The most important contribution Mary Breckinridge made to nursing was her work as a pioneer in nurse-midwifery and in the development of modern nursing services in rural communities. She introduced the first modern comprehensive health care system in the United States and provided professional services for primary nursing care and midwifery. She also promoted the growth of district nursing centers and hospital facilities in southeastern Kentucky.
Mary Breckinridge was the eldest daughter and the second of 4 children of an illustrious family. She was born on February 17, 1881, in Memphis, Tenn. Her father, Clifton Rodes Breckinridge (1846-1932), was a cotton planter and US representative from Arkansas. In 1894, he was appointed minister to Russia during the second administration of President Grover Cleveland (1837-1908). Her grandfather, John Cabell Breckinridge (1821–1875), was vice present to President James Buchanan (1791 – 1868) and a major general in the Confederacy during the American Civil War (1861-1865). He was also secretary of war in the cabinet of Jefferson Davis (1808-1889) in 1865.
Breckinridge's early education was provided by private tutors. From 1896 to 1898, she attended the Rosemont-Dezaley School in Lausanne, Switzerland. Breckinridge returned to the United States in 1898 and entered the Low and Hey wood School in Stamford, Conn, where she finished her education in 1899.
In 1904, Mary Breckinridge married. When her husband died of appendicitis in 1906, she decided to become a nurse. In 1907, she entered St Luke's Hospital School of Nursing in New York City and graduated in 1910. In 1912, she married again, and from 1912 to 1914, she taught French and hygiene at Crescent College and Conservatory for Young Women in Eureka Springs, Ark, where her husband was president. She retired from nursing and teaching in 1914 to have a family. She gave birth to a son in 1914 and to a daughter in 1916. The daughter died a few hours afterbirth, and the son died in January 1918. After the death of her son, Breckinridge left her husband and volunteered as a nurse in World War I (1914-1918). She and her husband divorced in 1920, and she assumed her maiden name, Mary Breckinridge.
In June 1918, Breckinridge served as a public health nurse in Washington, DC, during the influenza epidemic. She was in charge of 1 of the 5 medical areas of the city and supervised 5 other nurses and numerous trained aides. She volunteered in 1918 to go to France on behalf of the American Committee for Devastated France. She remained in France for 3 years, during which time she organized disaster relief, a special program for children and pregnant women, and a Child-Hygiene and Visiting-Nurse Association, for which she was awarded the Medaille Reconnaissance Français.
In 1921, Breckinridge returned to the United States to work among the poor of Kentucky. In 1922-1923, she took postgraduate courses at the Teachers College of Columbia University in New York City to learn the latest advancements in public health. Realizing that she needed to become qualified as a midwife, Breckinridge went to England in the fall of 1923 to study at the British Hospital for Mothers and Babies in the Woolwich district of London. She was awarded a certificate as a midwife in 1924, after which (mid-August 1924) she began touring nursing stations of the Scottish Highlands and the Inner and Outer Hebrides to gain additional information about rural nursing before returning to Kentucky. In 1924, she also took postgraduate courses at York Road General Lying-in Hospital in London.
In 1925, Breckinridge organized the Kentucky Committee for Mothers and Babies in Leslie County, which in 1928 became the Frontier Nursing Service (FNS). She served as director of the FNS for 37 years, until her death in 1965. In 1929, a staff member of the FNS formed the American College of Nurse Midwives, and in 1932, another FNS member started the first school of nurse-midwives (the Maternity Center in New York City). The center of FNS was in Hyden in southeastern Kentucky, where a hospital and health center were established in 1928 and a graduate school of midwifery in 1939.
Mary Breckinridge received many honors and awards during her lifetime, including an honorary doctor of law degree from the University of Kentucky. On May 16,1965, at the age of 84 years, Breckinridge died in Hyden, Ky. She was honored on a stamp issued by the United States in 1998.
© 1999 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.