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Competing hypotheses exist with regard to how men’s and women’s pregnancy desires and intentions are associated with births among contemporary heterosexual couples. There are compelling cultural and structural reasons to support either the hypothesis that men’s desires and intentions (patriarchal) or that women’s desires and intentions (matriarchal) will have more influence, or that both partner’s desires and intentions will be associated with births (mutual influence). In addition, patterns of change are likely to differ for couples that have children at wave 1 compared to those who do not. Path analyses of the of heterosexual couples (n = 615) who completed both waves of the National Survey of Fertility Barriers support the matriarchal hypothesis, because among couples without children, only women’s desires were associated with subsequent births. Among couples with children, men’s characteristics and desires are indirectly, and women’s are directly, associated with subsequent births, indicating support for the mutual influence hypothesis.