Changes in Age-Specific Pregnancy Prevalence Proportions over the Covid-19 Pandemic in Manicaland, Zimbabwe

Past infectious disease outbreaks have altered population fertility in ways that contribute to changes in population age-structure and subsequent needs for public services. However, little is known about how fertility changed over the Covid-19 pandemic in African populations where birth registration systems typically remain weak. Using serial cross-sectional data from population surveys conducted in Manicaland, Zimbabwe, before, during, and towards the end of Covid-19 (2018-23), we found that women's overall odds of current pregnancy had changed little at the height of Covid-19 but dropped following the relaxation of lockdown measures. In the middle of the pandemic, reductions in pregnancy rates in adolescents, associated with delays in sexual activity and marriage, offset increases in 25-34-year-old women linked to reduced use of contraception. Late in the pandemic, the overall odds of current pregnancy fell, with only a partial recovery in teenage sexual activity but a strong rebound in use of contraception.