The birthrate in America fell 4% last year, marking the biggest annual decrease in decades – suggesting that the coronavirus pandemic has taken the country’s downward trend into overdrive.

New provisional data released Wednesday by the Centers for Disease Control and Prevention shows that the birthrate in 2020 dropped for the sixth consecutive year. The steepest decline occurred in the last part of the year, when the first babies conceived during the U.S. pandemic would have been born.

Before the pandemic, American women were already having fewer children, doing it later in life or choosing to not have children. The newly released data indicated a sharpening of that trend. The U.S. birthrate fell across races, ethnicity and almost all age groups.

About 3.6 million babies were born in the United States in 2020, a decline from about 3.75 million in 2019. It is the lowest number of births since 1979 and the largest one-year drop in births, in percentage terms, since 1965, the year the baby boom ended, said Philip Cohen, a sociologist at the University of Maryland.

While the pandemic may have accelerated the decline, it did not cause it; the slowdown had been going for decades before the pandemic. Shortly before the coronavirus’s onset, the birthrate had fallen to 1.73 births per woman, after peaking in 1957 at 3.77 births per woman. It dipped in 1980, increased slightly a decade later and continued on a steady decline.

“It’s a shock but not a change in direction,” said Cohen, noting a continuous decline in birthrates since 2007.

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“Some of the things that might be driving down birthrates in the long run – like economic insecurity, the cost of health care, housing, child care and education, and our awful work-family policies – are probably things that were exacerbated in the last year,” Cohen said.

By disrupting American society in so many ways, the pandemic led some people to delay plans, experts say, with the prospect of children more daunting in the face of job losses, closed child-care centers and schools, and social isolation. At the beginning of the pandemic, the effects of the coronavirus on pregnant women was not yet known.

“It also slowed down the social metabolism, so there was less social interaction, and that means less sex, less coupling and marriage and pregnancies,” Cohen said. “I’m sure there is both a conscious and unconscious element to this, and we just don’t have enough data yet to know for sure what that balance is.”

For some, the pandemic brought long-cherished plans to a halt.

Hannah Crabtree was in the process of vitro fertilization – an already emotionally and physically draining process – when the pandemic hit.

Crabtree, 30, of Falls Church, Va., had just finished a procedure to have her eggs retrieved when her fertility clinic shut down. By summer, the offices were open again and Crabtree was ready to move forward – but her fiance, Joshua Abramsohn, was not.

“He was worried about me,” Crabtree said. Crabtree is diabetic, leaving her at high risk in the pandemic. They worried that pregnancy might make her more so. Abramsohn also said he would have to go back to work soon as an eighth-grade English teacher, further exposing them to the virus. They were stacking one risk on top of another, so they put their plans on hold.

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“It was a relief at first to have the summer off from the hormones, from having to think about pregnancy,” Crabtree said. But that relief turned into regret and second-guessing as she watched her best friend and others get pregnant during the pandemic. Abramsohn’s school never did reopen that fall.

So when the couple got vaccinated in January, they scheduled an embryo transfer. The pandemic had cost them precious time, but at least everything was back on track.

Two months ago, that first transfer ended in a miscarriage, devastating them both.

“This pandemic has just sucked in so many ways,” Crabtree said. “There’s no way around that fact. But what I’ve learned from this past year is that we have to find joy where you can and to take it one step at a time, one week at a time.”

She is grateful that she is still relatively young, she said. She and Abramsohn still have hope.

The data confirms that there were nearly 40,000 “missing births” in the final six weeks of 2020, reflecting the absence of babies that would have otherwise been conceived in the early months of the pandemic, said Phillip Levine, an economics professor at Wellesley College. Data from 2021 will reflect more of the pandemic’s effects, he said, adding that the 1918 flu pandemic led to similar dips in fertility.

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But any declines caused by the coronavirus pandemic are negligible compared with the overall direction of the country’s fertility rate, he said.

“Let’s say covid reduces births by a few hundred thousand,” Levine said. “In a country of 330 million, that just is not that big of a deal if it’s just a one-shot thing.”

The fact that the United States has around 700,000 fewer births annually than it did in 2007 is much more significant, Levine said.

“These are magnitudes that sort of rival the baby boom, kind of the opposite of the baby boom, and we know that the baby boom had a huge effect, on economics, on culture, on politics, on just about everything you can think of,” he said. “Losing that many people, it would be difficult to imagine that doesn’t have a large effect in a broad array of dimensions.”

Last year’s downturn was most significant among teenagers, continuing a long decline in birthrates for that group, and women between 35 and 44, an age group in which births had been increasing since 2007.

“Older women would be a prime target because having a second or third child would be harder in last year’s environment,” Levine said.

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It remains to be seen what long-term effects the pandemic may have.

Before the pandemic, Niki Akhaveissy, a 27-year-old lawyer in Dallas, had planned to have her first child by the time she turned 30, assuming that she would find a partner by then.

The past year has revised that timeline. Akhaveissy struggled with her mental health under amid the shutdowns, leading her to wonder how she might deal with postpartum depression. She watched friends lose their jobs, and co-workers struggle to balance paid work and child care. And she began to question how she would take care of a baby with the four weeks of paid leave allowed at her job.

So two months ago, Akhaveissy got an intrauterine device, or IUD, to prevent pregnancy, she said. Now, the only thing she is certain of is that she does not plan to have a child soon.

“At this point, I don’t even know if I want to have my first child by 35,” Akhaveissy said. “The more I think about it, it’s just not financially feasible for me to have a child at all right now.”

Alicia McCauley, 35, used to ask her friends with children to tell her honestly what it was like to be a parent. They were always straightforward about the ups and downs, she said. But during the past year, those conversations reached new emotional depths, with her female friends often sobbing as they struggled between choosing their jobs or their families.

“I had friends break down and cry on the phone because they felt like this was endless, this was interminable, and too much was being asked of them but there was no one to help,” said McCauley, a government employee in New York. “It wasn’t until the pandemic that my friends were like, ‘This is a whole other level of struggle.'”

Those phone calls confirmed something McCauley had long suspected: She does not want to give birth – particularly not in a country such as the United States, which does not offer universal paid leave. “It laid bare the ways in which America is hostile to mothers in many different ways,” she said. “To me, having a kid feels like you have to be willing to be punished for it.”