Mother St. John worked to restore the congregation as she knew it before the Revolution: little groups of Sisters living close to the people, wearing ordinary dress, visiting the homes of people who were sick and poor and helping all in need. But soon, the Sisters were required by the government to organize into a new pattern, much of it contrary to the vision of the founding Sisters. Their major work would be education, although the people they served would not be abandoned. The formerly independent small houses would be no more; instead, centralization into diocesan congregations would be the order of the day.
Although this move deprived the Sisters of the autonomy that allowed them to adapt readily to local conditions and the needs of the people, it provided the means for expansion. The Sisters spread out in France and to other countries as well. By the end of the 19th century, they were to be found in Italy, the United States, Canada, Norway, Sweden, Denmark, Iceland, Russia, India, England, Switzerland, Armenia, Algeria, Brazil and Argentina.
By 1830, the Sisters were wearing an official habit for the first time. All these changes, so far removed from their previous simplicity, were a source of great pain to Mother St. John. Nevertheless, she submitted to the will of the state-dominated Church. She died in 1843 after establishing more than 200 religious houses in France and planting the seeds of more than 40 new Congregations of Sisters of St. Joseph in the world.