This article examines the macro-level linkages between the cultural position of women and fertility levels in India. A major aim is to see whether the various dimensions of patriarchy are separable and distinct in their relationship to regional variations in fertility levels. District-level data, compiled primarily from the 1981 census and some secondary sources, are used to test the argument that fertility is lower in the districts of South India, where kinship and economic patterns are favorable to women, than in North India, where such patterns are less favorable. Three specific dimensions of patriarchy are examined: the marriage system, means of active discrimination against women, and women's economic value. The results confirm a strong macro-level relationship between patriarchy and fertility levels in India, both with and without controls for development and social stratification. The fact that indicators of social development show a strong negative relationship with fertility provides support for policy initiatives directed at not only women's, but general, welfare.