The idea that mortality decline precipitates fertility decline is a linchpin of demographic transition theory. At the aggregate level, two questions have focused on the demographic future of developing countries: Would fertility declines accompany mortality declines? How would population growth rates change as mortality declined? Stimulating interest at the family level is the notion that a couple's fertility is in part a product of the mortality environment in which they are building a family. Study results show that for certain groups of women, a child's death changes the fertility pattern of subsequent interval lengths relative to that pattern when a child survives. However, the changes are small in magnitude. It is unlikely that they have serious implications for completed levels of fertility or contribute to poor health for mothers or their offspring.