Staying the Course: COVID-19 Hasn’t Derailed Family Planning

Despite the stress and challenges of the COVID-19 pandemic, most women with employer-based health insurance continued plans to expand their families, according to research conducted by Evernorth in 2020. Evernorth asked 2,000 women ages 25 to 45 about the Impact of COVID-19 on family planning and explored whether spending many months under unique and sometimes difficult conditions – such as coping with virtual schooling or working from home or in a transformed workplace – had changed their desire to have more children.

We learned that 60 percent of women say their plans to have children didn’t changed, while 13 percent wanted to have more children than they previously planned. Among women 35 to 45, that number increased to nearly 20 percent.

Up to 14 percent of respondents were accelerating plans to add to their family. Many respondents said the pandemic helped them recognize the importance of family. Others were eager to increase their family because they have more flexibility and time at home.

The study also suggested that unintended pregnancies may be on the rise. Nearly 40 percent of respondents – including those who didn’t plan to have more children - reported increased sexual activity and a 10 percent decrease in birth control use. 

This prediction of a baby bump was confirmed two years after the release of the study by new research from the National Bureau of Economic Research (NBER). By the end of 2021, the rate of births among those mothers relative to its pre-pandemic trend was 6.2% higher, with data for California birth rates through September of 2022 suggesting that these increases may continue nationally.

Fertility treatments and prescriptions are increasing

As part of the Evernorth research, we asked if the respondents were undergoing fertility treatments. Many who were had stopped treatments early in the pandemic, when medical offices were closed for safety reasons, but more than 75 percent had already restarted treatments or plan to restart within one year. More than half of those currently undergoing treatments had begun during the pandemic.

These figures aligned with claims data from Express Scripts PBM, an Evernorth company, which showed a 42% near immediate increase in fertility claims when most fertility treatments were able to resume – reaching pre-pandemic levels within 6 weeks. In addition, we noted a 3 percent increase in fertility prescriptions for the year compared to 2019 – a steady increase in claims despite the pandemic. That suggests the number of people now seeking fertility treatments was higher than it was pre-pandemic.

Helping families achieve their goals

The older women get, the more likely they would need medical intervention to achieve pregnancy. The need for comprehensive fertility benefits will continue to grow, as illustrated by the number of 35- to 45-year-old women who say they wish to increase their families.

Additionally, separate studies indicate that 45% of workers say fertility benefits are an important component when considering a new job and more than 32% of employees saying that they will stay with a company longer if that company offers a fertility benefit

These studies indicated that the demand for broader fertility benefits would continue to increase in the years ahead. In fact, in 2021, 47% of large employers now provide this coverage.

Click here to access the full 2021 report.

Originally published on 2/24/21 and updated on 3/15/23.