As the new nation solidified its identity, early republican ideology increasingly emphasized that women’s most valuable contributions to the American republic came through domestic work. This shift profoundly affected women’s participation in medical care. When Dr. Benjamin Rush briefly offered instruction on the “principles of natural philosophy, chemistry, and medicine” to women at the Young Ladies’ Academy in Philadelphia in 1787, he justified women’s (theoretical) medical education not as preparation for professional practice, but for healing within their own households. The cultural value put on housewives’ unpaid domestic caregiving lowered the monetary value of waged nursing work. In combination with the rise of professionalized medicine, the number of marketable avenues available for women with medical skills gradually declined.