Should governments implement policies that affect fertility decisions on efficiency grounds? What is the correct notion of efficiency to use? To address these issues, this paper develops an extension of the notion of Pareto efficiency, referred to as "Millian efficiency", to evaluate symmetric allocations in an overlapping generations setting with endogenous fertility. This extension is based on preferences of those agents who are actually alive, and exclusively allows for welfare comparisons of symmetric allocations. First, we provide necessary and sufficient conditions to determine whether an allocation is Millian efficient or not, and we show that the sufficient conditions for dynamic efficiency offered by Cass (1972) and Balasko and She...