This report provides evidence on the lived experiences of women in low-income families, as they strive to balance their paid work and unpaid care work responsibilities. It presents the findings of a mixed-methods research project carried out in India, Nepal, Rwanda, and Tanzania during 2015–17. The findings of the research are clear and strong: that while women welcome the chance to earn income of almost any kind, their paid work options are few and poorly paid, and by no means contribute to their ‘economic empowerment’. Most women reported effects that can only be catalogued as physically and emotionally depleting. Further, an imbalance between paid work and unpaid care work was also found to have significant depleting effects on children, because of a reduction in the amount and quality of care they received, and their augmented roles as substitute providers of care and unpaid helpers at both home and their mother’s paid work. A key conclusion of this study is that this drudgery and resultant depletion faced by women and their families is neither an inevitable nor a necessary consequence of women’s engagement in paid work. The report analyses the extent to which existing women’s economic empowerment policies and programmes can achieve empowerment for women. It calls for changes in macroeconomic contexts and urgent prioritisation of removing the structural barriers to women’s empowerment.