Born into an influential Kentucky family, Mary Breckinridge had a privileged childhood, but after the deaths of her two young children, she devoted her life to improving the health of women and children. A registered nurse, she went to France during World War I, where she met British nurse-midwives and decided a nurse-midwifery program would be the best way to bring better healthcare to rural areas. Perhaps due to having family roots in Kentucky, Breckinridge looked to the eastern Kentucky Appalachian area to start her nurse-midwife program. She went on horseback through the mountains, seeking out every “granny midwife” and talking with the people to understand their needs. In 1925, she established the Frontier Nursing Service in Leslie County, Kentucky.
She recruited the first midwives from England, where she received her own midwifery training. Since American physicians discouraged the use of midwives during that time period, there were few formally trained American midwives. When England became embroiled in World War II in 1939, several of those British midwives felt compelled to go home and use their nursing skills serving their country. The resulting shortage of midwives in the Frontier Nursing Service led Breckinridge to establish a midwifery school in 1939 at the small Hyden Hospital she’d helped the community build in 1928.
Mary Breckinridge traveled all over the country speaking about the frontier nurses, procuring millions of dollars in donations and recruiting nurses and volunteers called couriers. These couriers, mostly young women from socially prominent families, took care of the horses, ran errands, and assisted the nurse-midwives. The nurses traveled by horseback or on foot to provide in-home prenatal and childbirth care, functioning as both midwives and family nurses. The service’s low fees could be paid in money or goods and no one was turned away. Maternal and infant mortality rates decreased dramatically in the area.
Breckinridge ran the Frontier Nursing Service until her death in 1965, but the FNS she established still serves southeastern Kentucky and the FNS School of Midwifery and Family Nursing continues to train nurse-midwives. Wendover, the headquarters and home of Mary Breckinridge, was selected as a National Historic Landmark in 1991. For more information, you can read Mary Breckinridge’s own story, Wide Neighborhoods: A Story of the Frontier Nursing Service.