Introduction . While the impact of the COVID-19 pandemic has been most tragically evident in the number of deaths it caused, it has also affected fertility and immigration. From the onset of the COVID-19 pandemic through December 2022, 1.07 million deaths from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recorded in the United States (U.S.). The number of excess deaths is estimated even higher, at 1.23 million1. This has contributed to a dramatic decline of 2.7...