Abstract Declining fertility and the persistent underrepresentation of women in the labour market are key concerns of our time. The fact that they overlap is not fortuitous. Traditionally, women everywhere have faced a conflict in balancing their career ambitions with family responsibilities. Yet, the pressures arising from this conflict vary enormously from one place to another. Existing research has tended to overlook the geographical features of this dilemma, which could result in an inadequate understanding of the issue and lead to ineffective policy responses. This article examines how variations in the quality of regional institutions affect women’s capacity to reconcile career and motherhood and, consequently, gender equality within Europe. Using panel data from 216 regions across 18 European countries, we uncover a positive effect of regional institutional quality on fertility rates, taking into account variations in female employment. Moreover, we show that European regions with better government quality provide a more reliable environment for managing the career/motherhood dilemma often faced by women. In contrast, women living in regions with weaker government institutions are more constrained in both their career and childbearing options.