The debate surrounding the use of period, cohort, and tempo-adjusted measures has framed most of the recent studies evaluating the utility of macro-level fertility indicators. Period measures are susceptible to distortions, due to birth timing changes, but there is currently no universally accepted adjustment technique. Recent comparative analyses have offered some insights but only as applied to the low-fertility developed world setting. The utility of different types of measures in the high fertility context is unclear. Furthermore, regional variation in the pace of fertility transition is characteristic of many less developed countries and is rarely incorporated into macro-level analyses. The purpose of this analysis is to evaluate macro-fertility indicators at the regional and national levels in a high-fertility country, Guatemala, using the four most recent survey data sets. The results support the use of macro-level period indicators and adjusted period indicators of fertility in developing country contexts.