No. In underdeveloped regions, high birth rates among those living in extreme poverty are partly a response to high child mortality – when a child is less likely to survive, parents are likely to have more children. However, investing in water and sanitation helps address this by improving health and reducing child deaths. A reduction in child mortality leads to a reduction in the need for families to have more children. High birth rates can also be a symptom of a lack of women’s empowerment. Access to water and sanitation, and the time-savings and health benefits they bring, has been shown to increase girls’ school attendance and women’s opportunities. Improving girls’ education and women’s social status are important factors in producing smaller, healthier families.