The late Mary Breckinridge, Founder Frontier Nursing Service. Mary Breckinridge was born in 1881 in Memphis. She attended the St. Luke’s school of nursing, and in 1910, graduated with a degree in nursing.

Mrs. Breckinridge joined the American Committee for Devastated France following the end of World War I. While in Europe, she became acquainted with the nurse-midwives in France and Great Britain and thought, with their training, she could meet the problem of medical care for mothers and babies in rural America.

Upon completing her work in France, Mrs. Breckinridge studied midwifery at the British Hospital for Mothers and Babies in London and spent some time with the Highlands and Islands Medical and Nursing Service in Scotland to observe the kind of decentralized health care that would become the model for the Frontier Nursing Service. After the war, she studied Public Health Nursing at Columbia University. She formulated two goals: improving the health of children and pioneering a system of rural health care that could serve as a model for systems serving the most remote regions of the world.

In 1925, Mrs. Breckinridge came to Southeastern Kentucky to complete her goals by establishing the FNS. The Service was a decentralized health care system with the hospital at the center and the outpost/nursing clinics located within a five-mile ride on horseback. These centers were staffed by nurse-midwives, who held clinics, made rounds on horseback providing home care, and went to the homes to attend births. They served an average of 250 families per outpost. They also held immunization clinics at one-room schools and provided advice regarding sanitization of wells and outhouses.

The health care system established by Mrs. Breckinridge worked so well that that there was an immediate decrease in infant and maternal mortality. By 1958, the FNS nurse-midwives had attended over 10,000 births. All maternal and infant outcome statistics for the Service’s first 30 years of operation (1925-1954) were better than for the country as a whole. The biggest differences were in the maternal mortality rate (9.1 per 10,000 births for FNS, compared with 34 per 10,000 births for the United States as a whole) and low birth weight (3.8 percent for FNS, compared with 7.6 percent for the country).

When World War II began in 1939, a number of the British staff wished to return to their homes as soon as they could be released. Under wartime conditions, it was not possible to continue sending American nurses to Britain for midwifery training, so the FNS put into immediate operation a graduate school of midwifery. The Frontier Graduate School of Midwifery admitted its first class in November 1939, and has been in continuous operation since that time.

Graduates have practiced their profession all over the United States and in many developing countries. In the late 1960s, as health care options became more complex, Frontier established a broader-based education necessary for nurses to be able to provide comprehensive primary care to all family members. At this time, Frontier developed the first certificate program to prepare family nurse practitioners (FNP). In 1970, the name of the school was changed to the Frontier School of Midwifery and Family Nursing  to reflect the addition of the FNP program. In 2011, the name changed to Frontier Nursing University to reflect the graduate level Master’s and Doctoral program offered.

The Service developed by Mrs. Breckinridge has provided excellent care to the people of Eastern Kentucky for over 80 years as well, as graduating nearly 4,000 nurse-midwives and nurse practitioners who serve all over the world.