In the commercialized United States of the early twenty-first cen­tury, then, household members still remain the principal providers of care to other household members. No doubt that household con­centration of caring services reinforces the supposition of a sharp division between the diffuse, sentimental, and noncommercial world of the family and the specialized, impersonal, and commercialized world of goods and services outside the family. We have already seen a major flaw in that division: the incessant buzz of economic production, consumption, distribution, and transfers of assets within households, not to mention in links between households and their kin elsewhere. But caring relations also regularly cross household

and kin boundaries, and just as regularly occasion the creation of differentiated ties involving well-defined economic transactions be­tween providers and recipients of care. As Francesca Cancian has argued forcefully, the commercialization of caring services by no means blocks the provision of personalized, caring attention.[35]

In North America, some kinds of care provided within households by persons based outside date far back in history. Take the case of midwife and healer Martha Ballard. As professional caregiver, Bal­lard occupied a powerful position among the residents of eigh­teenth-century Hallowell, Maine. In Laurel Thatcher Ulrich’s pre­sentation of Ballard’s diary we learn that within a twenty-one-day span in 1787, Ballard “performed four deliveries, answered one ob­stetrical false alarm, made sixteen medical calls, prepared three bod­ies for burial, dispensed pills to one neighbor, harvested and pre­pared herbs for another, and doctored her own husband’s sore throat” (Ulrich 1991: 40). Thus, as Ulrich remarks, in modern terms Ballard “was simultaneously a midwife, nurse, physician, mortician, pharmacist, and attentive wife” (40).

As midwife, Ballard intervened repeatedly at crucial moments in household lives. In the 1790s, her typical fee of six shillings for man­aging a birth equaled her husband Ephraim Ballard’s daily income in his professional activity as surveyor. It sometimes greatly ex­ceeded it, when some affluent households doubled or quadrupled her standard pay. Ballard carefully recorded her various midwifery payments:

Mr Lathrop paid me my fee for attending his wife the 19th of March last. .. received sugar Nov. 28

Mr Parker gave me 18/ for attending his Lady in her illness with her Last Child… his Lady made me a present of 1# yards ribbin

Received a lb coffee, 1 yd ribbon, & a cap border as Extraordi­nary for waiting on her (197, 199)

As the standard six shilling-fee for childbirth suggests, Ballard generally gauged her fee by the task, not by the time and effort involved. For impoverished families, she reduced or eliminated fees. In one case she sent her husband Ephraim “to see that [Mrs. Welch] had wood, and made her a shovel” (198, 384). Ballard varied the required payment not only by the service and the social relationship but also in the actual form of compensation. She received three main forms of pay: cash, in kind, and store credit. (Sometimes, grateful neighbors also made her gifts in appreciation of her caring services). As Ulrich reports, Ballard received everything from “1m shingles” to “a pair flat irons.” Most payments were in food, textiles, or house­hold necessities: cheese, butter, wheat, rye, corn, baby pigs and tur­keys, candles, a great wheel, unwashed wool, checked cloth, one – half quintal of cod, teapots, thimbles, a looking glass, handkerchiefs, and snuff (1991: 197). Merchants, however, were more likely to pay, often generously, with store credit. Martha Ballard’s caring econ­omy thus interwove subtly with the complex patterns of social rela­tions in this eighteenth-century village.[36]

More than two centuries later, professional caregivers are usually more specialized than Martha Ballard. They range from physicians to morticians. One of the less rewarded professions is commercial home health aid. Studying how changes in Medicare and managed – care financing restructured home caring practices, Deborah Stone interviewed twenty-four caregivers, including nurses, physical therapists, occupational therapists, and home-care aides. She dis­covered a payment system that compensated caregivers exclusively for patients’ bodily care, not for conversation or other forms of personal attention or assistance. She also discovered, however, that home-care workers did not transform themselves into unfeeling bureaucratic agents. They remained, Stone reports, “keenly aware that home health care is very intimate and very personal” (Stone 1999: 64).

Almost without exception, the care providers she interviewed re­ported visiting clients on their days off, often bringing some grocer­ies, or helping out in other ways. The agency’s warnings against becoming emotionally attached to their clients, aides and nurses told Stone, were unrealistic: “If you’re human,” or “if you have any human compassion, you just do” (66). To circumvent an inadequate payment system, home-care workers define their additional assis­tance as friendship or neighborliness. Furthermore, despite agen­cies’ prohibitions against gift giving, caregivers and clients fre­quently exchange presents. Nurses, for example, Stone reports, “often bring flowers, home-baked food, or small items they know a client can use” (Stone 2000a: 109; see also Aronson and Neysmith 1996; Karner 1998: 79). Care workers also manipulate the rules by treating other than the officially approved problems and sometimes even attending to a patient’s spouse’s health. To be sure, as Stone remarks, inadequate payment structures exploit paid caregivers’ concerns for patients. Her interviews conclusively demonstrate, however, that monetary payment systems do not obliterate caring relations. Instead, caregivers actually manipulate the payment sys­tem to make sure they can provide care appropriate to the relation­ship. Once again, we discover a correspondence of media, transac­tions, and meaningful social relations.

Similar processes occur in outsiders’ care of a household’s chil­dren. Historically, child-care workers have long been a part of American households as nurses, wet nurses, nannies, and govern­esses. During the later twentieth century, however, increasing em­ployment of mothers away from home generated an urgent demand for paid child care. A great deal of that care now takes place outside of households, in day-care centers and schools. Still, a majority oc­curs within households (Center for the Childcare Workforce 2002: 6). Many of the in-household caregivers come from minority and immigrant populations. Some of the immigrants, furthermore, lack legal residence, which makes them vulnerable to exploitation.

Child care by outsiders within households poses a series of deli­cate relational problems. Workers are hired to care for children, but they get their employment, pay, and working conditions from parents. They thus have to satisfy two sets of often conflicting du­ties; pleasing the child may sometimes contradict parents’ expecta­tions. If, for instance, the caregiver forms strong bonds with a child, that can complicate relations with the child’s parents. It often leads to competition between parents and caregivers for the child’s af­fection and respect. What’s more, although their caring labor is crucial to the family’s welfare, the workers are typically underpaid and powerless.

In this context, child-care workers’ economic transactions with their employers become delicate and often contentious. At issue is not only assessing hourly or weekly wages. Disagreements range over the household accommodations, the food provided, clothing standards, additional responsibilities such as cleaning and caring for pets, authority of the caregiver over the children’s comportment, and time off from work. These matters go far beyond wages and hours; they symbolize the social standing of the caregiver within the household and the social relations between the caregiver and household members. Mary Romero explains from her own observa­tions how this works:

Before beginning a college teaching post in Texas, I stayed at the home of a colleague who employed a live-in domestic worker. Until then, I had been unaware of the practice of hiring teenage undocumented women as live-in household help. Nor had I had access to the social or “private” space of an employer.

I was shocked at the way my colleague and his family treated the 16-year-old domestic whom I will call Juanita. Only re­cently hired, Juanita was still adjusting to her new environment; her shyness was reinforced by my colleague’s constant flirting.

I observed many encounters that served to remind Juanita of her subservient role. For example, one evening I walked into the kitchen as the employer’s young sons were pointing to dirty dishes on the table and in the sink and yelling, “Wash! Clean!” Juanita stood frozen; she was angry and humiliated. (Romero 1996: 2; see also Romero 1992)

As a result of such complications, child-care relationships within households often end in bitterness on the part of employer and worker. To be sure, household child care divides into several rather different employment contracts; some of the more obvious are the live-in nanny, live-in nanny-housekeeper, the live-out nanny-house­keeper, babysitters, paid kin, plus friends and neighbors who pro­vide child care under a variety of economic arrangements. In Los Angeles, Pierrette Hondagneu-Sotelo distinguishes three kinds of household employment among immigrant Latinas: live-in nanny- housekeepers, live-out nanny-housekeepers, and housecleaners. Her evidence concerning the first two groups comes from interviews of Latina workers and their employers conducted in the mid – to late 1990s, plus a survey questionnaire of the immigrant workers. Her findings show, counterintuitively, that living in provides less eco­nomic leverage to the workers than living elsewhere and coming in to provide child care. One might have thought that the accumula­tion of local knowledge and continuous presence in the household would build up a nanny’s influence, but in fact it increased her vul­nerability to exploitation and degradation.

Live-in nanny-housekeepers studied by Hondagneu-Sotelo worked an average of sixty-four hours a week, often earning less than the minimum hourly $5 wage. These payments, ordinarily in cash, were supplemented by lodging and meals. But the lodging was not always private; the caregivers often slept in the children’s bed­room and were thus on call throughout the night. Food was an even more ambiguous benefit: workers often complained bitterly that employers either provided no adequate food for them, or begrudged them access to any available supplies. One nanny volunteered that a senora had not only complained when she took a bag of fruit but also tried to charge her for it (Hondagneu-Sotelo 2001: 252n). Many of the women ended up using their wages to buy their own food—which was sometimes eaten by their employer’s family.

Clearly, the parties to such work contracts exert very unequal power. Employers of live-in nanny-housekeepers, according to Hondagneu-Sotelo, generally set wages by consulting with their own friends. Candace Ross, for instance, told her by what means she decided how much to pay her first live-in nanny-housekeeper: “I checked that [what neighbors were paying] out, and um, I found a real range. I found a range that went $125 a week on up to like $200, so we started her at $150, which would have been, in my opin­ion, a very good deal” (82). In fact, high-paying parents reported feeling pressure from their nanny-hiring neighbors to bring down the wages they paid (84). At the same time that they relied on their own networks to establish the “going rate,” employers typically tried to inhibit their nanny-housekeepers’ consultation with their coun­terparts in other households. Indeed, Hondagneu-Sotelo found that some employers forbade nannies’ taking children to the park, for fear that other nannies would tell them about better wages or work opportunities.

Many immigrants who began as live-in nanny-housekeepers un­derstandably moved out when they had a chance. Living out not only gave the workers more control over their time and private lives, but also brought them higher wages as well. In some cases, employ­ers of live-out nannies also reimbursed them for out-of pocket ex­penses. Twenty-four-year-old Ronalda Saavedra, for example, got $50 per week for her gasoline expenses. Ronalda “spent a portion of each afternoon driving on errands, such as going to the dry clean­ers and ferrying the children [two six – and nine-year-old boys] home from school and then to and from soccer practices, music lessons, and so on” (38). For live-out nannies, feeding the children became a more central activity. It sometimes involved their bringing in special homemade treats, such as homemade flan or pan con crema. Not all the nanny-housekeeper tasks, however, were so agreeable. Several of Hondagneu-Sotelo’s interviewees, for example, complained about having to take care of the family’s pets, including sick dogs, iguanas, snakes, lizards, and various rodents.

The very unequal negotiations over the details of the nanny’s job recurrently led to what Hondagneu-Sotelo calls “blowups”: “a screaming match that terminates employment” (114). As might be expected, however, some nannies and their employers develop more reciprocal economic relations. In her interviews of upper-middle – class parents and their children’s caregivers in Los Angeles and New York, Julia Wrigley heard from employers who provided a variety of services to the workers. These included money loans, paying medical and dental bills, taking workers to their own doctors, help­ing them negotiate with landlords and creditors, or even getting a caregiver’s relative out of jail. To be sure, some employers resented the additional economic burden. One Los Angeles mother com­plained about her Salvadoran caregiver: “She was only with us for four months, and in that four-month period she managed to borrow money to the amount of $600, and she had a color television that she took home so that her kids could use it” (Wrigley 1995: 90). Both Hondagneu-Sotelo and Wrigley, then, portray caring relations full of tension and negotiation over both their economic contents and their social meanings (see also Rollins 1985). The complexity of their relations increases because—as both Wrigley’s respondents and a semifictional best-selling memoir by two former Manhattan nannies confirm—both caregivers and parents tend to avoid explicit discussions about the financial conditions of their contract (Wrigley 1995: 88; McLaughlin and Kraus 2002: 3).

Expert advice to parents hiring nannies confirms many of these observations. In their guide “to navigating the parent-caregiver rela­tionship,” psychoanalysts Joseph Cancelmo and Carol Bandini note the peculiar character of that relationship: “At one end of the con­tinuum is the view that the caregiver is simply an employee. At the other end, she is viewed as a member of the family. Some days [peo­ple] feel one way, some days the other, with various gradations in between” (Cancelmo and Bandini 1999: 83).

Based on their interviews with mostly middle – and upper-middle class working professional parents and with in-home caregivers, who were primarily immigrant women, Cancelmo and Bandini note that even the employers’ lexicons revealed the variety of relation­ships: “Is she the babysitter, someone sitting in, a day mother (as several mothers succinctly characterized the relationship), a nanny, a caregiver, a special friend?” (87). Caregivers and the children in their charge likewise differentiated among relationships. Sudha, who had cared for five-year-old Michael since birth noted: “That does not feel right inside of me [clasping her hand to her breast]…. In the beginning I was just a babysitter. Gradually, more than a baby­sitter I became. Like I was in the family and feeling close to Michael, and the new little boy. I love these kids so much” (91-92). Michael

in turn called Sudha “Auntie” after hearing her own nieces and nephews using that term when they visited. Another seven-year-old boy, after hearing his parents’ responses, offered his own critique of the term caregiver: “It doesn’t make any sense to me. Who is she caring for, anyway—a “giver”? I like babysitter. It’s like—she has re­ally taken care of me since I was a baby—she is my babysitter, you know what I mean?” (93).

Payment systems, Cancelmo and Bandini found, likewise re­flected the multiple relationships. Along with the “official” wages, for instance, they found an “unofficial” salary that sustained kin­like ties:

Caregivers were given tickets to ballgames, new and nearly new clothing, museum memberships, and special trips and meals out with the family. Some families handed down outdated but us­able computer equipment to their own children and to the chil­dren of the caregiver. Lawyers did free legal work for the care­giver and her family, doctors provided referrals to specialists, just as they would do for their own family. .. . Many parents would also provide money, ostensibly loans for things a care­giver might need but could never afford on her salary. This included airfare to visit a dying mother or father in another country, and help in paying for funeral costs. (102)

Even the availability and supervision of petty cash served to differ­entiate employer-caregiver relationships:

Some [parents]. .. wanted exact documentation of all expenses. Several nannies and au pairs described it this way: “Like it’s my allowance or something.” Other parents were more flexible, providing a well-stocked jar with sufficient money for emergen­cies, without rigid rules for documentation or use. .. . But for some, there was… a depriving quality. . .. When expenses were incurred during the caregiver’s daily management of the household, she was expected to submit receipts for reimburse­ment, as if in a business setting (104).

Children also created their own monetary markers. As one eight – year-old boy promised his caregiver who had been with him since infancy, “I’m going to be a baseball star for the Yankees. I’m going to make a lot of money and I’m going to give you a million dollars” (104).[37] In short, nannies, their employers, and children negotiate definitions of who they are, how they are related to each other, what sorts of economic transactions are proper for their relationship, and in what media those transactions should occur. Similar negotiations with different outcomes occur in a variety of other transecting rela­tions: babysitters, paid and unpaid kin care, exchanges of child care among single mothers, and even the establishment of child-care ser­vices in local currency communities.[38]

Immigrant nannies themselves establish distinct personal and economic relations with family members or paid help who care for their own children. In these cases, the immigrant nannies regularly provide money and gifts to their children’s caretakers.[39] When care­giving crosses household boundaries, it makes more salient and deli­cate the sort of mutual defining that occurs wherever intimacy, care, and economic activity intersect.