Extensive demographic scholarship shows that the population-level implications of mortality crises such as the COVID-19 pandemic extend beyond mortality dynamics to affect fertility and family-formation strategies. Using novel municipality-level data from Chile covering all births that occurred between January 2017 and December 2021, this study explores trends in fertility and implications of the COVID-19 pandemic for “quantum” and “quality” of births in the Chilean context. Building both a monthly and a yearly panel of 346 municipalities and leveraging fixed-effects regression analyses, we focus on births and crude birth rates to measure quantum, while quality is assessed through the share of births that are low-weight (LBW) and preterm (PTB). Our findings provide evidence of a significant drop in fertility in the wake of COVID—of the magnitude of a reduction of 1.3 live births per 1,000 individuals—which reaches a minimum around February 2021, followed by an incipient rebound in late 2021. Moreover, estimates on child health at birth suggest that the COVID period was associated with an increase in LBW and, foremost, PTB, by 1 and 2.2 percentage points, respectively. Findings from this study shed light on the role of policy interventions in the health arena and the linkages between short- and long-run effects in relation to the various COVID-19 waves in Chile.