Labor Day is a chance to reflect on and celebrate workers, the people who get things done and keep our society running. But given this year’s horrific Supreme Court decision overturning Roe v. Wade, I’ve been thinking a lot about the other most famous kind of labor — the labor of giving birth — and what the decision on Dobbs v. Jackson means for people who can get pregnant.

Nurses know firsthand just how much work goes into giving birth for our patients, especially if we’re labor and delivery nurses or parents ourselves. I’m an emergency room nurse, but I’m also a mom, so I know that the miracle of birth isn’t always so miraculous in the moment. Yes, there’s joy and celebration, but there’s also a lot of pain and hard work.

And that’s just the beginning. Without a system like Medicare for All, the costs of giving birth can be astronomical. And after birth is when the real work and costs of raising children start to stack up, eventually totalling more than $300,000 per child, according to one recent analysis. In addition to the high costs of high-quality health care in the U.S., including for people giving birth, our lacking social safety net often fails to support parents in the work (and costs) of raising children, and these same parents may already be workers at multiple other jobs to support their families. That lack of support isn’t limited to health care, as the process of raising children has other costs — expenses like food, housing, clothing, childcare, and education.

As a highly gendered workforce, nurses know that most care work is assumed to be the responsibility of women and mothers. I’ve seen it myself in the ways it’s always assumed I have my act together as a mom while dads often aren’t viewed the same way. This gender dynamic, coupled with the simultaneous denial of trans people’s reproductive rights and health care needs, helps uphold the same systems of gendered oppression that devalue our labor as nurses due to stereotypes about our profession and gender.

Despite all this, most parents would tell you that all the work is worth it. Because even though executives may only see the next generation of workers when they look at our kids, we see our children in all their beauty, joy, and humanity. We’re with them through the good times and the bad, putting in the work to help them find their way in life.

I love being a mom to my kids and take my job as a parent seriously. I am in charge of raising human beings who will determine the future. It’s an everyday commitment, a financial and emotional journey. In fact, I’m able to support the children I have now — both financially and emotionally — because I had the right to make a choice that determined the trajectory of my life.

When I made my choice, I was fresh out of college with no sense of direction and pregnant. We weren’t ready to be parents. I was even on birth control at the time, but no contraception is ever 100% effective. Luckily, I had the right to choose. It made it possible to pursue my career and my family on my own terms — autonomously!

Forcing women to have children when they’re not ready is an injustice. We have so many problems in the world. I didn’t want to be forced into parenting, and I wasn’t. My life and my kids’ lives are better off for it.

In a society that demands labor of so many of us, having control of the kinds of labor we’re called to do on a daily basis has life-changing implications. The decades-long campaign to take these choices away is basically a campaign to institute forced birth on anyone who gets pregnant. The people taking away choice don’t care about the potential medical complications, whether they’re physical or mental. People with the ability to give birth are being treated as a separate class with freedoms denied.

Given that these resources and support are often denied in the U.S., this campaign for forced birth is also a campaign for forced work. This is especially true when accounting for other factors like race, immigration status, region, or income level, all of which can further limit an individual’s access to resources and escalate the demands for labor in their lives.

As we face attempts to criminalize reproductive health care, it’s important to remember the realities of the criminal justice system, as well. Many believe slavery was abolished, but in reality, it was reformed, as the U.S. Constitution’s 13th Amendment outlaws slavery and involuntary servitude except as a punishment for a convicted crime. Given recent attempts to criminalize abortion access, it is alarming that many could be left not with choices of determining their own future, but only a choice between the forced labor of birth or the forced labor of prison.

With so much emphasis on letting individual states decide the legal status of abortion access, there’s another unnerving echo in history for me. Slavery and racism: We know how that went when we left it up to states. The federal government had to step in.

We must protect and advance everyone’s rights to bodily autonomy, personal choice, health care access, labor justice, and economic freedom. We need lawmakers to step up to protect these rights, just as we need voters to make their voices heard when this issue comes to the ballot box. Voters in Kansas have already shown how important this issue is to people across the country. Collective bargaining has long been an effective way to protect workers’ rights, and we believe it can be on this issue, as well.

Nurses will always stand with our patients because we know abortion is health care and health care must not be denied. I’ve been in that position myself, wondering how a pregnancy would change my life. I had the ability to make a choice that helped me create the future I wanted for myself. Everyone else deserves the same.

Mawata Kamara, RN, is an emergency department nurse at San Leandro Hospital in San Leandro, California, and a board member of the California Nurses Association.