Mary Breckinridge established the Frontier Nursing Service in 1925 as a private charitable organization serving an area of about 700 square miles in southeastern Kentucky. Born in 1881 to an influential Kentucky family, Mary was educated in the United States and Europe. Widowed at a young age and losing both her children when they were young, Breckinridge dedicated her life to improving the health of women and children.
She became a registered nurse in 1910, and while working in France during World War I, she was exposed to British nurse-midwives, first in France and then in London. After the war, Breckinridge studied public health nursing at Columbia University. She decided to focus on health issues of women and children in rural Kentucky and after surveying their needs, she found that women lacked prenatal care and typically delivered with the help of self-taught midwives. Determined to make a difference, she returned to London to become a certified as a nurse-midwife. After earning her certification, she visited Scotland to observe the work of a community midwifery system serving poor, rural areas. This program’s decentralized structure served as the model for her Frontier Nursing Service.
Returning to Kentucky in 1925, Breckinridge raised over $6 million dollars (about $141,915.00 in today’s money) to support the new Frontier Nursing Service. The staff was initially composed of nurse-midwives trained in England who traveled on horseback and on foot to provide quality prenatal and childbirth care in the patients’ own homes, functioning as both midwives and family nurses. She also founded the first family care center in the United States where clients could pay the low fees in money or goods, and where no one was turned away. In the areas served, both maternal and infant mortality rates decreased dramatically.
One of Breckinridge’s Frontier Nursing Service trained nurse-midwives began the first American school of midwifery in New York in 1932. In 1939, the Frontier Nursing Service founded its own school in Hyden, Kentucky. Breckinridge ran the Frontier Nursing Service until her death in 1965.
Today, the Frontier Nursing Service still serves southeastern Kentucky, with a hospital in Hyden, four rural health clinics, a home health agency, and the Frontier Nursing Service School of Midwifery and Family Nursing. People come from around the world to study the Breckinridge model of rural health and social service delivery.

The American College of Nurse Midwives recognizes Breckinridge as “the first to bring nurse-midwifery to the United States” and the school as “a leading institution in nurse-midwifery in the United States and a tribute to the accomplishments of Mary Breckinridge and her contemporaries.”
In 1982, Breckinridge was inducted into the American Nurses Association’s Hall of Fame for her contributions to the nursing profession in women’s health, community and family nursing, and rural health care delivery.
Mary Breckinridge is just one of many American nurses who formed the history of nursing in the United States and whose contributions continue be used in the profession today.  Barco’s Nightingales Foundation is proud to recognize Mary Breckinridge who exemplifies the courageous heart of nursing and who served as an example as an advocate for nurses and the nursing profession.