Mary Carson Breckinridge
Mary Carson Breckinridge (February 17, 1881 – May 16, 1965) was an American nurse midwife and the founder of the Frontier Nursing Service (FNS), which provided comprehensive family medical care to the mountain people of rural Kentucky. FNS served remote and impoverished areas off the road and rail system but accessible by horseback. She modeled her services on European practices and sought to professionalize American nurse-midwives to practice autonomously in homes and decentralized clinics. Although Breckinridge's work demonstrated efficacy by dramatically reducing infant and maternal mortality in Appalachia, at a comparatively low cost, her model of nurse-midwifery never took root in the United States. Early childhood and family Mary Breckinridge was born February 17, 1881, in Memphis, Tennessee, the second of four children, into the wealthy southern family of Katherine Carson and Clifton Rhodes Breckinridge. As the granddaughter of Vice President John C. Breckinridge, who served under President James Buchanan, and the daughter of an Arkansas congressman and U.S. Minister to Russia, Mary Breckinridge grew up in many places that included estates in Mississippi, Kentucky, and New York; seats of government in Washington, D.C., and Saint Petersburg, Russia; and schools in Lausanne, Switzerland, and Stamford, Connecticut. These political and family connections that provided international travel experiences, public speaking practice, and access to influential and wealthy benefactors willing to support philanthropic causes would enable her to raise private funds that would serve the impoverished residents of Leslie County, Kentucky. Although Breckinridge was born into a prominent family with means, she was dissatisfied that her older brother was afforded a higher quality education in private schools while she and her sister were taught at home by governesses or her own mother. Though she did not experience the quality of education of her older brother, she was educated by private tutors in Washington, D.C., Switzerland and in St. Petersburg, Russia. Several childhood connections and experiences made a lasting impression that helped prepare Breckinridge for a career committed to family-centered public health, and to a midwifery model of continuous care that would provide maternal and child nutrition, immunizations, prenatal care, birth support, and post-natal check ups. In 1894, Breckinridge and her family moved to Russia when President Grover Cleveland appointed her father to serve as the U.S. minister to that country. They returned to the United States in 1897. Her autobiography emphasizes the story of her younger brother's birth at the American Legation in St. Petersburg, Russia as her first encounter with a trained midwife that would prove to be formative in her vision of the Frontier Nursing Service. She was 14 at the time. Her mother was attended by two physicians, a family physician and an obstetrician, as well a Russian nurse-midwife, Madame Kouchnova, who took the lead while the doctors stood by. Her mother and the young Russian Empress Alexandra of Russia, mother of the Grand Duchess Olga, chose to breastfeed their infants, at a time when women of rank customarily relied on wet-nurses. Breckinridge, born in Memphis, Tennessee, during the Reconstruction