The objective of this chapter is to report the main results of an extensive study of the trends in fertility and child mortality in the regions and counties of England and Wales. The period covered by the study is from the establishment of vital registration, effectively in the fifth decade of the nineteenth century, to the present. The full examination and presentation of the data are contained in Mohammad Kabir’s doctoral thesis. Here attention will be concentrated on the earlier stages of the demographic transition (say from around 1875 to 1915), although some use will be made of measures outside this range for comparisons. With this limitation of the period it can be assumed that the basic records of census and vital registration from which the measures are derived were of high accuracy, certainly relative to the purposes for which they are used.