Since early in the twentieth century, quilts have played a role within the informal institutions of mutual aid in Amish society. Women helped one another complete quilts at quilting frolics, communities gave quilts to friends and neighbors in need, and even sent quilts to those far away but experiencing hardship—such as the Wingard family in Topeka, Indiana, who received a Center Diamond quilt from the Lancaster settlement when their home and barn were destroyed in a 1965 tornado. Other Amish quiltmakers knot comforters to send overseas to those in need through Christian Aid Ministries.

Since the Amish do not use commercial insurance, they have come to rely on the mutual aid of the community in times of need. As such, benefit events are a time when members of church districts come together to raise money for medical bills, school construction, new barns, or local volunteer fire companies. Quilts have been a staple at these events. When outsiders began to flock to Amish settlements in search of quilts, they too frequented these sales and auctions, buying quilts, sometimes at bargain prices and sometimes at inflated ones, knowing that the cause was righteous.