Many women founded the first marks of civilization in their areas, including schools and churches. Women often met with other women at church and had many superficial friendships to repel loneliness. Health care on the frontier was the responsibility for women, as very few doctors were available. If an entire household fell ill, a neighboring woman was responsible for nursing them back to health. Childbirth also weighed on women as a risky proposition that often resulted in the death of the mother. As a result, the process was feared, dreaded, and often went unmentioned in diaries from the period. The pressures of childbirth, being the primary health care provider and chief farm operator upon their husband's departure gave many frontier women anxiety.