By Tim Mastro

DOVER — Family planning during a pandemic can get a little hectic to say the least.

When Brianna Boggerty of Camden had her baby boy Logan in October of 2021, there was just so much on her plate.

“It was very nerve-racking, just that fear of the unknown,” Ms. Boggerty said. “We didn’t know what to expect.”

For Ms. Boggerty, the hardest part was just trying to breathe through her coronavirus mask during delivery. Then when Logan was born, only one person was allowed to visit each day in the hospital due to capacity limits.

But seven months later, celebrating her first Mother’s Day, the pride of being a parent was well worth it for the Boggertys. Ms. Boggerty is once again pregnant with their second child.

“We just want to be the best version of ourselves for our child and love them as best as we can and providing the best environment for them,” her husband, Latuan Boggerty, said. “Pandemic or no pandemic, we’re gonna do that anyway.”

The Boggertys were one of the families whose decision to have children went unaffected by the COVID-19 pandemic.

However, early data has shown the pandemic has contributed even more to an already declining birth rate nationwide.

For December 2020, there was a 7.7% decline in births compared to December 2019 in the United States. These December 2020 babies would have been conceived in March of 2020, when the pandemic was in its infancy in the United States.

“That was the very first indication that women were delaying childbirth,” said Janice Barlow, director of KIDS COUNT in Delaware. “There was already the declining trend for the year, but December of 2020 was a really big decline.”

In Delaware, the number of births declined 1.6% between 2019 and 2020, compared to just a 0.6% decline from 2018 to 2019.

Contributing factors to the declining birth rate included rising unemployment, public health concerns and school or daycare closures. Since birth rate is a lagging indicator, the actual effect of the COVID-19 pandemic on births might not be seen until several years into the future, experts said.

Economy

Becky McColl, an assistant policy scientist at the University of Delaware’s Biden School of Public Policy & Administration, said birth rates historically decrease during times of economic decline.

She said previous research by the Brookings Institution showed substantial declines in birth rates following the Great Depression and the Great Recession, before swinging back up when the economy began to stabilize. One analysis of unemployment and birth data following the Great Recession, officially lasting from December 2007 to June 2009, revealed a 1% increase in unemployment was related to a 1.4% reduction in birth rate.

The unemployment rate in Delaware rose to 7.8% in 2020, compared to 3.7% in 2019, according to the Center for Community Research and Service.

“I think a lot of the challenges that came along with the pandemic not only affect people in the moment, but can really set them back economically and will continue to impact them for years to come,” Ms. McColl said.

“The ramifications of losing a job, not being able to afford to purchase a home or experiencing food insecurity — you’re caught in the stress of wondering how you’re going to be able to not only feed yourself, but any potential children. All of these things can really set people back so that even when they do get their feet back under them, even if they are able to get employment, they’ve maybe been set back economically by several years and may have to push out any family planning considerations even further.”

The economic impact of the pandemic, in addition to rising housing prices, also led to many families experiencing housing instability.

Erin Nescott, also an assistant policy scientist at the University of Delaware’s Biden School, said studies have shown couples with secure housing are more likely to plan to have a first child than those without secure housing.

Food insecurity also increased in Delaware during the pandemic. The percentage of households with children in Delaware reporting that they sometimes or often did not have enough to eat peaked in October and November of 2020 at 19%.

“If you’re a mom, and you’re in that situation, and in kind of that crisis mode, that’s probably going to affect your future choices,” Ms. Nescott said.

Public health

A public health crisis such as the pandemic can both limit access to medical care and cause individuals to delay medical care, Ms. Nescott said.

She said a May 2020 Household Pulse Survey showed 37% of survey respondents in Delaware reported delaying medical care in the previous four weeks. Women were also more likely to have delayed medical care than men, according to the same survey.

Fertility treatments fell into what was considered an elective procedure at the beginning of the pandemic as many health systems were postponing all elective procedures to ensure they had enough hospital capacity.

“That directly impacted many individuals’ ability to get pregnant,” Ms. Nescott said. “Families are still feeling the effects of that in their decision-making processes.”

In addition to these major changes in health care, Ms. McColl added, “People were in general just being more cautious and there are a lot of personal health concerns when it comes to pregnancy during a pandemic.”

Pregnancy is considered an underlying health condition. Pregnant individuals are more likely to experience severe reactions to COVID-19, therefore more likely to have ICU admittance and potentially bigger complications, Ms. McColl said.

“In interviews with the different news outlets, there were women who cited potential COVID-related health reasons as why they were delaying childbearing throughout the pandemic,” she said.

Fewer teen pregnancies

Both Ms. Nescott and Ms. McColl said it is important to note that the fertility rate was already declining prior to the pandemic, both nationally and locally. In Delaware, the fertility rate fell from 60.8 per 1,000 people in 2014 to 56.5 in 2020.

The greatest decline in fertility rate between 2010 and 2020 was seen in teenagers between the ages of 15- and 9, from 34.2 to 16.7. Delaware’s birth rate for this age group declined 62% between 2007 and 2019, according to KIDS COUNT in Delaware’s most recent report, which was published Wednesday.

Ms. Nescott said there have been more resources devoted to help Delaware teens be aware of their choices.

“From the advocacy and policy side, throughout the state over the past 10 years, there have been a lot of efforts towards supporting teens, supporting young adults in that decision-making process,” she said.

Ms. Nescott mentioned the Delaware Contraceptive Access Now initiative, which she said “focuses on reducing unintended pregnancy by increasing access to contraceptives, particularly same-day access.”

Several bills were also passed in the Delaware State Senate in 2021 to expand access to care outside of a doctor’s office.

Senate Bill 105 allows pharmacists to “both prescribe and administer certain contraceptives without a prescription from an additional health care provider,” while House Bill 160 expanded Delawareans’ access to telehealth and telemedicine services.

“These bills enable eligible women to skip the doctor’s office altogether for certain services and, paired with programs such as DelCAN, bring the state closer to a comprehensive approach to eliminating barriers to effective reproductive care,” Ms. Nescott said.

More younger individuals turned to telehealth for contraceptives during 2020, Ms. McColl added.

From one survey of online contraceptive platforms, most respondents reported an increase in patient volume over 50% during the pandemic. These platforms were especially popular among younger women, Ms. McColl said, as 71% of patients were between the ages of 18-30.

“Visits to online platforms for contraception really skyrocketed in popularity,” Ms. McColl said. “Women and individuals seeking contraception now have the option to either have a telehealth visit or rely on online platforms or apps.”

Child care

The pandemic also exacerbated financial and logistical concerns about child care for many families, Ms. Nescott said.

Schools were shut down for in-person learning throughout 2020 while daycares were also forced to close. Ms. Nescott said this made many parents and grandparents take on additional child care responsibilities.

The Boggertys found this out firsthand. They are still wait-listed at every day care facility they have called. Mr. Boggerty, a traveling nurse, and Ms. Boggerty, an MRI technologist at Bayhealth, said they have received plenty of help from their parents and other family members taking care of Logan.

“It takes a village,” Mr. Boggerty said.

Grandparents have taken on critical roles since the pandemic began, according to KIDS COUNT in Delaware’s yearly report.

“Some have provided childcare for parents when traditional childcare facilities have closed, helped with academics when school went virtual, or temporarily cared for grandchildren when parents had to quarantine,” the report said.

The years 2020 and 2021 were far from normal for child care, but the Boggertys wouldn’t change a thing.

“At the end of the day, we just felt like it was our destined time to have a family,” Mr. Boggerty said.

“Obviously God wouldn’t put anything on us that we couldn’t bear. This was just our time, something we were meant to go through.”