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Ninety percent of the differences across countries in total fertility rates are accounted for solely by differences in women's reported desired fertility. Using desired fertility constructed from both retrospective and prospective questions, together with instrumental variables estimation, it is shown this strong result is not affected by either ex-post rationalization of births nor the dependence of desired fertility on contraceptive access or cost. Moreover, despite the obvious role of contraception as a proximate determinant of fertility, the additional effect of contraceptive availability or family planning on fertility is quantitatively small and explains very little cross country variation. These empirical results are consistent with theories in which fertility is determined by parent's choices about children within the social, educational, economic, and cultural environment that parents, and especially women, face. They contradict theories that assert a large causal role for expansion of contraception in the reduction of fertility.
Lant Pritchett (Tue,) studied this question.