The article analyzes differences in the interrelations between family (or demographic) policy and fertility in familist and paternalist societies. It is argued that explanations of such differences based on multiple modernities theory and institutional approach are more comprehensive and better consistent with the empirical data than those presented by second demographic transition theory. The paternalistic nature of state-family relations caused an earlier launch of pronatalist measures, such as paid maternal leave in Soviet Russia in 1981 and “speed premium” in Sweden in 1986, as compared with Japan and South Korea, in which familism long prevented to implement the similar measures. Besides, in both Russia and Sweden fluctuations of fertility, due to its procyclical changes and jumps in response to pronatalist policy measures, were much stronger than in Southern Europe, South Korea and Japan. Although transmission of family loyalty patterns to corporative sphere strongly contributed to successive economic and technological modernizations of Japan and South Korea, it had a negative effect on fertility. Due to peculiarities of modernization, in Russia, as well as in Japan and South Korea, paternal leaves, unlike the Scandinavian countries, are still not popular. While solidarity of family members continues to play a vital role, it cannot provide for satisfactory level of fertility today and should be supplemented by policy aimed at increase of fertility.