Mary, 20, was pregnant when the coronavirus reached Papua New Guinea. Four weeks after the country went into lockdown, doctors refused to treat her because of the closure, even after she collapsed in the clinic. She was suffering from pregnancy toxemia and her fetus died in utero.
Prof. Glen Mola, the head of obstetrics and gynecology at the University of Papua New Guinea’s School of Medicine, used Mary’s story to call on women in his country to avoid pregnancies for the next two years. But there were only 11 diagnosed coronavirus patients in Papua New Guinea when the doctor made his recommendation. What about countries where COVID-19 has infected hundreds of thousands and killed tens of thousands?
Historical precedent and initial data suggest that the pandemic will bring about far-reaching demographic changes, accelerating the trend of lower birth rates in most of the world and damaging the global economy. A baby bust is on the way.
“Historically, economic crises have never been the preferred period for a couple to decide to have a baby. The millions of jobs lost in those circumstances, even when a couple is not directly affected, create a climate of great uncertainty, which depresses family projects. We may therefore expect the economic crisis due to the coronavirus emergency to produce similar demographic outcomes,” write three researchers in a paper published in May that surveyed people aged 18-43 in Italy, Germany, France, Spain and Great Britain. Most of the participants said they will postpone having children, or not to have children at all.
Even before the pandemic struck, the birthrate in most of the world was in decline. The rate in half of the countries of North America, Europe, East Asia and the Middle East has dropped below the replacement rate, meaning their populations will gradually shrink. A study published in the The Lancet two weeks ago estimated that by 2100, the world population will be two billion less than the present United Nations forecasts; within 80 years, the populations of Japan, Spain and Italy will have fallen by half. That endangers economic growth because fewer young people of working age are there to support the older people who have retired.
According to the Washington-based Brookings Institution, the decline in births could be on the order of 300,000 to 500,000 in the U.S. next year. This estimate was reached by looking at studies of fertility behavior and data from the Great Recession of 2007-2009 and the 1918 Spanish Flu. Why? “As any parent will tell you, children come at a cost. They require outlays of money, time, and energy. Certainly, they are also a source of joy and love,” the researchers explain in a blog post.
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Israel may be an exception. In conversations with TheMarker, women of childbearing age express anxiety about the economic crisis, but almost all of them see many advantages in expanding the family.
Sharon, 33 (not her real name), married with a 2-year-old, had been trying to get pregnant when she was put on unpaid leave and later laid off from her job at a large bank. “The moment I discovered that I was fired, we stopped the process [of trying to conceive]. I thought of postponing the start of pregnancy, but after several weeks we discovered it was too late. I know that things will be much harder for me now, but life moves on and there are things that shouldn’t be put off. I don’t regret the pregnancy,” she says.
Almost all the researchers who spoke to TheMarker said that Israel won’t experience a baby bust, and might even see a rise in the birth rate among certain populations. But they aren’t lauding the trend: Israel’s continued high birth rate will make the country more crowded, exacerbate social disparities and lead to shortages of resources.
“It will be a sick place. Think about the traffic jams, the number of children in each class. Israel already has only half the number of nurses per person than other developed countries, and a shortage of doctors. When will these gaps be closed?” asks University of Haifa’s Prof. Daphna Birenbaum-Carmeli, an expert on the social and political aspects of medical technologies and a member of the steering committee of Tzafuf (crowded), an nongovernmental organization studying the implications of population density in Israel.
“The world’s rules don’t apply to Israel,” she says. “On the one hand, the economic catastrophe is seen as unprecedented in its gravity – and that’s not a theoretical issue: You need to house and feed children and you can’t afford to buy an apartment for them. On the other hand – and this is very significant in Israel – this pandemic is causing great existential distress. People are cut off from their family frameworks. People in small families are gathering a critical mass of relatives around them. Being limited to the nuclear family is not entirely natural in Israel. Many extended families meet on a weekly basis, in addition to holidays and special events.”
Shira, an artist and teacher who lives with her partner in Tel Aviv, has experienced just that. Three months after she gave birth to her first child in December, Israel went into lockdown. “Family ties were disrupted,” she says. “My mother doesn’t come to see our child, and her other grandmother comes once or twice a week. For me personally it’s very hard. We haven’t thought about more children yet, but the coronavirus shows that it’s hard to raise children without help and family, and without meeting friends.”
When there’s no help, it’s difficult to combine work and child care during a lockdown. People are under pressure and stress is not good for births – even on the physical level. If we’re lucky, the pandemic will end in a year from now, but the recession won’t end so fast. It will take years to recover from it.
But when it comes to children, Birenbaum-Carmeli says non-economic considerations may also play a factor for many Israeli families. “The longer the restrictions on contact and the separation continue, ... the more likely that in some way ‘my home is my castle’ will take on the meaning of ‘I have to fill this house,’” she says.
“Paradoxically, a child is the sure thing. In this balance, between the overcrowding and economic distress on the one hand, and existential distress on the other, I imagine that different people and communities will arrive at different solutions,” she concludes.
Sharon, who was laid off during her pregnancy, found the lockdown to be a source of joy. “When I was at home with my son, I experienced him as I never have before. As someone who had been returning home every day at 6 P.M., suddenly I enjoy my child, I have this experience of creation.” Shira, whose baby is 6 months old, found great satisfaction in a shared fate with her partner: “My partner is at home and we’re raising her together. Daddy no longer returns from work between 6 and 7 P.M.”
Rassem Khamaisi, a professor of geography at the University of Haifa, warns that it’s still too early to see a change in trends. “In periods such as these there’s a tendency toward an increase, even if not at a high rate. Israeli society is a more religious society, and in such societies, behavior patterns differ from those in the Western world. Although the middle class is more sensitive to the economic situation, it doesn’t affect the weaker populations, because their situation is problematic in any case,” he explains.
Khamaisi notes that faith is not the only reason, and perhaps not even the main one, for fertility patterns in Israel. “Among the middle-class Jewish population there’s the factor of national and cultural mobilization. This is a society that still sees children as part of the national project, without anything being planned on the family level. Even in the middle class there’s a trend toward becoming more religious, and there are even [financially] strong families that want more children for community and heritage reasons,” he says.
That applies to Arab society, too, he says: “Fifty percent of the community is already below the poverty line, so they won’t be affected as much. The coronavirus will affect the middle class, which is entering a period of financial distress and already exhibits behavior patterns such as getting married when older. Among Bedouin Arabs, particularly in the unrecognized villages, we anticipate an increase, among the Christians and Druze there won’t be a change, and among the Muslim population there will be a slow increase.”
All these processes are likely to lead to an increase in economic disparities, “especially in the outlying areas, where there are large weak populations,” stresses Khamaisi. “We have to prepare: We have to create policy mechanisms that will moderate the gaps, and create employment opportunities and education in outlying areas in order to improve their quality of life and bring about effective and correct family planning.”
Dr. Micha Baum, director of the sperm bank at Sheba Medical Center in Tel Hashomer, says fertility treatments have not declined due to the crisis – on the contrary. “Fertility treatments seem like a luxury, but that really isn’t so,” he says. “This crosses ages, religions and communities. Last month there was an unusual boost. We thought that it was a rebound from the month when there was no activity, but it’s continuing and maintaining the pace that existed before the virus.
“I’m not a demographer, I’m only a gynecologist, but we’re a nation that lives in existential fear and distress. The moment we’re threatened, we have some kind of urge to multiply. The fear and the threat don’t deter us from having children, they actually reinforce the need.”
Nairouz, 37, from Haifa, is the mother of a 2-year-old boy. Last week she gave birth to a baby girl. Before the coronavirus crisis, she and her husband ran arts events. “Before the birth, I sent my son to nursery school, but a month and a half later came the coronavirus and destroyed all my plans. Before the birth we asked an aunt to come to babysit for our son,” she says.
She wonders how families with three or four children are managing with distance learning. “And if the mother is also a teacher, and has to teach remotely? It’s problematic. The children’s future is unclear. It changes all the aspects of raising children,” she says. “Two children, especially a son and a daughter, is enough for me. I don’t want more children. As far as I’m concerned, it doesn’t make sense to have children and be preoccupied all the time with findings ways to feed them, but it depends on your order of priorities. I know that other people do want [more children].”
Or maybe not. All over the world, millennials are less likely to marry and more likely to live with their parents well into adulthood and postpone starting a family. The phenomenon is less prevalent in Israel, but the coronavirus and the social protests led by young people may be heralding a sea of change.
“I’m starting to see people in their mid-twenties – mainly my impression from people I know – who say they’re not sure that they want children, or that they know they don’t want children,” says Birenbaum-Carmeli. “Ten years ago it was less legitimate to say such a thing. It’s the start of a trend of choosing not to be parents. The pandemic is likely to be a trauma that will change things. Maybe people will be afraid to have children, afraid that they won’t be able to support them.
“It’s something of a shock doctrine. These thoughts were already in the air, but the pandemic could reinforce them. Don’t forget that these children [the millennials] grew up in prosperity – they traveled abroad, studied whatever they felt like, including impractical subjects. So the thought that they will encounter material distress and raise a child in material distress can be very threatening for them.”
Mor Yaacov, 30, is in her ninth month of pregnancy. The married Tel Avivian works at Playtika, a high-tech company. “I’m grateful that I’m working. I don’t want to think about the mental distress of people who have no job,” she says. “The coronavirus didn’t hit me hard. But it does raise fears about what our new life will look like.”
Yaacov is sure that the crisis will affect family planning for many people. “Anyone who was affected will think twice about whether to have a child. I wouldn’t have a child if I didn’t have a job. But people say, ‘Everything will be all right, the child will bring the money.’ In the final analysis, it’s a phase, and it will pass. We shouldn’t let our fears control us.”