What have couples been doing in lockdown? We might know in nine months

Binge watching box sets, doing jigsaws and sharing almost every human activity possible through video apps are some of the most talked about ways of connecting and alleviating boredom during the coronavirus shutdown.

But what else are couples doing more of behind closed doors?

Maybe nine months will tell.

There has been plenty of light-hearted chatter predicting a wave of “coronababies” around Christmas and into 2021. A UK discount chain reported, with some glee, towards the end of April that sales of pregnancy test kits were up 25 per cent since the lockdown had begun in Britain on March 23rd.

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However, while each pregnancy is ultimately the responsibility of just two people, what’s going on in the wider society and economy have a huge bearing on a country’s birth rate. The current crisis is unprecedented and the ramifications are only starting to unfold.

We can only speculate on what impact the Covid-19 era might have, for better or for worse, on procreation in Ireland.

Here are some factors to consider:

Fertility rate versus number of births

At the outset, it’s important to understand the distinction between these two measurements when talking about increases and decreases in our baby population.

The fertility rate is the average number of children born to women of childbearing age (15-44), while the number of births is recorded as the number of live births per 1,000 of the population each year.

Here in Ireland, our birth numbers have shot up and down in recent decades while our fertility rate has slowly drifted downwards.

We had the highest birth rate in the EU in 2018, with 12.5 births per 1,000 residents while Italy recorded the lowest, at 7.3 per 1,000. However, this is primarily shaped by demographics (see below) rather than personal decision-making about whether or not to start, or enlarge, a family.

An EU comparison of fertility rates for 2017 showed Ireland had the third highest fertility rate, with 1.77 live births per woman, behind France, which topped the list with 1.90 live births per woman, and Sweden fractionally ahead of us with 1.78.

Sixty years ago, our fertility rate was 3.78 births per woman in 1960, the highest in Europe, and we held on to that top spot through 1970 and 1980 but by 1990 our fertility rate of 2.11 trailed that of Cyprus, Iceland and Sweden.

Migration

One of the biggest influences on Ireland in the past three decades has been migration, explains Prof Tony Fahey, Professor of Social Policy in UCD, and its effects are seen clearly in the maternity hospitals.

While “the propensity of each woman to have children hasn’t changed that much over the last 30 years, the number of children who have been born has changed enormously”, he points out.

The Republic’s highest number of births in the 20th century was in 1980, at 74,064 according to CSO figures, and that fell to a low of just over 48,000 in 1994 – reflecting the 1980s tide of emigration – until a new peak of 75,554 births was reached in 2009.

The upsurge from the mid-1990s was driven entirely by the inflow of women in their late 20s, early 30s, “so it was far more women having children, rather than women having more children”, says Fahey.  The tendency of the average woman to have children hasn’t changed very much and has continued to be relatively high in Ireland.

In considering the impact of the coronavirus, he says it’s interesting to note that this pattern of childbearing was not affected much by the financial crisis in 2008 to 2012.

“It did edge down a little, but you didn’t get the kind of collapse you got in southern Europe and eastern Asia. We have never had a fall like that in Ireland but that could still happen.”

Inward or outward migration, post-Covid-19, will depend not just on what happens to the economy in Ireland but also its relative performance to that of other countries.

“We could have another bout of inward migration, or it could be flat, or, if recovery is stronger elsewhere sooner, we could have people leaving Ireland again, which would push the birth rate down again.”

Libido

How was it for you? The change of life imposed by Covid-19 that is. Mixed anecdotal messages about increased or decreased sex drive could be broadly explained by individual responses to changes in circumstances – and with whom you’re sharing your home.

Just because many cohabiting couples have had more time and opportunity for sex, doesn’t mean they wanted it. For some the novelty of change in routine, with perhaps more sleep, no commute and the relief of being removed from the communal workplace, may have been invigorating. For others, the heightened anxiety is paralysing; or maybe it’s the exhausting effect of ever-present children.

Stress has an impact on intimacy and desire, says Dublin psychotherapist and couples counsellor Bernadette Ryan, who points to the fear engendered by the pandemic. "Suddenly, our bodies have become our enemy and that can bring a lot of anxieties up for people; those kinds of things impact on sexual intimacy."

Sex therapist Diane Gleim, writing on the effect of this time on libido, explains: "A person's sex drive needs just enough anxiety/tension/uncertainty to get activated but not too much anxiety/tension/uncertainty or else the person can get overwhelmed, flooded, and then sex drive goes underground."

It’s a spectrum, she says in “Psychology Today”, on which any one of us can move up and down, depending on how you’re coping mentally with the pandemic fallout.

With short-term national emergencies in the recent past, such as the crippling snowfalls in February, 2018, courtesy of “The Beast from the East”, there was an air of excitement, says Ryan about “battening down the hatches for a couple of days and that might heighten the sense of wanting to be intimate. This is different; this is endless and we don’t know what the new normal is going to be.”

Routines and distractions for all of us have radically changed, which alters the dynamics of every relationship. Sex tends to be the thing that goes on the back burner at times of stress, she says, and if it has for you, “that is fine – don’t feel under pressure”.

Ryan expects a post-Covid-19 surge in demand for counselling at her Ranelagh practice (dsixcounselling@gmail.com), fearing that the pressure of living with the restrictions will have exacerbated cracks couples might have had in their relationship.

For “people cooped up with small children in small places, it’s tough,” she adds. “It really will test the mettle of the relationship.”

Fertility experts say that couples often don’t have sex frequently enough to give themselves the best chance of conceiving, with intercourse three or four times every week being recommended. If that level of sexual activity has been more attainable since mid-March for more couples, there would surely be an increased pregnancy rate among those who are not using contraception.

You can add to that a surmise that anecdotal accounts of more alcohol being consumed at home, along with trade reports of a 40 per cent rise in take-home alcohol sales on the same period last year, may have increased sexual risk-taking and faulty use of contraceptives.

Family planning

Since we’re living through what amounts to a social experiment, there is no knowing whether the psychological impact would make couples less or more likely to think about starting a family or, indeed, enlarging one.

On the one hand there is huge uncertainty about what sort of world you might be bringing a child into in nine months’ time, Ryan points out, on the other hand people can realise through all this what is important for them in life. Those who might have been putting off starting a family, may now feel the time has come, she suggests.

Up to now, the number of Irish women going on to have a third or fourth child has tended to keep the birth rate up in Ireland, says Fahey. “Often it is the middle-class and professional women who are having the third and fourth child, which really is a bit unusual in international terms.”

While immigrant women have accounted for a sizeable share of births in Ireland – some 25 per cent of births in 2012 were to non-Irish mothers – they tend to have fewer children than Irish women, he says, as many of them come from Eastern Europe where birth rates are lower and family sizes smaller than in Ireland.

This likelihood of the third or fourth child is one thing that Fahey thinks may change, not just due to the Covid-19 economic fallout but other pre-existing issues, such as the housing crisis.

East German example

A standout example in recent times of the impact mass uncertainty can have on a country’s birth rate is what happened in East Germany over the period of reunification with West Germany.

“It is probably the most astonishing case study we have,” says Dr Jo Murphy-Lawless, research fellow at NUI Galway’s Centre for Health Evaluation, Methodology Research and Evidence Synthesis.

Between 1989, the year the Berlin Wall fell, and 1991, a year after reunification, the number of births in the old GDR fell by 44 per cent, she reports. The completed fertility rate was 1.57 in 1989; by 1991 it was 0.8.

“It didn’t really begin to recover at all, only slightly, until the mid-1990s. It was almost as if women in East German, seeing the collapse of Communism, just gave up having children because of the absolute lack of confidence in their immediate futures.”

Murphy-Lawless had a master’s student who had lived in East Germany and who did her thesis on the experience of women there making the transition to a united Germany. Her research highlighted how the former GDR had given significant support to women as child bearers and child rearers, says Murphy-Lawless.

“Somehow that shock of having to recalibrate their lives led to this colossal drop in fertility, unlike anything we have ever had. In general, we have been floating down.”

Yet, she adds, “we still seem to have quite a fondness for children in Ireland. We have the highest percentage of households with children in them in the EU, which is 40 per cent.”

Travel restrictions

The impact possible long-term travel restrictions post Covid-19 might have on people’s decisions on family formation is something that Murphy-Lawless also muses about.

Global consumerism capitalism, which has been part and parcel of individualisation, has meant people have just “moved on” to greener pastures, be it for economic, career or lifestyle reasons. How easy it is going to be to do that now “is the great unknown”, she suggests.

If the opportunity and/or social pressure to see the world before starting a family is curtailed, that may have an effect if more people choose to “settle down” in Ireland now. There may be fewer stories originating from this period of “going away for a year” and ending up staying away for a lifetime.

Housing market

The housing problem is a factor in the margins that Fahey has been considering as having implications for our birth rate. “The traditional three-bed semi-detached was suitable for a three- or four-child family where a two-bedroom apartment is not.”

Having a little garden out the front and the back makes having children a lot easier, he suggests – indeed, never more so than right now.

The difficult of acquiring a long-term home in the first instance may deter people from starting families at all, he says – or at least delay them, with possible repercussions for fertility the longer they wait. An inability to trade up to a bigger property might also deter couples from having a third or fourth child.

“They were the factors that were there and, oddly enough, the indications are that maybe the current crisis will ease the housing problem,” he says, pointing, for example to Airbnb properties coming onto the rental and sales markets.

Also, if the lack of capacity in the construction sector has hindered the building of new houses, he wonders if the inevitable stalling of plans for new hotels in the Dublin area over the next few years might free up a workforce to accelerate the numbers of homes being built.

“This is a roundabout way in which a crisis like this could have an upside effect rather than a downside effect,” he adds.

Assisted reproduction on hold

The closure of assisted reproduction clinics since the last week of March was devastating for couples in the midst of, or about to embark on, treatment. They have lost months in what some regard as a race against time.

We didn't get an "absolute direction" to close, says Dr John Kennedy, medical director of the Sims Dublin and Cork and the Rotunda IVF clinics. "We closed because it was the right thing to do."

The health services were under huge pressure, he points out. However, he had been a little surprised at the European Society of Human Reproduction and Embryology (ESHRE) advising, in a statement on March 19th, that, as a precautionary measure against possible negative effects of Covid-19, all fertility patients should avoid becoming pregnant.

On April 23rd, the ESHRE rowed back on that, advising that, as infertility is a disease and with the risk of Covid-19 decreasing, “all ART treatments can be restarted for any clinical indication, in line with local regulations”.

At the time of writing, Kennedy is in the midst of planning for reopening the first week of May, with a new way of working, including extended opening hours to allow for social distancing through segregated team working and space in patient waiting areas. However, he adds, “everything comes with an asterisk, as we are in uncharted waters”.

Final word

That goes to Prof Fahey who has written extensively over the years on demographics: “As with anything in this field, there are so many factors piling in together and they are not all pointing in the one direction of what the overall outcome will be.”