Chapter 3 is devoted to the demographic impact of the famine in terms of mortality, fertility, and its long-term biological effects. It shows that in the entire crisis period of September 1944-July 1945, the estimated war-related excess deaths among civilians was 35,000 in the three famine-exposed western provinces. Deaths in the large conurbations began to rise sharply after December 1944 and reached a peak in March 1945. It took until the summer of that year before mortality reached normal patterns again. Fertility followed similar patterns, with birth rates in the urban west two to three times lower in the famine’s wake. The long-term effects of the famine are present even today, in adults who were conceived or born during the famine.