Contrary to all expectations, Bulgaria's birth rates did not increase during the pandemic, dropping from 54,762 births in 2019 to 53,968 in 2020, according to an analysis based on the data of the National Health Insurance Fund (NHIF).

The year-on-year plunge of 794 births makes 2020 yet another year of falling birth rate in Bulgaria. Last year's deliveries were disproportionately distributed among 105 medical institutions. Thirty hospitals each registered over 1,000 births in 2020, six each assisted over 2,000 deliveries, and four of them are in Sofia: Maichin Dom (3,397 births), Sheinovo (2,285), St. Sophia (2,233), Nadezhda (2,045). Plovdiv's Selena Hospital (2,279) and Varna's Prof. Dimitar Stamatov Hospital (2,001) are in the same group. Another 14 hospitals each registered under 100 births last year. The lowest rates (under 50) we reported by smaller municipal hospitals in Kavarna, Kubrat, Madan and Belogradchik.

The share of C-section deliveries was 47 per cent, almost equal to the number of natural births. The two methods were favoured
disproportionately by Bulgaria's medical institutions. Nearly 40 percent of hospitals carried out more C-sections than the
country's average. Meanwhile, there were also hospitals where 100 percent of the births were natural: St. Petka Bulgarska
Hospital in Nova Zagora (122 births), Belogradchik Hospital (44)
and Ihtiman Hospital (91), among others.

The mortality rate during birth stands firmly under 1 per cent. It was 0.62 percent last year, up from 0.52 percent in 2019. The
highest mortality rates (2 or even 4 per cent) were registered in three hospitals with fewer deliveries in Vidin, Nova Zagora
and Belogradchik.

In 2020 the share of premature births dropped by 1 percent compared to 2019, reaching 12.37 percent.