Provisional births in England and Wales: 2021

• There were 625,008 live births in 2021, an increase of 1.5% from 615,557 live births in 2020, but still well below the 2019 number; 2021 remains in line with the long-term trend of decreasing live births observed before the coronavirus (COVID-19) pandemic.

• The total fertility rate (TFR) in 2021 was an estimated 1.61 children per woman compared with 1.58 in 2020; this is the first time since 2012 that the TFR has increased.

• In 2021 there were 2,628 stillbirths, an increase of 199 from 2020 when there were 2,429 stillbirths; this is similar to the 2,596 stillbirths observed before the coronavirus pandemic in 2019.

• The stillbirth rate in 2021 was 4.2 stillbirths per 1,000 births compared with 3.9 in 2020; the stillbirth rate was above the five-year average in seven months of 2021.

• In 2021, the monthly stillbirth rate increased for the majority of months compared with 2020, with the exceptions of March and April 2021; however, the 2021 monthly rates remain similar to pre-coronavirus pandemic levels

• The largest increase in age-specific fertility rate was in women aged 35 to 39 years, which rose from 59.4 live births per 1,000 women in 2020 to 62.5 in 2021 (5.2%); the rate is still in line with the pre-coronavirus pandemic trend.

Statistician’s comment

“The number of births increased year-on-year for the first time since 2015. However, the total number remains in line with the long-term trend of decreasing births observed in pre-coronavirus years.

There was also an increase in stillbirths compared with 2020, especially in the second half of 2021, and it is important to remember that every stillbirth is a tragedy for the family involved. While this increase coincides with a higher number of live births during this period, when looking at 2021 stillbirth rates in relation to historical years, they are mostly in line with what we saw prior to the pandemic.”

Traditionally, our birth statistics for England and Wales are derived from information recorded when live births and stillbirths are registered as part of the civil registration process. Where relevant, we link birth registrations to their corresponding NHS birth notification to enable analysis of further factors such as gestational age and ethnicity of the baby. Because of delays in birth registration data in 2021, NHS birth notification data allow for more timely estimates of 2021 births in England and Wales.

For comparability over time, we have compared these figures with birth notification figures for previous years, not registration data. Therefore, the statistics in this release are provisional and not directly comparable with other releases that are derived using birth registrations. Further information regarding quality of the data can be found in Section 8: Data sources and quality.

Based on birth notification data, there were 625,008 live births in England and Wales in 2021. This is a 1.5% increase in the number of live births compared with 2020 (615,557) and the first annual increase since 2015. The majority of the increase in live births occurred during the second half of 2021. Comparing live births in 2021 with pre-coronavirus (COVID-19) births, the number of live births remains lower than the 640,635 in 2019.

The total fertility rate (TFR) also increased to 1.61 children per woman in 2021, up from 1.58 in 2020. This was the first time the TFR increased since 2012. The TFR in 2021 was still lower than in 2019 and in the previous 10 years.

2021 saw a slight rise in overall fertility rates with an increase in the general fertility rate (GFR) to 55.8 live births per 1,000 women in 2021 from 55.1 in 2020 (1.3%).

When compared with the same months in the previous year, monthly fertility rates in 2021 have generally increased. The exceptions include decreases in January (10.0%), February (1.5%) and May (2.4%) 2021. These GFR decreases reflect the reduced number of births during those months compared with 2020 (Figure 2).

In the second half of 2021, November and December saw the largest increases in the GFR compared with 2020. December saw the GFR increase to 53.8 births per 1,000 women in 2021 from 50.1 in 2020 (7.4%). In November it increased to 56.9 from 54.4 births per 1,000 women (4.6%). Births occurring in the second half of 2021 will relate mostly to children conceived during coronavirus restrictions from November 2020 to March 2021.

The increase in fertility has been driven by women at older ages. In 2021, the age-specific fertility rates (ASFR) of women under 20 and those aged 20 to 24 years decreased. In all other age groups, fertility rates increased (Figure 3). The largest increase in ASFR was among those aged 35 to 39 years, from 59.4 live births per 1,000 women in 2020 to 62.5 in 2021 (5.2%). Looking back to pre-coronavirus years, the overall fertility rate in 2021 is lower than in 2019, where the GFR at all ages was 57.6 live births per 1,000 women.

The NHS guidance on pregnancy and coronavirus (COVID-19) currently highlights that pregnant women are at higher risk of getting seriously ill from coronavirus (COVID-19). In addition, if a woman gets COVID-19 late in her pregnancy, the baby could also be at risk. Guidance from the Royal College of Obstetricians and Gynaecologists highlights that while stillbirth remains a rare outcome, maternal COVID-19 infection is associated with an increased risk of stillbirth.

Every stillbirth is a tragedy for the family involved, but the number of stillbirths that occur each month in England and Wales is relatively small and monthly stillbirth rates are volatile. Provisional data for 2021 show there were 2,628 stillbirths, 199 more than in 2020 (2,429 stillbirths). The number of stillbirths in 2021 was similar to the 2,596 stillbirths observed pre-coronavirus in 2019. Compared with 2020, July to December 2021 saw an increased number of stillbirths and coincides with a higher number of live births. However, 2021 stillbirth rates are mostly in line with monthly stillbirth rates observed in pre-coronavirus years.

The stillbirth rate is a better measure for monitoring change over time than the actual number of stillbirths. This is because rates account for the total number of births each year. In 2021, the stillbirth rate rose to 4.2 stillbirths per 1,000 births from 3.9 stillbirths per 1,000 births in 2020, a 7.7% increase. The stillbirth rate is now similar to the rate observed in 2018.

In 2021, the stillbirth rate increased for the majority of months compared with 2020, with the exceptions of March and April. In addition, the monthly rates from February to June 2021 were the only months below the five-year average (Figure 4). The highest stillbirth rates were in January 2021 and December 2021, 4.7 and 4.6 stillbirths per 1,000 live births, respectively. The rates by month are still within the plausible range we might expect to see from random variation. For context, in 2018, the last time the total stillbirth rate was 4.2 stillbirths per 1,000 births, the highest monthly rates were 4.8 and 4.7 stillbirths per 1,000 births, during February and March 2018.

The number of stillbirths in 2021 increased across all maternal age groups, except for women aged 20 to 24 years where it decreased from 372 stillbirths in 2020 to 364 in 2021. Women aged under 20 years had the largest percentage increase in stillbirth rates between 2020 and 2021, with the stillbirth rate rising from 4.4 stillbirths per 1,000 total births to 5.3 stillbirths per 1,000 births (20.5%).

The provisional total fertility rate (TFR) increased across the majority of regions in 2021. The West Midlands was the only English region to see any decrease in TFR compared with 2020, falling from 1.65 to 1.64 children per woman. The TFR in Wales remained the same as 2020, at 1.48 children per woman.

In 2021, Yorkshire and The Humber saw the largest increase in the stillbirth rate, from 3.8 stillbirths per 1,000 total births in 2020 to 4.7 in 2021. London was the only English region to witness a decrease in 2021 compared with 2020, falling from 4.4 to 4.3 stillbirths per 1,000 total births.

Figure 5: The South West had the lowest stillbirth rate in 2021

Stillbirth rate by area of usual residence of mother in Wales and English regions, 2011 to 2021

Download the data

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We also explored other variables such as gestational age, birthweight or type of place of birth and found patterns to be consistent with our previous releases. The data for these variables can be found in our downloadable data tables.

Live birth

A baby showing signs of life at birth.

Stillbirth

A baby born after 24 or more weeks completed gestation and who did not, at any time, breathe or show signs of life.

Total fertility rate (TFR)

The average number of live children a group of women would have if they experienced the age-specific fertility rates for the calendar year in question throughout their childbearing lifespan.

General fertility rate (GFR)

The number of live births in a year per 1,000 women aged 15 to 44 years. Measure of current fertility levels.

Traditionally, our birth statistics for England and Wales are derived from information recorded when births are registered as part of the civil registration process. Where relevant, we link birth registrations to their corresponding NHS birth notification to enable analysis of further factors such as gestational age and ethnicity of the baby. The birth notification is a document completed by the doctor or midwife present at the birth.

Birth registrations in England and Wales have been delayed because of the coronavirus (COVID-19) pandemic. We are monitoring registrations regularly and are working to ensure that our final birth registration data are as complete as possible before publication.

In this release we have used NHS birth notification data to provide more timely estimates of births in England and Wales. The birth notification is a document completed by the doctor or midwife present at the birth.

The NHS birth notification figures presented are based on births that occurred in 2021. To make direct comparisons over time, we have compared these figures with birth notification figures for previous years. The statistics in this release are provisional and are not directly comparable with other releases, which are derived using birth registrations.

For more information on data sources and quality, please see sections 2 and 10 of our provisional births: 2020 release, which contains information on NHS birth notifications and our fertility rate adjustment methodology.

For more information on the impact of the coronavirus (COVID-19) pandemic on births data and the differences between birth registration and birth notification data, please see our births explained article.