Total fertility rates in sub-Saharan Africa are nearly double that of any other region in the world. Some argue that providing contraceptives has only a negligibly small impact on fertility. I exploit exogenous, temporary reductions in contraceptive supply in Ghana, resulting from cuts in US funding, to examine impacts on pregnancy, abortion, and births. Women are unable to fully compensate for the 10%–16% supply reduction using traditional methods for preventing pregnancy, which increases by 10%. Only nonpoor women offset these unwanted pregnancies with induced abortion. Using separate data, I find that poor women experience increases in realized fertility of 7%–10%.