1 Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Social Sciences, Isfahan University, Isfahan, Iran

4 Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran


The COVID‑19 pandemic has had considerable consequences in many areas of life, including the
social area and childbearing plans. The present narrative review aimed to examine the childbearing
decisions and its related factors during the COVID‑19 pandemic. This review was conducted by
searching in scientific databases, including Web of Science, Science Direct, Google Scholar, Scopus,
Cochrane, PubMed, ProQuest, Scientific Information Database (SID), Iranian Research Institute
for Information Science and Technology (IranDoc) and Iranian Journal Database (Magiran) in June
2022. The search resulted in 111 sources, of which 16 were in line with the research objective.
Couples have mainly cancelled or delayed their previous plans related to childbearing decisions.
There are two groups of direct and indirect factors related to childbearing decisions during the
COVID‑19 pandemic: The former includes (1) well‑being‑related factors such as economic conditions,
interpersonal relationships and gender roles in terms of task division; and (2) health‑related factors,
including health emergencies and physical and psychological health. The latter includes factors such
as social distancing and social media. Based on the results, governments should facilitate childbearing
by adjusting existing policies, addressing economic insecurity and protecting the livelihoods of
those affected by the crisis. Health policymakers and planners must also prioritize women’s access
to reproductive health services in a safe environment while promoting equity in access. It is also
necessary to promote the quality and quantity of indirect care and virtual counseling based on the
needs of women in crisis.


  1. Vaiarelli A, Bulletti C, Cimadomo D, Borini A, Alviggi C, Ajossa S,
    et al. COVID‑19 and ART: The view of the Italian society of fertility
    and sterility and reproductive medicine. Reprod Biomed Online 2020;40:755‑9.
    2. Fumagalli S, Ornaghi S, Borrelli S, Vergani P, Nespoli A. The
    experiences of childbearing women who tested positive to
    COVID‑19 during the pandemic in northern Italy. Women Birth
    3. Sienicka A, Pisula A, Pawlik KK, Kacperczyk‑Bartnik J, Bartnik P,
    Dobrowolska‑Redo A, et al. The impact of COVID‑19 pandemic
    on reproductive intentions among the Polish population. Ginekol
    Pol 2021. doi: 10.5603/GP.a2021.0135.
    4. Voicu M, Badoi D. Fertility and the COVID‑19 crisis: Do gender
    roles really matter? Eur Soc 2021;23:S199‑214.
    5. Safdari‑Dehcheshmeh F, Noroozi M, Taleghani F, Memar S.
    Explaining the pattern of childbearing behaviors in couples:
    Protocol for a focused ethnographic study. J Educ Health Promot
    6. Ullah M, Moin AT, Araf Y, Bhuiyan AR, Griffiths MD, Gozal D.
    Potential effects of the COVID‑19 pandemic on future birth rate.
    Front Public Health 2020;8:578438.
    7. Tan J, Dahan MH, Ata MB, Nair S, Shoham Z, Tan SL. Trends
    in fertility practice during the Covid‑19 pandemic: A global
    survey of 299 clinics representing 228,500 IVF cycles. Fertil Steril
    8. Sobotka T, Matysiak A, Brzozowska Z. Policy responses
    to low fertility: How effective are they? 2019. Available
    9. Vignoli D, Tocchioni V, Mattei A. The impact of job uncertainty
    on first‑birth postponement. Adv Life Course Res 2020;45:100308.
    10. Zhu C, Wu J, LiangY, Yan L, He C, Chen L, et al. Fertility intentions
    among couples in Shanghai under COVID‑19: A cross‑sectional
    study. Int J Gynaecol Obstet 2020;151:399‑406.
    11. Flynn AC, Kavanagh K, Smith AD, Poston L, White SL. The impact
    of the COVID‑19 pandemic on pregnancy planning behaviors.
    J Health Psychol 2021;2:71‑7.
    12. Mughal M, Javed R. Perturbed nuptiality, delayed fertility:
    Childbirth effects of Covid19. J Popul Res (Canberra) 2021;1‑9.
    doi: 10.1007/s12546‑021‑09270‑4.
    13. Boberg‑Fazlic N, Ivets M, Karlsson M, Nilsson T. Disease and
    fertility: Evidence from the 1918–19 influenza pandemic in
    Sweden. Econ Hum Biol 2021;43:101020.
    14. Arpino B, Luppi F, Rosina A. Changes in fertility plans during the
    COVID‑19 pandemic in Italy: The role of occupation and income
    vulnerability. 2021. Available from:
    15. UNFPA. The impact of COVID‑19 on human fertility
    in the Asia‑Pacific region. 2020. Available from:
    16. United Nations: Department of Economic and Social
    Affairs (DESA). A review of research related to the impact of
    the COVID‑19 pandemic on fertility. 2021. Available from:
    17. Guetto R, Bazzani G, Vignoli D. Narratives of the future shape
    fertility in uncertain times. Evidence from the COVID‑19
    pandemic. Universita’degli Studi di Firenze, Dipartimento di
    Statistica, Informatica; 2020. Available from: https://ideas.repec.
    18. CoutinhoRZ, Lima LCd, Leocádio VA, BernardesT. Considerations
    about the COVID‑19 pandemic and its effects on fertility and
    sexual and reproductive health of Brazilian women. SciELO Brasil
    19. Lin TK, Law R, Beaman J, Foster DG. The impact of the COVID‑19
    pandemic on economic security and pregnancy intentions among
    people at risk of pregnancy. Contraception 2021;103:380‑5.
    20. Emery T, Koops JC. The impact of COVID‑19 on fertility
    behaviour and intentions in a middle income country. PLoS One
    21. Naya CH, Saxbe DE, Dunton GF. Early effects of the COVID‑19
    pandemic on fertility preferences in the United States: An
    exploratory study. Fertil Steril 2021;116:1128‑38.
    22. Malicka I, Mynarska M, Świderska J. Perceived consequences of
    the COVID‑19 pandemic and childbearing intentions in Poland.
    JFR 2021;33:674‑702.
    23. Kahn LG, Trasande L, Liu M, Mehta‑Lee SS, Brubaker SG,
    Jacobson MH. Factors associated with changes in pregnancy
    intention among women who were mothers of young children
    in New York city following the COVID‑19outbreak. JAMA Netw
    Open 2021;4:e2124273.
    24. Lindberg LD, VandeVusse A, MuellerJ, Kirstein M. Early impacts
    of the COVID‑19 pandemic: Findings from the 2020 Guttmacher
    survey of reproductive health experiences. 2020. Available from:‑2020‑guttmacher‑survey‑reproductive‑heal
    25. Karp C, Wood SN. Contraceptive dynamics during COVID‑19
    in sub‑Saharan Africa: Longitudinal evidence from Burkina Faso
    and Kenya. BMJ Sex Reprod Health 2021;47:252‑60.
    26. Micelli E, Cito G. Desire for parenthood at the time of COVID‑19
    pandemic: An insight into the Italian situation. J Psychosom
    Obstet Gynaecol 2020;41:183‑90.
    27. Marteleto LJ, Dondero M. Navigating women’s reproductive
    health and childbearing during public health crises: Covid‑19
    and Zika in Brazil. World Dev 2021;139:105305.
    28. Coombe J, Kong F, Bittleston H, Williams H, Tomnay J, Vaisey A,
    et al. Contraceptive use and pregnancy plans among women of
    reproductive age during the first Australian COVID‑19 lockdown:
    Findings from an online survey. Eur J Contracept Reprod Health
    Care 2021;26:265‑71.
    29. Tan PL, Ryan J, Lim‑Soh, JW. Epidemics and fertility change:
    Responses to Zika and COVID‑19 in Singapore. 2021. Available
    30. Muhaidat N, Alshrouf MA. Infertility management disruption
    during the COVID‑19 outbreak in a middle‑income country:
    Patients’ choices, attitudes, and concerns. Patient Prefer
    Adherence 2021;15:2279‑88.
    31. Banaei M, Nia HS, Mokhtarian‑Gilani T, Kariman N. The role of
    the COVID‑19 pandemic on childbearing intentions in Iranian
    women: A path analysis. 2021. Available from: https://assets.‑368798/v1/0b948f1a‑bcf8‑4f0e‑96bd
    ‑c376766a560d.pdf?c=1631880221. [Last accessed on 2022 Mar 25].
    32. Luppi F, Arpino B, Rosina A. The impact of COVID‑19 on fertility
    plans in Italy, Germany, France, Spain, and the United Kingdom.
    Demogr Res 2020;43:1399‑412.
    33. Riederer B, Buber‑Ennser I, Brzozowska Z. Fertility intentions
    and their realization in couples: How the division of household
    chores matters. J Fam Issues 2019;40:1860‑82.
    34. Dommermuth L, Hohmann‑Marriott B, Lappegård T.
    Gender equality in the family and childbearing. J Fam Issues
    35. Del Boca D, Oggero N, Profeta P, Rossi M. Women’s and men’s
    work, housework and childcare, before and during COVID‑19.
    Rev Econ Househ 2020;18:1001‑17.
    36. Kreyenfeld M, Zinn S. Coronavirus and care: How the coronavirus
    crisis affected fathers’ involvement in Germany. Demogr Res
    37. Michael TO, Agbana RD, Ojo TF, Kukoyi OB, Ekpenyong AS,
    Ukwandu D. COVID‑19 pandemic and unmet need for family
    planning in Nigeria. Pan Afr Med J 2021;40:186.
    38. Hall KS, Samari G, Garbers S, Casey SE, Diallo DD, Orcutt M,
    et al. Centring sexual and reproductive health and justice in the
    global COVID‑19 response. Lancet 2020;395:1175‑7.
  2. 39. Fostik A. COVID‑19 and fertility in Canada: A commentary. Can
    Stud Popul 2021;48:217‑24.
    40. Aassve A, Cavalli N, Mencarini L, Plach S, Livi Bacci M. The
    COVID‑19 pandemic and human fertility. Science 2020;369:370‑1.
    41. Chandi A, Jain N. State of assisted reproduction technology in
    the coronavirus disease 2019 era and consequences on human
    reproductive system. Biol Reprod 2021;105:808‑21.
    42. Tokgoz VY, Kaya Y, Tekin AB. The level of anxiety in infertile
    women whose ART cycles are postponed due to the COVID‑19
    outbreak. J Psychosom Obstet Gynaecol 2020; 19:1‑8.
    43. Kamath MS, Joseph T, Karuppusami R, Chinta P, Pal A,
    Nallamilli SR, et al. Knowledge, anxiety levels and attitudes of
    infertile couples towards COVID‑19 and its impact on self‑funded
    fertility treatment: A cross‑sectional questionnaire survey. Hum
    Reprod Open 2021;2021:hoab039. doi: 10.1093/hropen/hoab039.
    44. Ben‑Kimhy R, Youngster M, Medina‑Artom TR, Avraham S,
    Gat I, Haham LM, et al. Fertility patients under COVID‑19:
    Attitudes, perceptions, and psychological reactions. Hum Reprod
    45. Mimoun E, Ben Ari A. Psychological aspects of employment
    instability during the COVID‑19 pandemic. Psychol Trauma
    46. Kirubarajan A, Patel P, Tsang J, Prethipan T, Sreeram P, Sierra S.
    The psychological impact of the COVID‑19 pandemic on fertility
    care: A qualitative systematic review. Hum Fertil (Camb)
    47. Silverio‑Murillo A, Hoehn‑Velasco L, Balmori de la Miyar JR,
    Rodríguez A. COVID‑19 and women’s health: Examining changes
    in mental health and fertility. Econ Lett 2021;199:109729.
    48. Venegas‑Vera AV, Colbert GB, Lerma EV. Positive and negative
    impact of social media in the COVID‑19 era. Rev Cardiovasc Med
    49. Mirmohammadkhani M, Bemanalizadeh M, Yazdi M, Goli P,
    Mohebpour F, Saffarieh E, et al. Knowledge, attitudes, and
    practices toward COVID‑19 among Persian birth cohort
    participants. J Educ Health Promot 2021;10:358.
    50. Schaler L, Wingfield M. COVID‑19 vaccine ‑can it affect fertility?
    Ir J Med Sci 2021; 1971: 1‑3.
    51. Barra F, La Rosa VL. Psychological status of infertile patients who
    had in vitro fertilization treatment interrupted or postponed due
    to COVID‑19 pandemic: A cross‑sectional study. J Psychosom
    Obstet Gynaecol 2020;30:1‑8.
    52. Varnum MEW, Grossmann I. Pathogen prevalence is associated
    with cultural changes in gender equality. Nat Hum Behav
    53. Mickler AK, Carrasco MA. Applications of the high impact
    practices in family planning during COVID‑19. Sex Reprod Health
    Matters 2021;29:1881210.
    54. Goel A, Gupta L. Social media in the times of COVID‑19. J Clin
    Rheumatol 2020;26:220‑3.