First Professional Nurse-Midwife Service in the U.S.
Nurses have always fascinated me. Perhaps I developed a romanticized view of the field from the Sue Barton novels that I read as child. Rural nursing in particular always seemed like an adventure. The demanding nature of everyday tasks, the sacrifice and dedication of the rural nurses to provide medical care and services to people living in rural, often isolated areas, are inspiring.
Kentucky has the distinction of having the first nurse-midwife service that used trained nurses in the United States. In 1925 Mary Carson Breckinridge, the granddaughter of Vice-president John Breckenridge, established the Frontier Nursing Service (FNS). The initial goals of the FNS were to provide infant and maternal care to those living in the mountains of southeastern Kentucky. With no formalized midwife-nurse training available in the country, nurses were recruited from Great Britain or sent overseas for training.
Due to the inaccessibility and harsh terrain of travel in the region, nurses rode on horseback with their supplies packed in specially designed saddlebags. “Mrs. Breckenridge’s Nurses” provided midwifery and general nursing care to about 10,000 people in a 700 square mile area and were headquartered in Hyden. Due to the region’s poverty, the annual fee per family was one dollar with additional services charged on an hourly basis and often payment was accepted in chickens or produce in lieu of cash.
To finance the FNS, Breckinridge sought philanthropic support outside the mountains by traveling extensively on fundraising tours and lecturing about the rural health care effort in Kentucky. By the time of her death in 1965, she had raised approximately $6 million for the Frontier Nursing Service. Today, the FNS influence reaches far beyond Eastern Kentucky through the Frontier Nursing University, which was the first family nurse practitioner program in the U.S. The school was founded in 1939 when traveling abroad for formalized midwifery training was not feasible during WWII.
Oral history interviews with Frontier Service Nurses and about rural health care in Kentucky can be found on Pass the Word, Kentucky’s Oral History Discovery Web Tool.