Saving for a Home Birth: How COVID-19 Will Change Fertility in the United States

by Sophia Garbarino, February 25, 2021

The novel coronavirus pandemic has significantly changed life in the United States, both temporarily and probably permanently in many ways. Not only has it impacted or directly caused the death of over 200,000 Americans, but it also rapidly changed the social norms of relationships and birth (CDC). Quarantining, social distancing, and working from home are all essential to the new normal American life. COVID-19 and the policies it has produced will ultimately accelerate the U.S. population decline by delaying marriage while pushing more parents away from medicalized births and into the comfort of their own homes.

Financially, the pandemic will decrease the fertility rate via unemployment. According to a July 2020 report by the National Women’s Law Center, “women have disproportionately suffered pandemic-related job losses: since February 2020, women have lost over 8 million net jobs, accounting for 55% of overall net job loss since the start of the pandemic” (Ewing-Nelson). On top of rising “levels of student loan and credit card debt,” unemployment and social distancing measures have forced many couples to delay marriage and pregnancy (Mather). Before the pandemic, the U.S. had already seen a “historically low birthrate” due to women’s increased participation in the workforce, meaning “women are having their first child at a later age. And when that happens, the total number of kids they have is fewer” (Belluz). Now that unemployment numbers are skyrocketing, the nation can expect to see older parents with up to “300,000 to 500,000 fewer births next year” (Kearney and Levine). For many, COVID-19 is simply not the ideal, welcoming baby climate.

While financial hardship is turning parents away from expensive hospital births, the pandemic will also change the fertility experience via fear and COVID healthcare policies. As more patients become afraid to seek or are denied direct hospital care, more expecting parents are turning to alternative, natural birthing plans, like delivering at home with a midwife and/or doula (de Freytas-Tamura). Even before the pandemic, the “rise of surgical births with other medical interventions has meant a set of concerns over the high costs of births, as well as of the safety of maternal and neonatal patients” (Curreli and Marrone 29). Hospital birth is expensive and more risky now that coronavirus poses a potentially fatal threat, making home births seem much more appealing. In fact, the U.S. may see a drive towards European birth culture, “where more than 75 percent of all births are assisted by trained midwives… midwives [are] safer, less expensive, and more likely to facilitate a satisfying experience for the mother and family” (Wagner 37-40). Currently, “only three-quarters of the states allow licenses for midwives to practice out-of-hospital deliveries,” meaning many women will still have to give birth in a hospital or a birthing center (de Freytas-Tamura). As such, several expecting mothers are switching from hospital to birthing center deliveries, a trend that will likely continue to increase past the pandemic.

It’s difficult to say exactly how the pandemic will affect U.S. fertility in the long-term, but there are several short-term responses that suggest what the American birth experience may look like years from now. Unemployment, delayed marriage and birth, and home births are just a few responses indicating a future decrease in fertility and reduced medicalization of birth.


1Based on the U.S. COVID-19 mortality rate reported on October 1, 2020.


Works Cited

Belluz, Julia. “The historically low birthrate, explained in 3 charts.” Vox, 22 May 2018, https://www.vox.com/science-and-health/2018/5/22/17376536/fertility-rate-united-states-births-women.

“CDC COVID Data Tracker.” CDC, https://covid.cdc.gov/covid-data-tracker/#cases_casesinlast7days. Accessed 1 October 2020.

Curreli, Misty, and Catherine Marrone. “Professional Certification and Doula Work: Measuring the Significance of Credentialing in the Field of Birth Companionship.” Marrone, pp. 29-34.

De Freytas-Tamura, Kimiko. “Pregnant and Scared of ‘Covid Hospitals,’ They’re Giving Birth at Home.” The New York Times, 21 April 2020, https://www.nytimes.com/2020/04/21/nyregion/coronavirus-home-births.html.

Ewing-Nelson, Claire. “June Brings 2.9 Million Women’s Jobs Back, Many of Which Are At Risk of Being Lost Again.” National Women’s Law Center, July 2020, https://nwlc-ciw49tixgw5lbab.stackpathdns.com/wp-content/uploads/2020/07/june-jobs-fs-1.pdf.

Kearney, Melissa S., and Phillip B. Levine. “Half a million fewer children? The coming COVID baby bust.” The Brookings Institution, 15 June 2020, https://www.brookings.edu/research/half-a-million-fewer-children-the-coming-covid-baby-bust/.

Marrone, Catherine, editor. Deeply Private, Incredibly Public: Readings on the Sociology of Human Reproduction. Cognella, 2019.

Mather, Mark. “Life on Hold: How the Coronavirus Is Affecting Young People’s Major Life Decisions.” Population Reference Bureau, 23 July 2020, https://www.prb.org/how-the-coronavirus-is-affecting-major-life-decisions/.

Wagner, Marsden. “Maternity Care in Crisis: Where are the Doctors?” Marrone, pp. 35-41.

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