Female mammals experience a very high and often unappreciated rate of reproductive failure. Among human pregnancies alone, over 50 per cent fail between conception and parturition, and the majority of these failures are unexplained. These findings present important problems for evolutionary theory as well as for health care practices. This paper addresses these high rates of reproductive failure among mammals, by extending the work of a number of evolutionary biologists regarding the reproductive consequences of environmental adversity. The basic model upon which we elaborate, termed the Reproductive Suppression Model, argues that females can optimize their lifetime reproductive success by suppressing reproduction when future conditions for the survival of offspring are likely to be sufficiently better than present ones as to exceed the costs of the suppression itself. These costs are a function of reproductive time lost and the direct phenotypic effects of the suppression itself. To evaluate the benefits and costs of suppression, the following types of cues should be assessed: the female's physical and mental health, her stage of reproduction, the physical and genetic status of her offspring, and the external conditions at the time of birth. We also examine various issues of social suppression, whereby the conditions for survival of offspring are a function of the reproduction and support of other group members. Under such conditions, some females may be able to improve current conditions for reproduction by suppressing the reproduction of others. Field data from our own work are presented, describing socially mediated reproductive competition among continuously breeding female yellow baboons and among female hoary marmots. Social suppression in other mammals is also evaluated, including that in human beings, and we conclude with some implications of the Reproductive Suppression Model for sexual selection theory regarding female-female reproductive competition, as well as human health care.