The decision to have a child usually requires a feeling of stability and confidence in the future, says Natascha Braumann, Director of Global Government and Public Affairs for Fertility at EMD Serono, on this week’s episode of Friday Podcasts.  But with COVID-19, especially in the first months of the pandemic, there was no feeling of stability. “No one knew what was going to happen.”

The COVID-19 pandemic has exacerbated decades of slow population growth in many high-income countries. Many factors have led to the decline in birth rates. One positive factor is the advancement of women in society. “For the past few decades, women have spent more time in education,” says Braumann. “They’ve spent more time climbing the ladder at work, so to speak.” Progress on gender equity and access to modern contraception contribute to this decline.

Yet women don’t necessarily want fewer children. Evidence shows that people generally have fewer children than they say is ideal, says Braumann. Financial struggles are part of the equation. In high-income countries, families often must rely on income from both parents to live, particularly in urban areas. Childcare costs also factor into these decisions. When taken in aggregate, shifting roles for women, financial stress, and high costs of care influence individuals’ choice to delay childbearing, which then leads to lower fertility rates, says Braumann.

Policies tend to favor government-funded care for the old rather than the young, because voting populations in democracies are increasingly old. To increase birth rates, policymakers must consider factors like the cost of caregiving. If you look at those countries like France, where the gap between the ideal number of children and the actual number of children is fairly low, you see countries that have a very robust and well-funded government system of providing day care, says Braumann.

The discussion about a pandemic baby bust fails to acknowledge how intentional delays in childbearing are occurring only in high-income countries, says Braumann, where women have reproductive choices available to them and can delay childbearing in times of uncertainty. In low- and middle-income countries, the COVID-19 pandemic has closed clinics, delayed services, and reduced access to contraception, which has increased rates of unintended pregnancies. “And that is a backsliding of huge progress that’s been made over the last years,” says Braumann, “and a really tragic and distressing side effect of the COVID pandemic and the lockdowns that happened.”  

The COVID-19 pandemic made clear what many families around the world already knew: having children is expensive and challenging. “Everyone saw the very fragile construct of many modern families come crashing down in a very short amount of time,” says Braumann. People with children will think more critically about having more, and people without children who saw the misery that those families went through, will also think long and hard about having children in the future, she says. That goes double for women who were torn between all the different responsibilities that often fell on their shoulders, says Braumann. “And I think there’s no easy solution to that. But it’s going to linger over the next years.”