Kentucky's Intrepid Nurses on Horseback

Mary Breckinridge - Founder of the Frontier Nursing Service



Mary Breckinridge was born in 1881, in Memphis, Tennessee, to an influential southern aristocratic family. She enjoyed a privileged childhood, with an education from renowed private tutors in the U.S. and Europe. Her family traveled extensively, and she was exposed to many different cultures and lifestyles. Her father was the U.S. ambassador to Czar Nicholas II of Russia from 1894 to 1897.

Mary Breckinridge's first husband died prematurely in 1906. Tragically, she also lost both her children (from a failed second marriage) before they were five years old. At this point, Breckinridge decided to dedicate her life to improving the health of women and children. She became a registered nurse in 1910. While working in France during World War I, she was exposed to nurse-midwifery, which was to become her life-calling. She became a certified midwife at a London, England, hospital in 1925.

In the early 1900s, many women in rural areas of the United States had no access to health care. Most women gave birth to their children at home, with only the help of family or neighbors. The maternal and infant mortality rates were very high.

Mary Breckinridge enlisted nurse-midwives to impact the crisis of maternal and fetal mortality in rural Appalachia. She created the Frontier Nursing Service (FNS) in 1925, taking health care on horseback to the rural areas of Eastern Kentucky. To provide professional services to neglected people of a 700 square mile area in southeastern Kentucky, she created a decentralized system of nurse-midwives, district nursing centers, and hospital facilities, which offered training to midwives.

Eastern Kentucky was then an impoverished territory, with few roads, no licensed physicians, and no hospitals. The area was inaccessible to cars, so Breckinridge rode on horseback or hiked through the region, finding that most Appalachian women lacked prenatal care and were delivered by self-taught local midwives. The hill country women averaged nine children, and the children lacked good quality neonatal and pediatric care. Fathers, most of whom worked in coal mines, suffered from tuberculosis, malnutrition and alcoholism.

The Service's nurse-midwives lived in the area they served. They would visit families on horseback, providing both maternity and pediatric services in this vast region. This model rural health care system lowered the rate of death in childbirth in rural southeastern Kentucky from the highest in the nation to substantially below the national average.





The FNS staff also started the American Association of Nurse-Midwives, a precursor to the American Academy of Nurse-Midwives.

http://www.nursingadvocacy.org/news/...prov_jour.html

http://www.ana.org/hof/brecmx.htm

http://www.nursingadvocacy.org/press/breckinridge.html

http://www.kytales.com/mbreck/mbreck.html