Mary Breckinridge | Biography

Mary Breckinridge was an American nurse who started the Frontier Nursing Service in the Appalachian region of Kentucky, in order to provide health care to poor people who lived in remote mountain settlements. Breckinridge also founded the first school in America that trained and certified midwifes. Her efforts were instrumental in reducing the high infant and maternal mortality rates in pre World War II Appalachia.

Mary Breckinridge was born in Kentucky on Feb. 16, 1881. Her father, Clifton Breckinridge, was a US Congressman, and a diplomat to Russia under President Cleveland. Her grandfather, John Cabell Breckinridge, had been Vice President of the United States under Buchanan, and Secy. of War under Jefferson Davis. Breckinridge had three siblings, a brother Carson, born in 1878, a sister Lees born in 1884, and brother Clif born in 1895.

Raised amidst wealth and high society, Breckinridge traveled extensively in her youth. She grew up in her mother's ancestral home on a southern plantation in Oasis, Mississippi, in her father's ancestral home, near Lexington, Kentucky, and on her maternal grandmother's estate in Hazelwood, New York. During her teenage years, when her father served as a Russian diplomat, she lived in both Russia and western Europe. Tutored by French and German governesses at first, she later attended the Rosemont Dezaley Boarding School in Lausanne, Switzerland. Upon her return to the United States at the age of seventeen, she enrolled for two years of study at Miss Low's finishing school in Stamford, Connecticut. Several years later she began a brief marriage that ended in her husband's death in 1906. Driven by this loss, she chose to pursue a career in nursing. In 1907 she went to New York to begin her studies at the St. Lukes Hospital Training School. She graduated in 1910, and soon began a second marriage. Her first child, a boy whom she called Breckie, short for Breckinridge, was born on Jan. 21, 1914. A daughter, Polly, was born in 1916, but lived for only a few hours. Then Breckie died, after a brief illness, on Jan. 23, 1918. Shortly after the death of her son, Breckinridge divorced her second husband.

The death of her two children motivated Breckinridge to devote her life to improving the health of others. In 1918 she traveled to the slums of Washington DC, to nurse those fallen ill in the influenza epidemic. A year later she joined the Comité: Amé:ricain pour les Ré:gions Dé:vasté:es de la France. Within a few months of reporting to a small town just north of Paris, she asked permission to organize a visiting nurse program. Two years later, her program a success, she was supervising dozens of women, trained as both nurses and midwifes, who would travel about France caring for young children and pregnant women. In the United States there were as yet no schools of midwifery, and when Breckinridge returned home in 1921, she vowed she would start one. In 1922 she entered the Teachers College of Columbia University in NYC, to study public-health nursing. In the summer of 1923 she conducted a public health survey in the Appalachian Mountains of Kentucky. Riding over 650 miles on mule and horseback she traveled along trails in Appalachia and interviewed the "granny women" who attended the delivery of babies. They were largely illiterate and none were trained in nursing. No licensed physicians served the region, which had one of the highest birth rates in the country, as well as the highest infant mortality.

After completing her studies at Columbia University, Breckinridge traveled to England to enroll at the British Hospital for Mothers and Babies in southeast London. In 1924 she obtained her certificate in midwifery, then went on to the Highlands and Islands Medical and Nursing Service in Scotland for additional training. In both England and Scotland, Breckinridge witnessed the correlation between the low incidence of death during childbirth, the low infant mortality, and the high quality of care-giving provided by the nurse midwives. Meanwhile, in America, the death rate for women in childbirth was amongst the highest in the developed world.

Arriving in Leslie County, Kentucky, in May of 1925, Breckinridge announced her intent to bring a nursing and midwifery service to Appalachia. The Kentucky Committee for Mothers and Babies, which in 1928 changed its name to the Frontier Nursing Service, established itself that summer in the town of Hyden. A two-story building with a small medicine dispensary served as headquarters. Breckinridge hired six nurse midwifes trained in England and Scotland, to provide general health care and to attend births on their daily rounds in the county. No reliable transportation existed other than horseback and mule, and the women soon became known as the "nurses on horseback." Within a year, as word of the service spread, American nurses began to arrive in Hyden. Originally funded by the personal wealth of the Breckinridge family, the success of the service eventually attracted large donations. By 1928, enough funds had been raised to establish a small hospital in Hyden, and to hire a medical director with training in obstetrics. The small nursing staff formed the American Association of Nurse-Midwifes that same year. By the early 1930s, the service was reaching one thousand rural families in a seven hundred square mile area, and had established several outpost nursing centers. In addition to delivering babies, the service treated such then-common illnesses as tuberculosis and trachoma. In 1931 while traveling on horseback, Breckinridge suffered a serious fall, crushing a vertebra in the small of her back. For over a year she was unable to mount a horse. The accident left her dependent on a steel brace for the remainder of her life.

As the Frontier Nursing Service grew, Breckinridge began sending American nurses to England for midwife training. Eventually the expense became too high, and plans were made to establish the Frontier School of Midwifery and Family Nursing, the first such school in America. In the early 1940s, the school began graduating Certified Midwives (CM), licensed to practice in Kentucky. Their training included a six-month program of classroom instruction and fieldwork.

Breckinridge died at age of 84, on May 16. 1965. She was buried along side her two children in a Lexington, Kentucky cemetery. In her forty years of work with the Frontier Nursing Service, well over 50,000 registered patients were treated and over a quarter of a million inoculations were administered. Only eleven maternal deaths were recorded.