Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study

The COVID-19 pandemic may have motivated racial/ethnic minorities, sexual minorities, and those experiencing mental health issues to change their fertility preferences and try for a child later.

VOLUME 116, ISSUE 4, P1128-1138


Christine H. Naya, M.P.H., Darby E. Saxbe, Ph.D., Genevieve F. Dunton, Ph.D.



To explore early disparate impacts of the COVID-19 pandemic on fertility preferences


Cross-sectional study


Online survey questionnaire


A total of 440 female participants who were trying to conceive (TTC) in the past year or currently are TTC.


No interventions administered.

Main Outcome Measure(s)

Change in fertility preference


Approximately 1 in 3 participants reported changing their fertility preferences because of the COVID-19 pandemic. Of those that reported changing their fertility preferences, 23.9% reported TTC earlier and 61.6% reported TTC later. Preliminary findings show the odds of changing fertility preferences in black or African American women were 5.45 (95% confidence interval [CI], 1.50–19.90) times that of white women and in nonheterosexual women were 2.76 (95% CI, 1.41–5.42) times that of heterosexual women. Furthermore, every 1 unit increase in state anxiety and depressive symptoms was associated with a 26% (95% CI, 3%–54%) or 17% (95% CI, 5%–31%) increase in odds of pushing back TTC, respectively.


This exploratory study highlights how the fertility preferences of racial and ethnic minorities, sexual minorities, and those experiencing mental health issues may be disparately influenced by the pandemic. Research is needed to examine further the disparate effect of the COVID-19 pandemic on fertility preferences.

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Go to the profile of Kelsey Wright
about 1 year ago

I really appreciate the authors doing this work and providing a jumping off point for other researchers working on this topic. However, it seems like some of the references may be incorrect. For example, the authors write "This finding is consistent with other recent studies reporting that approximately a third of their respondents had altered their fertility preference, mostly abandoning or pushing back TTC (89)." and reference 9 is just the DHS country report on Rwanda for 2005, which doesn't seem like it would be relevant for the current pandemic? Thank you for any clarification on the reference materials!