Content Warning: This section discusses death by suicide, miscarriage, abortion, and sexual assault.

Marshall contends that bodily autonomy is central to self-determination and a person’s ability to control their fate. Further, the author portrays reproductive rights as an essential component of that bodily autonomy, using the central characters’ arcs to show the cascading effects that an unplanned pregnancy can have.

Evelyn and Maggie are denied bodily autonomy when they are forced to live at St. Agnes’s and to give their children up for adoption. This lack of control over their own bodies begins a chain of events that drastically alters the course of their lives. For Evelyn, the trauma and grief of losing her child leads her to suicide. Maggie responds by violently attacking Sister Teresa and attempting to die by suicide as well. Eventually, Maggie (under the name Evelyn Taylor) is motivated by her experience at St. Agnes’s to dedicate her life to defending the bodily autonomy of others through her work with the Jane Network.

Marshall uses abortion rights as the central lens through which to portray reproductive rights as an essential component of bodily autonomy. Inability to access legal abortion leads Clara (Nancy’s cousin) to seek a dangerous underground abortion.