The objective of this study was to determine if higher fertility and lower contraceptive use among the poorer segments of society should be considered an inequality, reflecting a higher desire for large families among the poor, or an inequity, a product of the poor being prevented from achieving their desired fertility to the same degree as wealthier segments of society. Using the most recent Demographic and Health Surveys from 41 countries, the study analysed the differences in fertility in light of modern contraceptive use, unwanted fertility (defined as actual fertility in excess of desired fertility) and the availability of family planning services found among poorer and wealthier segments of society. The asset index in each survey was used to construct wealth quintiles and the concentration index (CI) of income inequality was found in health variables.