and say, ‘No, I’m never going to have those kids.’ ”

The new report found that the average age of a first-time mother reached a record high of 27.3 years in 2021. Birth rates increased among women ages 25 to 44, while the teen birth rate reached a record low.

Still, research throughout the pandemic has raised concerns about the risks COVID-19 poses to pregnant women and their developing babies at any age.

Compared with pregnant individuals who weren’t infected, those who got COVID-19 were nearly four times more likely to be admitted to an intensive care unit, according to the review. They were 15 times more likely to be ventilated and were seven times more likely to die. They also had higher risks of pre-eclampsia, blood clots and problems caused by high blood pressure.

A larger international review found that babies born to women who had COVID-19 were at higher risk for preterm birth and low birth weights.

The preterm birth rate in the US reached a record high in 2021, up to 10.5% of all births, according to the CDC report.

The share of babies born with low birth weight and who were delivered by C-section also increased in 2021.

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CNN’s Brenda Goodman contributed to this report.