RIO DE JANEIRO, BRAZIL – With the Covid-19 pandemic, the number of births in Brazil in 2020 was the lowest since 1994, according to data from the Ministry of Health’s Live Births Information System (SINASC). There were 2,687,651 births last year, compared to 2,849,146 in 2019, down 5.66%.
Between 2018 and 2019, there was a 3.2% decrease in the number of births. In contrast, between 2017 and 2018, the country registered a slight 0.7% increase.
The impact of the pandemic on the number of births was higher than the zika and microcephaly outbreak that affected Brazil between 2015 and 2016. At the time, when many couples delayed pregnancies for fear of the sequelae left by zika in some children, births fell by 5.3%. The last time Brazil recorded a lower number of births than in 2020 was 26 years ago, when 2,571,571 babies were born in 1994.
The 2020 data analyzed on a monthly basis show that the largest percentage drops occurred in November and December, precisely 9 and 10 months after the coronavirus was confirmed in Brazil. In these months the drop stood at 9%, almost double the average for the year.
A drop in births is something that typically occurs in critical periods, but it does not mean that it will be constant over the years, explains Joice Melo Vieira, professor of the Department of Demography (DD/IFCH) and researcher at the Elza Berquó Nucleus for Population Studies (NEPO) at the State University of Campinas (UNICAMP).
“If we look back at similar cases throughout human history, the number of births declined during pandemics but there is some rebound after that critical period is over,” she notes. “There are certainly cases of women who experience crisis periods in the final years of their reproductive cycle and may have experienced two major shocks – zika and now Covid-19 – who will have a lower chance of recovering their desired fertility.”
According to Joice, resuming plans to have children once the pandemic passes will hinge on policies beyond controlling the spread of the virus.
“People, especially women, will want to have children if and when they feel comfortable having them, if they find favorable conditions for it. Policies that reduce inequalities and provide greater financial stability to families, policies that promote gender equality in the public and private sectors, policies that favor better management of the time dedicated to work and personal life, all of this will favor the recovery of birth rates,” she highlights.
Raquel Zanatta Coutinho, associate professor in the Department of Demography at the Federal University of Minas Gerais (UFMG), says it is not yet possible to determine if people will give up their plans to have children or if this will have an inverse effect.
“It could be that a pandemic of this magnitude will change the desire to have children forever. Faced with the insecurities of the world, it may be that people who were tempted not to have children before will decide once and for all that motherhood is not a good option,” Raquel says. “On the other hand, the pandemic may increase birth rates as women lose what little access they have to control methods. There could perhaps be a ‘baby boom’ for some groups.”
The emergence of the zika virus had its impact, according to the UFMG professor, and it mainly affected women in vulnerable situations.
“At the national level, the effect was slight but important, about 5% less than the year before. For some states, like Pernambuco, where microcephaly cases were concentrated, there was a 23% decline in 2016. This shows that the fear of microcephaly and its geographical proximity were crucial in triggering reproductive responses. But what is most striking about zika is the fact that younger women, under 25, were more likely to delay their pregnancies, while older women stuck to their plans, largely for fear of lacking the biological time to become pregnant,” Raquel explains. “In addition, women with more schooling and more financially stable were able to keep their plans. I have no doubt that the worst consequences of Covid-19 will be felt by women, particularly those with lower schooling and income.”
The pandemic has had different impacts on the number of births worldwide. An October survey by The Economist noted a downward trend in births in higher income nations, such as Singapore, while in lower income countries, such as Uganda, it was rising.
Egg freezing
Last year there was a decline in egg freezing compared to 2019 because many clinics either suspended services or focused on patients with a greater urgency in preserving fertility, such as women with cancer.
Then, there was an upturn. “Every time there is a restriction, a repressed demand is created, the demand for clinics has greatly increased,” says Gynecologist Emerson Cordts, a member of the Brazilian Society for Assisted Reproduction (SBRA).
The number of women seeking egg freezing has increased by up to 25% in fertilization clinics, according to specialists. Women who are not in a stable relationship are the main users. “The pandemic has intensified this process due to insecurity regarding their reproductive future,” says Urologist and medical coordinator at Fleury Fertility Daniel Suslik Zylbersztejn.