Among U.S. women born 1957–64, 63% of the lowest cognitive-skill quartile give birth before 22, against 18% of the highest. The gap is in unintended births, opens in high school, survives family background. In a life-cycle model where skills shift adherence—reliability of use—beyond wages and schooling, common adherence is rejected: it fits neither first-birth timing by skill nor within-method failure. Equalizing adherence cuts births by 21 by 16%, mostly for low-skill women; removing contraception’s cost does nearly as much, but its gains go to the high-skilled. Adding a long-acting method matches the fall in births Colorado’s program achieved.