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We survey the literature on sub-Saharan Africa to identify how gender has factored into explaining fertility levels and behavior. Tracing the development of male role theory, we argue that despite increasing awareness of men's authority, fertility research continues to focus almost exclusively on women and treats gender as a property of individuals instead of as a system of inequality. The mainstream fertility literature generally overlooks the decision-making nexus wherein men's authority seemingly overrides women's preferences. Positing that male authority in the reproductive and sexual arenas is predicated on cultural rights negotiated at marriage—and undergirded by bridewealth payments—we contend that attempts to understand (and change) reproductive behavior will hardly be sustainable without attention to this contextual realm. In that vein, we speculate that efforts to empower women (via increased education, occupational opportunities, microcredit schemes, etc.) may hardly yield sustainable outcomes without concurrent efforts to alter cultural distributions of gendered power.