Current health care reform is resulting in increasing demands on women to care for others. Little is known about the process of women's caring or the effects of caring on women. This feminist grounded theory study resulted in a substantive theory that explains how women manage the problematic aspects of caring and explicates the ways that environment influences women's responses to caring demands. Of particular concern is the evidence that the existing social structure creates and intensifies problems for women caring. The discussion considers the implications of the findings for health policy and nursing practice.