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We use monthly birth data collected by the Human Fertility Database to analyze the impact of the COVID‐19 pandemic on birth trends until September 2022 in 38 higher‐income countries. We also present estimates of the monthly total fertility rate adjusted for seasonality. Our analysis reveals that the pandemic led to distinct swings in births and fertility rates. The initial pandemic shock was associated with a fall in births in most countries, with the sharpest drop in January 2021. Next, birth rates showed a short‐term recovery in March 2021, following the conceptions after the end of the first wave of the pandemic. Most countries reported a stable or slightly increasing number of births in the subsequent months, especially in autumn 2021. Yet another, quite unexpected, downturn in births started in January 2022, linked with the conceptions in spring 2021 when the pandemic measures were mostly eased out and vaccination was gaining momentum. Taken together and contrary to some initial expectations, the coronavirus pandemic did not bring a lasting "baby bust" in most of the analyzed countries. Especially the Nordic countries, the Netherlands, Germany, and the United States experienced an improvement in their birth dynamics in 2021 compared with the prepandemic period. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What are the factors influencing the decline in the birth rates observed in higher-income countries in the later phase of the COVID-19 pandemic? SUMMARY ANSWER Our results suggest that economic uncertainty, non-pharmaceutical policy interventions, and the first wave of the population-wide vaccination campaign were associated with the decline in birth rates during 2022. WHAT IS KNOWN ALREADY During the COVID-19 pandemic, birth rates in most higher-income countries first briefly declined and then shortly recovered, showing no common trends afterwards until early 2022, when they unexpectedly dropped. STUDY DESIGN, SIZE, DURATION This study uses population-wide data on monthly total fertility rates (TFRs) adjusted for seasonality and calendar effects provided in the Human Fertility Database (HFD). Births taking place between November 2020 and October 2022 correspond to conceptions occurring between February 2020 and January 2022, i.e. after the onset of the pandemic but prior to the Russian invasion of Ukraine. The data cover 26 countries, including 21 countries in Europe, the USA, Canada, Israel, Japan, and the Republic of Korea. PARTICIPANTS/MATERIALS, SETTING, METHODS First, we provided a descriptive analysis of the monthly changes in the TFR. Second, we employed linear fixed effects regression models to estimate the association of explanatory factors with the observed seasonally adjusted TFRs. Our analysis considered three broader sets of explanatory factors: economic uncertainty, policy interventions restricting mobility and social activities outside the home, and the progression of vaccination programmes. MAIN RESULTS AND THE ROLE OF CHANCE We found that birth trends during the COVID-19 pandemic were associated with economic uncertainty, as measured by increased inflation (P  < 0.001), whereas unemployment did not show any link to births during the pandemic (P  = 0.677). The stringency of pandemic policy interventions was linked to a postponement of births, but only in countries with lower institutional trust and only in the early phase of the pandemic (P  = 0.003). In countries with higher trust, stricter containment measures were positively associated with birth rates, both for conceptions in the first year of the pandemic (P  = 0.019) and, albeit only weakly significant, for conceptions later in the pandemic (P  = 0.057). Furthermore, we found a negative association between the share of the population having received the first dose of the COVID-19 vaccination and TFRs (P  < 0.001), whereas the share of the population having completed the primary vaccination course (usually consisting of two doses) was linked to a recovery of birth rates (P  < 0.001). LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Our research is restricted to higher-income countries with relatively strong social support policies provided by the government as well as wide access to modern contraception. Our data did not allow analyses of birth trends by key characteristics, such as age, birth order, and social status. WIDER IMPLICATIONS OF THE FINDINGS This is the first multi-country study of the drivers of birth trends in the later phase of the COVID-19 pandemic. In the past, periods following epidemics and health crises were typically associated with a recovery in births. In contrast, our results show that the gradual phasing out of pandemic containment measures, allowing increased mobility and a return to more normal work and social life, contributed to declining birth rates in some countries. In addition, our analysis indicates that some women avoided pregnancy until completion of the primary vaccination protocol. STUDY FUNDING/COMPETING INTEREST(S) This study did not use any external funding. The authors acknowledge funding from their home institution, the Vienna Institute of Demography of the Austrian Academy of Sciences, and from the Open-Access Fund of the Austrian Academy of Sciences. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript versions arising from this submission. All authors declare that they have no conflicts of interest. [ABSTRACT FROM AUTHOR]

The article "Reply: Birth rate decline, COVID-19 pandemic, and vaccination programmes" responds to a letter critiquing the study's use of population-level data to analyze birth trends during the pandemic. The study covers births in 26 countries across four continents, revealing that disadvantaged populations, particularly migrants, experienced sharper and longer-lasting declines in birth rates. While the study did not delve into psychological and emotional factors influencing family planning, it did highlight the impact of trust in government on fertility rates during the pandemic. The research suggests that economic and family support policies implemented during the pandemic helped stabilize or even increase birth rates in many countries in 2021. [Extracted from the article]