Economists have often argued that high fertility rates are mainly driven by women’s demand for children (and not by family planning efforts) with low levels of unwanted fertility across countries (and hence with little room for family planning efforts to reduce population growth). We study the relationship between wanted fertility and number of children born in a panel of 200 country-years controlling for country fixed effects and global time trends. In general, we find a close relationship between wanted and actual fertility, with one desired child leading to one additional birth. However, our results also indicate that in the last 20 years, the level of unwanted births has stayed at 2 across African countries but has, on average, decreased from 1 to close to 0 in other developing countries. Hence, women in African countries are less able to translate child preferences into birth outcomes than women in other developing countries, and forces other than fertility demand have been important for previous fertility declines in many developing countries. Family planning efforts only partially explain the observed temporal and spatial differences in achieving desired fertility levels.