When America entered World War I, American women were already in the workforce. Their employment opportunities expanded beyond traditional women's professions, and women worked in clerical positions and especially in garment and textile factories. During the war, women held jobs previously reserved for men, including work in transportation and construction as well as war production. Four hundred and three women were on active duty in the Army Nurse Corp during the war, increasing to over twenty thousand by the end of the war, with ten thousand of the nurses serving overseas. More than 200 nurses died in service, and twenty three received the Distinguished Service Medal.