In this note, we examine how family size preferences evolved for women with and without children in response to changing COVID-19 mortality exposure during the first two years of the COVID-19 pandemic. We leverage spatiotemporal variation in COVID-19 deaths occurring during panel surveys in 2020 and 2021 with a population-based sample of 2,520 women, ages 18–34, across 94 municipalities in Pernambuco, Brazil. We use individual fixed-effects regressions to examine whether changes in municipality-level COVID-19 death rates are associated with changes in women’s desired family size, net of own/family COVID-19 infection status and other time-varying sociodemographic factors. We find that women with and without children at baseline respond differently to changing municipality-level COVID-19 deaths—while women without children do not change their desired family size, women with children see a small but significant increase in their desired family size in response to rising COVID-19 mortality. These innovative findings suggest that women with children responded to widespread COVID-19-related loss within their communities by wanting to build and consolidate their families. We advance knowledge about varying contextual influences on fertility preferences during epidemics in a middle-income country with young and below-replacement fertility.