In this paper, we leverage newly available rich administrative data to study the heterogeneous evolution of fertility and newborn health during the pandemic. We focus on Tuscany, a representative region of Italy, which was one of the first countries to experience the severe impact of the COVID-19 outbreak in early 2020. Our findings indicate a decline in the number of births relative to the pre-pandemic trend in late 2020 and early 2021, roughly nine to twelve months after the pandemic onset. However, starting in March 2021, birth numbers consistently exceeded the pre-pandemic trend, resulting in a cumulative “baby bump” compared to the counterfactual scenario. This aggregate increase conceals significant heterogeneity across sociodemographic groups, with positive deviations entirely driven by native, educated, and employed parents. During the same period, newborn health indicators showed no signs of deterioration and, if anything, slightly improved.

Neonatal mortality is one of the leading causes of under-five mortality globally, with the majority of these deaths occurring in low- and middle-income countries. In Ghana, there is a belief in an array of newborn conditions, called Asram, that are thought to have a spiritual, rather than physical, cause. These conditions are predominantly managed by traditional healers as they are considered unable to be treated by allopathic medical providers. Through a series of semi-structured qualitative interviews of medical providers in Kumasi, Ghana, conducted in July–August 2018, this study sought to elucidate perspectives of allopathic medical providers about Asram, including the perceived implications of traditional newborn care patterns on newborn health and higher-level neonatal care. Twenty health care providers participated and represented a tertiary care hospital and a district hospital. Medical providers were universally aware of Asram but varied on the latitude they gave this belief system within the arena of newborn care. Some providers rationalized the existence of Asram in the backdrop of high neonatal mortality rates and long-standing belief systems. Others highlighted their frustration with Asram, citing delays in care and complications due to traditional medical treatments. Providers utilized varying approaches to bridge culture gaps with families in their care and emphasized the importance of open communication with the shared goal of improved newborn health and survival. This study describes the importance of providers being aware of socio-cultural constructs within which pregnant women operate and suggests a focus on the shared goal of timely and effective newborn care in Ghana.