The Battle of Wilson's Creek in 1861 showed that military medical services on both sides were ill prepared and ill equipped to treat and transport wounded soldiers. Civilian social reformers organized relief societies based on models from the eastern United States. The Ladies' Union Aid Society (LUAS) provided medical supplies and services to Union soldiers, freedmen, orphans, and refugees. The Western Sanitary Commission (WSC) was established to organize conditions in hospitals and camps and worked in concert with LUAS. These types of organizations became increasingly important during the war as advancements in weapons technology and unsanitary conditions contributed to hundreds of thousands of casualties on the battlefield.

The Ladies' Union Aid Society was an independent organization operated by prominent St. Louis women, but it served under the auspices of the male-dominated WSC. Still, the positions of responsibility—particularly as nurses on battlefields and as organizers of fund-raising fairs—that women held in LUAS and in other charitable organizations during the war challenged attitudes about women's capabilities and their place in society.