Life history theory predicts that where resources are limited, investment in reproduction will cause a decline in body condition and ultimately may lower survival rates. We investigate the relationship between reproduction and mortality in women in rural Gambia. We use a number of different measures of reproductive investment: the timing of reproduction, intensity of reproduction, and cumulative reproductive investment (parity). Though giving birth is clearly a risk factor for increased mortality, we find limited evidence that the timing, intensity, or cumulative effects of reproduction have a survival cost. Instead, there is some evidence that women who have invested heavily in reproduction have higher survival than women with lower reproductive investment: both high parity and late age at last reproduction are associated with high survival. The only evidence for any cost of reproduction is that women who have given birth to twins (considered a marker of heavy investment in reproduction) have higher mortality rates than other women, after the age of 50 years. A potential confounding factor may be differences in health between women: particularly healthy women may be able to invest substantially in both reproduction and their own survival, leading to the positive correlations between survival and both parity and age at last birth we observe. To control for differences in health between women, we reanalyze the relationship between reproduction and mortality but include variables correlating with health in our models (height, BMI, and hemoglobin). Even when controlling for health, the positive correlation between investment in reproduction and survival remains unchanged.