We investigate women's fertility and labor force participation responses to the large declines in both child and maternal mortality that occurred following a plausibly exogenous medical innovation. The decline in child mortality led women to delay childbearing and have fewer children overall. Fewer women had three or more children, and a larger share remained childless. We present a new theory of the extensive margin response, premised upon reductions in child mortality reducing the time women need to achieve their target number of children. This prompts fertility delay and labor market entry which, coupled with wage or fecundity shocks, can result in childlessness. Consistent with these predictions, we find that reductions in child mortality increased women's labor force participation, improved their occupational status and reduced their chances of ever having married. Maternal mortality decline had opposing effects on all of these outcomes.
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