Rural and Urban Fertility Impacts of COVID-19 and Stay-at-Home Orders

Michael Betz , The Ohio State University

Several studies have documented the impact of the COVID-19 pandemic on fertility outcomes in a variety of countries (Aassve et al 2021; Bailey, Currie, and Schwandt 2022; Kearney and Levine 2023; Fallesen and Cozzani 2023). Much of the evidence suggests those considering pregnancy at the outset of the pandemic delayed conception until the later half of 2020, when there was a return to some sense of normalcy (Kearney and Levine 2023). Most of these studies consider aggregate national-level fertility responses, but geographic heterogeneity within states likely exists. This is particularly true between rural and urban areas, where differential access to prenatal care can be substantial. Attitudes towards the pandemic also differed between rural and urban areas, which could have also influenced fertility behaviors. We use restricted birth register data to investigate whether fertility responses to the COVID-19 pandemic differed between rural and urban areas in the U.S. Additionally, we assess whether pandemic policies—like stay-at-home orders that varied across U.S. states—impacted rural and urban fertility differently. Preliminary results suggest that both rural and urban areas saw significant decreases in birth rates in late 2020, which then rebounded in early 2021. Rural areas had less dramatic changes in fertility behaviors compared to pre-pandemic trends, but the birth rebound in 2021 was less pronounced. Conversely, we find stay-at-home orders impacted rural areas less, somewhat dampening what could have been more dramatic rural fertility declines during the pandemic in states that implemented such orders.

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 Presented in Session 58. Regional Heterogeneity of Fertility within Countries