Policymakers in many countries, including the Russian Federation, are attempting to encourage fertility as part of their response to the challenge of population aging. Whether pro-natalist policies will be effective depends crucially on how well they address the underlying causes of low fertility and barriers to larger family size. While in some countries in Western Europe postponing childbearing and increased childlessness seem to be driving the fertility decline, these factors do not appear to be as influential in Russia. Instead, the problem seems to be the relatively low frequency of second and higher-order births, which persists despite major changes to pro-natalist policies introduced in 2007 and the prevalence of the two-child ideal of family size. This study analyzes current and prospective fertility trends in contemporary Russia, with special attention to second-child birth dynamics and its determinants. Stable employment and accessibility of formal childcare options are found to be factors that are correlated with mothers preferences for additional children and the probability that they will have a second child. In light of this observation and international experience, a menu of policies to improve work-family balance is suggested.