MEXICO CITY – Everyone knew the pandemic would lead to death. Edith García Díaz thought it would bring birth too – a lot of birth.
As a public health official, she feared that the crisis would hamper access to contraceptives, leading to an increase in pregnancies. Doctors were overwhelmed with covid-19 patients. The couples were squatting at the house, afraid to go out. At the onset of the pandemic, the Mexican Population Agency warned that the pandemic could lead to an additional 120,000 unplanned births – an unfortunate reversal in the long battle to bring the fertility rate under control.
But as data has poured in, state after state has signaled the opposite trend. Births in Mexico fell 11% in the first six months of 2021 compared to the same period a year earlier, according to preliminary data from the Ministry of Health. García Díaz, head of maternal health in Zacatecas, looked at his state’s annual statistics in November and was surprised. There were 5,000 fewer newborns.
“I had never seen anything like it,” the doctor said.
As demographers try to quantify the effects of the pandemic, they find more short-term baby busts than booms – at least, so far. The United Nations Population Fund initially predicted up to 7 million more unplanned pregnancies in developing countries if long periods of lockdown hampered access to birth control. Yet in a recent study of 15 of those countries, the agency found that only two had seen more births: Bhutan and Bangladesh.
“Economic insecurity and covid fears are indeed [causing] a profound blow to people’s hopes, expectations and plans for the future, ”said Rachel Snow, senior United Nations population official. “It can be much more universal than expected. “
Authorities are warning that it is too early to tell if there has been a global drop in births. Data are scarce in the world’s poorest countries, where births may have increased. And even middle-income countries with decent health data systems, like Mexico, face delays in collecting birth statistics, so the numbers may change somewhat.
It is also not known whether the health crisis will have a long-term impact on fertility. In many wealthy countries, including the United States, births plunged in late 2020 and early 2021, when the first “pandemic pregnancies” came to term. But they quickly rebounded to pre-covid levels.
Health professionals are still investigating why births in many regions have fallen more than expected. In Mexico, some health services have been successful in maintaining family planning programs despite immense pressure on the medical system. The number of marriages has plummeted, leading some couples to postpone starting a family. The lockdowns could have prevented the teens from socializing. A switch to long-acting contraceptives, already underway before the pandemic, could have been a factor. Health professionals and women’s advocates also point to the growing attention to birth control in a country where half of all pregnancies were previously unintended.
“The women are aware,” said García Díaz, “and they are determined not to have babies, for the time being.”
The decline in fertility can be seen in preliminary birth certificate statistics reported by Mexican cities for the first half of 2021: Births fell 17% in Mexico City compared to the same period a year earlier, the data showed. They fell by 18% in Monterrey, 21% in Mérida and 29% in Tlaxcala. The trend has also manifested itself in stores, clinics and churches.
“We have closed 10 out of 25 stores this year,” said Jesús Prado, a senior executive at Bebé Mart, a national chain that sells “everything a baby could need”: diapers, powder, strollers and baby clothes. clothes. Income is still only 70 to 80% of what it was before the pandemic. “And it’s a good day.”
Aide Licona has also seen her business dry up. She runs the Sunny Side preschool education center in Tulancingo, a town in the state of Hidalgo about 120 km north of the Mexican capital. Before the pandemic, she says, about 20 women attended her prenatal “early stimulation” course; when the coronavirus arrived, it fell to zero. Only two people signed up for breastfeeding coaching this year.
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Part of the decline may be due to people’s reduced incomes. But the couples have also postponed the pregnancy for fear of the coronavirus. At least 440,000 Mexicans have died from covid-19, according to official estimates – one of the highest death toll in the world.
“When you are struck by this reality, an illness that could quickly end your life, you are afraid,” Licona said.
The 26-year-old and her husband have postponed their plans to start a family. One of the factors was the economic crash; Mexico’s gross domestic product fell more than 8% last year. Licona was also uncomfortable about giving birth in a hospital full of Covid-19 patients: “A lot of people were worried about this – if they gave birth, under what conditions? would it be? “
The drastic change in social life during coronavirus shutdowns may also have contributed to fewer pregnancies. With churches closed and large gatherings banned, Mexico’s traditionally noisy wedding parties have been suspended. The number of marriages plunged 35% last year, according to the national statistics institute.
Gabriela Cuéllar works in a boutique in Tulancingo that sells fairytale puffy wedding dresses and tiny embroidered christening gowns.
“I can’t tell you when things will get back to normal,” she said. “I think a lot of women think twice about having a baby – because of the economy, the crisis, the lack of regular classes in school.”
Demographers say it is common for births to decline during times of economic crisis, as happened during the Great Depression and the 2008 financial crisis, due to financial concerns. In Mexico, uncertainty has been compounded by the absence of a national unemployment insurance system and a limited government coronavirus stimulus package.
For some in Tulancingo, the tension has grown too much. In July 2020, a baby was abandoned in the Roman Catholic cathedral, for the first time in over a decade. Then last May, a woman asked a man praying in the church to watch her baby while she went to the bathroom. She never came back.
Mexican health officials note that births were already on the decline before the pandemic. This is in part due to a vigorous family planning campaign that reduced the average number of children per woman from nearly seven in the 1970s to just 2.1 in 2019. Today, most contraceptives are available. provided free of charge by government institutions.
When the pandemic started, the government declared reproductive and sexual health services “essential”. Authorities have worked to ensure people have access to birth control – with everything from bowls of free condoms at medical centers to social media campaigns aimed at adolescents.
In many cases, patients did not need to be persuaded to consider birth control. In Tlaxcala state, the number of people requesting sterilization has skyrocketed, Health Minister Rigoberto Zamudio Meneses said. “Before, it was difficult for men to decide to have a vasectomy,” he said. “Now they do it more regularly. “
Graciela Vázquez Sándoval, director of Zacatecas Women’s Hospital, said that in the past few of her patients planned pregnancy. In 2020, that has changed. Increasingly, women demanded long-acting contraceptive methods such as implants and hormonal intrauterine devices, or IUDs.
“People said to me, ‘I can’t have so many children with this economic situation,’” the doctor said.
Ling Zhou, a government doctor responsible for reproductive health in the Monterrey suburb of Apodaca, said the increase in demands for birth control and vasectomies appeared to be “a long-term change.”
Yet women’s groups across the country have received a plethora of complaints from people unable to obtain contraceptives at overwhelmed clinics. Tania Gabriela García, a 23-year-old slim young woman with a baby’s face, says she panicked when her health center in Tabasco state, in the south of the country, only had contraceptive injections. she had received. She and her husband had lost their jobs and were already struggling to care for their toddler. They did not have the money to buy the drugs from a pharmacy.
“If I bought the injections, I wouldn’t be able to afford the diapers,” she said.
When she found out she was expecting another baby, she cried. She considered terminating her pregnancy, but her husband dissuaded her. “I know a lot of girls who have recently had abortions,” she said. The fact that the procedure is not available legally in most Mexican states – except in limited cases, such as rape – did not stop them, García said. “They go online or find a midwife to help them. “
Legal abortions declined in 2020, government records show. Yet clandestine abortion is very common, making it difficult to determine whether the procedure has increased during the pandemic. (The Supreme Court decriminalized abortion in September, but only six of Mexico’s 32 states legalized it.)
Reproductive rights groups have reported a growing demand for information about misoprostol, an ulcer drug used by women to induce abortions “at home”. Before the pandemic, the nonprofit Di RAMONA in Hidalgo state received requests for such advice from about four women every week. By early 2021, that number had climbed to 75. “We are in an unprecedented situation,” said co-founder Daniela Téllez.
Téllez attributed the demand to various factors: couples’ difficulties in obtaining birth control, rising unemployment, and increasing domestic and sexual violence. “It was a pandemic in the other,” she said.
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Gina Jiménez Ríos and Gabriela Martínez of the Washington Post contributed to this report.