Mary Breckinridge was the nation's foremost pioneer in the development of American midwifery and the provision of care to the nation's rural areas as founder of the Frontier Nursing Service.

Breckinridge, descendant of a distinguished family that included a U.S. vice president and a Congressman and diplomat, lost her first husband and two children to early death. She turned to nursing as an outlet for her energies, committed to "raise the status of childhood everywhere," as a memorial to her own lost children. She spent time as a public health nurse during World War I, and became convinced that the nurse-midwife concept could help children in rural America. After additional nursing studies and midwifery training, she went to rural Kentucky and began work in 1925. In 1928 her service was named the Frontier Nursing Service, and was for several years entirely underwritten by Breckinridge's personal funds. Designed around a central hospital and one physician with many nursing outposts designed to compensate for the absence of reliable roads or transportation, the service featured nurses on horseback able to reach even the most remote areas in all kinds of weather. Within five years, FNS had reached more than 1,000 rural families in an area exceeding 700 square miles and staff members of FNS formed the organization that became the American Association of Nurse-Midwives. Breckinridge masterminded the fundraising and publicity necessary to keep the service growing. The Frontier School of Midwifery and Family Nursing, another part of FNS, trained hundreds of midwives. The FNS hospital in Hyden, Kentucky is now named the Mary Breckinridge Hospital, and it operates today, with a new Women's Health Care Center, still fulfilling the mission that Breckinridge created in the 1920s. On her deathbed Breckinridge commented, "The glorious thing about it is that it has worked!"