In the NLSY79, 69% of women in the lowest cognitive ability quartile have a first birth before age 22, compared with 22% in the highest. This gradient persists within education groups and within contraceptive method, suggesting that neither education sorting nor method selection fully accounts for it. I estimate a life-cycle model in which cognitive ability shifts the effectiveness of fertility control, beyond standard opportunity-cost channels. Restricting effectiveness to be equal across ability groups causes the model to underpredict the ability–fertility gradient by a factor of five. Equalizing effectiveness to high-ability levels reduces births before age 22 by 50% and raises college attendance by 15%. A cost-reduction policy generates welfare gains of 10% of lifetime consumption for the lowest ability quartile but near-zero gains for the highest, suggesting that improving effectiveness matters more than reducing cost for disadvantaged women.