Mary Breckinridge, Frontier Nursing

Service, Frontier Nursing University, and the

Courier Program

In 1928, Mary Breckinridge, founder of Frontier Nursing University established the Courier Program, recruiting young people to come work in the Kentucky Mountains and learn about service to humanity. Couriers escorted guests safely through remote terrain, delivered medical supplies to remote outpost clinics, and helped nurse-midwives during home visits and births. Frontier has benefited tremendously from the 1,600 Couriers who have served since 1928. Below is an abridged version of a timeline created by Brittany Edwards and others, featured in Unbridled Service. You can visit the full version of the timeline here.


1881:  Frontier founder and pioneer nurse Mary Breckinridge is born in Memphis, Tennessee.


1910:  Mary Breckinridge graduates from St. Luke’s Hospital Training School for Nurses in New York.


1916-1918:  Mary Breckinridge’s newborn daughter, Polly, dies, followed two years later by the unexpected death of her four-year-old son, Breckie. The deaths of her two children spark an overwhelming motivation to devote her life to the care of children.


1918-1919:  Mary Breckinridge joins the American Committee for Devastated France to help those who were starving in French villages, a task that would strongly shape her resolve, her purpose and her future. Her experience of working with midwives and nurse-midwives while serving on this Committee leads her to conclude that nurse-midwifery services are a logical solution to many health problems in her home country. Back home in Kentucky, progressive reforms had improved the lives of women and children, especially in America’s cities. But children in remotely rural regions had been neglected.


1923:  Mary Breckinridge conducts a survey of Leslie County, Ky., and verifies the need for nursing and midwifery services in the area


1924-1925:  Mary Breckinridge completes midwifery training in Woolwich, England, and returns to rural Kentucky. Inspired by the knowledge she gained abroad and the evident need for nursing services in rural Kentucky, Mary Breckinridge is instrumental in establishing the Kentucky Committee for Mothers and Babies. This is the first organization in America to use nurses trained as midwives under the direction of a single medical doctor.


1926: The first rural outpost clinic, the Jessie Draper Memorial Nursing Center (Beech Fork Clinic) opens.


1928: The name of the Kentucky Committee for Mothers and Babies is changed to the Frontier Nursing Service (FNS). Also, the Hyden Hospital opens, staffed by Frontier Nursing Service nurse-midwives and one physician. Simultaneously, the Courier Program begins. Couriers assist nurses with everyday chores, including delivering communications and supplies to clinics, caring for the horses, and assisting with home visits.


1939: The Frontier Graduate School of Midwifery is established by Mary Breckinridge and admits its first class. The first two students were Hannah Mitchell and Jennie Burton.


1940:  Technology advancements impact rural Appalachia. Nurse-midwives begin using Jeeps instead of horses to traverse the eastern Kentucky mountains. In 1949, electric lights come to Wendover.


1942:  The Garden House at Wendover is destroyed by fire and then rebuilt through donations.


1952:  Mary Breckinridge’s autobiography Wide Neighborhoods is published.


1954:  The 10,000th FNS baby, Marlene Wooten, is born. All maternal and infant outcome statistics for FNS’s first 30 years of operation are better than the country as a whole.


1965: Mary Breckinridge passes away at age 84 and leaves behind a legacy. She is buried at Lexington Cemetery in Lexington, KY with her family, including her two children. After her death, Helen Browne, known as “Brownie,” becomes second Director of the Frontier Nursing Service. Brownie had been Mrs. Breckinridge’s assistant and did much traveling on behalf of FNS.


1966:  Home health began at each of the FNU District clinics in response to the Medicaid/Medicare law in 1966.


1975:  Mary Breckinridge Hospital opens to serve the local Hyden, Kentucky community.


1978:  The 20,000th FNS baby is born. Also, 1978 marks the 50th year of the FNS Courier Program.


1989:  FSMFN looks at new ways to increase the number of midwives while remaining focused on the mission of educating nurses in rural and underserved areas. The first distance learning nurse-midwifery program is launched as the Community-Based Nurse-Midwifery Education Program (CNEP), allowing students to remain in their home communities while completing their education at Frontier. This CNEP program is the culmination of the efforts of FSMFN, AABC, Maternity Center Association and Case Western. The CNEP program is piloted in Perkiomenville, PA, and led by Kitty Ernst. FSMFN adopts the CNEP program in 1990 and launches it as the primary nurse-midwifery program. The program includes a course on birth centers with training and compensation for clinical preceptors. FSMFN becomes a pioneer in the field of distance learning.


1991:  The Big House at Wendover, Mary Breckinridge's original log cabin home, becomes National Historic Landmark by National Park Services.


2001: Mary Breckinridge’s home, the Big House, opens as a Bed and Breakfast in Hyden, Kentucky.


2010:  The Mary Breckinridge statue is dedicated in Hyden, Kentucky to commemorate Frontier’s founder. The is also the last year the Courier Program occurs until 2013.


2011:  U.S. News and World Report names Frontier as one of the top 50 graduate schools of nursing in early 2011. Frontier's nurse-midwifery and family nurse practitioner programs are also named in the top 15 in the country.


2011:  FSMFN kicks off the first annual PRIDE Diversity Impact Event in summer 2011 inviting students, alumni, faculty and staff to unite on campus to focus on cultural awareness and diversity issues. PRIDE seeks to promote recruitment and retention to increase diversity in nurse-midwifery and nurse practitioner education. In the same year, FSMFN is renamed Frontier Nursing University (FNU) in July 2011.


2012:  The FNS Courier Program is taken over by the University and continues in the summer of 2013.


2014:  Frontier Nursing University celebrates its 75th Anniversary. This milestone marks 75 years of dedication to the mission of educating nurse-midwives and nurse practitioners to provide care to women and families with a focus on rural and underserved communities.