Sub-Saharan Africa (SSA) accounts for around 40% of projected global births over the next 80 years. To investigate the roots of persistently high fertility rates across the region, I assemble micro data from 192 Demographic and Health Surveys covering 66 low-and-middle-income countries and document three key facts. First, women’s fertility ideals and intentions are, on average, substantially higher in SSA than other low-and-middle-income regions. This gap is particularly large among poorer households: the socioeconomic gradient in desired fertility is twice as steep (more negative) on the sub-continent. Second, poorer women are also significantly less likely to work for a wage in SSA, where there exists a robust negative relationship between female wage work prevalence and desired fertility across provinces. Third, exploiting within-SSA variation across 25 countries, I find that increases in female salaried employment opportunities at the province level are associated with a flattening of this gradient over time, conditional on a rich set of covariates. These findings provide suggestive evidence that the nature of SSA’s occupational change process may be an important contributor to the region’s distinct fertility transition.