Herald-Leader Editorial

Mountain Blessings

Frontier Nursing's reach has expanded worldwide from origins in Appalachian Kentucky

December 24, 2013 

This year, the Herald-Leader has revisited the Eastern Kentucky Harry Caudill described 50 years ago in his landmark book, Night Comes to the Cumberlands: A Biography of a Depressed Area.

For Christmas, the editorial board decided to look at another person whose work has had profound impact in the region and beyond, Mary Breckinridge.

After her two young children died, Breckinridge, a member of a prominent wealthy family, decided to devote her life to improving the health of babies and children. In 1925, she founded the Frontier Nursing Service, the first organization in the U.S. to use nurse-midwife care. She chose a part of Eastern Kentucky served by no doctors and few roads. Most people lived in places that could be reached only on horseback or by mule team.

Working house to house, fording streams on horseback, delivering prenatal care, babies, innoculations and advice about sanitation and healthful living, the nurses had an enormous impact. In 1955, the FNS reviewed its meticulous statistics, reporting that the maternal mortality rate among those it served was 9.1 per 10,000 births compared with 34 for the nation, and that low birthweight babies comprised 3.8 percent among FNS-assisted births, compared with 7.6 percent for the entire country.

Initially FNS midwives were trained in Great Britain, and many British midwives came to Kentucky. When World War II disrupted travel, the FNS started the Frontier Graduate School of Midwifery. Now called Frontier Nursing University, the school began in 1989 to offer distance learning, allowing nurses to stay in the communities they are serving while advancing their knowledge. Graduates work throughout the United States and around the world.

Christmas reminds us blessings can come from unsuspected places. One woman's mission to provide better care for children born in the most humble circumstances has outlived her and reached far beyond the hills she loved.

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