The fertility of Latin America is gradually decreasing as it determinants exert their influence on the number of births: economic development, the participation of women in the workforce, rural urban travel, motivation and preference for girls families, changes in intermediate variables, etc., lead to lower fertility figures in the near future. It is difficult to foresee the rate of this decline, but the experience observed in Costa Rica is an example of rapid changes in this variable. The doctor and especially the ob-gyn, have increased public demand for medical care in relation to the changes and reduced fertility.