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<li id="toc-Establishment_of_FNS_and_early_years" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Establishment_of_FNS_and_early_years"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Establishment of FNS and early years</span> </div> </a> <ul id="toc-Establishment_of_FNS_and_early_years-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Development_of_the_Frontier_Graduate_School_of_Midwifery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Development_of_the_Frontier_Graduate_School_of_Midwifery"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Development of the Frontier Graduate School of Midwifery</span> </div> </a> <ul id="toc-Development_of_the_Frontier_Graduate_School_of_Midwifery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Addition_of_Family_Nursing_Education" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Addition_of_Family_Nursing_Education"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.3</span> <span>Addition of Family Nursing Education</span> </div> </a> <ul id="toc-Addition_of_Family_Nursing_Education-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Frontier_Nursing_University" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Frontier_Nursing_University"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Frontier Nursing University</span> </div> </a> <ul id="toc-Frontier_Nursing_University-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Impact" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Impact"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Impact</span> </div> </a> <ul id="toc-Impact-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Relocation_of_Frontier_Nursing_University" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Relocation_of_Frontier_Nursing_University"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Relocation of Frontier Nursing University</span> </div> </a> <ul id="toc-Relocation_of_Frontier_Nursing_University-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Kentucky_Law" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Kentucky_Law"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Kentucky Law</span> </div> </a> <ul id="toc-Kentucky_Law-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" 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.geo-inline-hidden{display:none}.mw-parser-output .longitude,.mw-parser-output .latitude{white-space:nowrap}</style><span class="plainlinks nourlexpansion"><a class="external text" href="https://geohack.toolforge.org/geohack.php?pagename=Frontier_Nursing_Service&params=37_09_55_N_83_22_45_W_region:US_type:landmark&title=Frontier+Nursing+Service"><span class="geo-default"><span class="geo-dms" title="Maps, aerial photos, and other data for this location"><span class="latitude">37°09′55″N</span> <span class="longitude">83°22′45″W</span></span></span><span class="geo-multi-punct"> / </span><span class="geo-nondefault"><span class="vcard"><span class="geo-dec" title="Maps, aerial photos, and other data for this location">37.16528°N 83.37917°W</span><span style="display:none"> / <span class="geo">37.16528; -83.37917</span></span><span style="display:none"> (<span class="fn org">Frontier Nursing Service</span>)</span></span></span></a></span></span></div></div> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">American rural healthcare service</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">United States historic place</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox" style="border-spacing:1px;"><tbody><tr><td colspan="2" class="infobox-subheader" style="padding:0; border:none;"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="skin-nightmode-reset-color" style="width:100%; font-size:110%; font-weight:bold;color: #202122; background: #A8EDEF; line-height:1.5">Frontier Nursing Service</div></td></tr><tr><td colspan="2" class="infobox-full-data"><div style="width:100%; text-align:center; line-height:1.5;color: #202122; background: #A8EDEF;"><a href="/wiki/National_Register_of_Historic_Places" title="National Register of Historic Places">U.S. National Register of Historic Places</a></div></td></tr><tr><td colspan="2" class="infobox-full-data"><div style="width:100%; text-align:center; line-height:1.4; color: #202122; background: #E6E6FA"><a href="/wiki/Historic_districts_in_the_United_States" title="Historic districts in the United States">U.S. Historic district</a></div></td></tr><tr style="display:none"><td colspan="2"> </td></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:FNU_building_on_Hickory_Street,_Hyden.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/19/FNU_building_on_Hickory_Street%2C_Hyden.jpg/250px-FNU_building_on_Hickory_Street%2C_Hyden.jpg" decoding="async" width="250" height="166" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/19/FNU_building_on_Hickory_Street%2C_Hyden.jpg/375px-FNU_building_on_Hickory_Street%2C_Hyden.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/19/FNU_building_on_Hickory_Street%2C_Hyden.jpg/500px-FNU_building_on_Hickory_Street%2C_Hyden.jpg 2x" data-file-width="6016" data-file-height="4000" /></a></span></td></tr><tr><th scope="row" class="infobox-label" style="font-weight:bold; border: 0;">Location</th><td class="infobox-data" style="border: 0;">Hospital Hill, off Hickory St., <a href="/wiki/Hyden,_Kentucky" title="Hyden, Kentucky">Hyden, Kentucky</a></td></tr><tr><th scope="row" class="infobox-label" style="font-weight:bold; border: 0;">Coordinates</th><td class="infobox-data" style="border: 0;"><span class="geo-inline"><style data-mw-deduplicate="TemplateStyles:r1156832818">.mw-parser-output .geo-default,.mw-parser-output .geo-dms,.mw-parser-output .geo-dec{display:inline}.mw-parser-output .geo-nondefault,.mw-parser-output .geo-multi-punct,.mw-parser-output .geo-inline-hidden{display:none}.mw-parser-output .longitude,.mw-parser-output .latitude{white-space:nowrap}</style><span class="plainlinks nourlexpansion"><a class="external text" href="https://geohack.toolforge.org/geohack.php?pagename=Frontier_Nursing_Service&params=37_09_55_N_83_22_45_W_region:US_type:landmark&title=Frontier+Nursing+Service"><span class="geo-default"><span class="geo-dms" title="Maps, aerial photos, and other data for this location"><span class="latitude">37°09′55″N</span> <span class="longitude">83°22′45″W</span></span></span><span class="geo-multi-punct"> / </span><span class="geo-nondefault"><span class="vcard"><span class="geo-dec" title="Maps, aerial photos, and other data for this location">37.16528°N 83.37917°W</span><span style="display:none"> / <span class="geo">37.16528; -83.37917</span></span><span style="display:none"> (<span class="fn org">Frontier Nursing Service</span>)</span></span></span></a></span></span></td></tr><tr><th scope="row" class="infobox-label" style="font-weight:bold; border: 0;">Area</th><td class="infobox-data" style="border: 0;">2.3 acres (0.93 ha)</td></tr><tr><th scope="row" class="infobox-label" style="font-weight:bold; border: 0;">Built</th><td class="infobox-data" style="border: 0;">1928</td></tr><tr><th scope="row" class="infobox-label" style="font-weight:bold; border: 0;">NRHP reference <abbr title="number">No.</abbr></th><td class="infobox-data" style="border: 0;"><a rel="nofollow" class="external text" href="https://npgallery.nps.gov/AssetDetail/NRIS/90002126">90002126</a><sup id="cite_ref-nris_1-0" class="reference"><a href="#cite_note-nris-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="font-weight:bold; border: 0;">Added to NRHP</th><td class="infobox-data" style="border: 0;">January 11, 1991</td></tr></tbody></table> <p>The <b>Frontier Nursing Service</b> (FNS) provides healthcare services to rural, underserved populations since 1925, and educates <a href="/wiki/Nurse_midwife" title="Nurse midwife">nurse-midwives</a> since 1939. </p><p>The Service maintains six rural healthcare clinics in eastern <a href="/wiki/Kentucky" title="Kentucky">Kentucky</a>, the <a href="/w/index.php?title=Mary_Breckinridge_Hospital&action=edit&redlink=1" class="new" title="Mary Breckinridge Hospital (page does not exist)">Mary Breckinridge Hospital</a> (now part of Appalachian Regional Healthcare<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>), the <a href="/w/index.php?title=Mary_Breckinridge_Home_Health_Agency&action=edit&redlink=1" class="new" title="Mary Breckinridge Home Health Agency (page does not exist)">Mary Breckinridge Home Health Agency</a>, the <a href="/wiki/Frontier_Nursing_University" title="Frontier Nursing University">Frontier Nursing University</a> and the <a href="/wiki/Wendover_(Hyden,_Kentucky)" title="Wendover (Hyden, Kentucky)">Bed and Breakfast Inn at Wendover, Kentucky</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=1" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Establishment_of_FNS_and_early_years">Establishment of FNS and early years</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=2" title="Edit section: Establishment of FNS and early years"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The organization was founded in 1925 in <a href="/wiki/Leslie_County,_Kentucky" title="Leslie County, Kentucky">Leslie County, Kentucky</a> by <a href="/wiki/Mary_Carson_Breckinridge" title="Mary Carson Breckinridge">Mary Breckinridge</a> (1881–1965) shortly after she had witnessed the operation of the <a href="/wiki/Highlands_and_Islands_Medical_Service" title="Highlands and Islands Medical Service">Highlands and Islands Medical Service</a> which had been founded in <a href="/wiki/Scotland" title="Scotland">Scotland</a> twelve years earlier.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> In choosing that site, she traveled through Leslie, Knott, and Owsley counties to determine what childbearing women and families needed most in those areas. On her travels, she spoke with midwives, recording data such as age, birthplace, literacy status, number of years in practice, cleanliness, and number of children reared for each midwife she spoke to.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Breckinridge, who graduated from St. Luke's Hospital of Nursing in New York in 1910, chose that area of Kentucky as a site for the school for several reasons: it was a remote region that was difficult to access, suggesting that success there would equate to success anywhere; there were no licensed physicians in Leslie county; Breckinridge was from a well-known family in Kentucky, resulting in a built-in network for monetary support from other parts of the state.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Breckinridge served as Director until her death in 1965. </p><p>Breckinridge intended that the Frontier Nursing Service would provide healthcare for children in remote rural areas, being moved to this work by the deaths of her own two children, Polly, who died four hours after her birth, and Breckie, who died four days after his fourth birthday.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Additionally, death rates of infants and mothers were high in the United States during the 1920s: in 1923, the national maternal death rate stood at 6.7 per 1,000 live births;<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> in 1920, the national infant mortality rate was 6 deaths for every 1,000 live births.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> During this time period, debates among physicians, health officials, and social reformers about the causes of high maternal and infant mortality were frequent and resulted in disagreements about who was best to oversee childbirth: general practitioners, obstetricians, or midwives.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Frontier Nursing Service was the first group in the United States to employ nurses who were also qualified midwives. Since there were no midwifery schools in the US, FNS was able to secure qualified staff by offering scholarships to American nurses to study in Great Britain or by hiring qualified midwives from Great Britain.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Originally, the organization was known as the Kentucky Committee for Mothers and Babies.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>The Frontier Nursing Service grew rapidly during its first five years. With the help of two nurses, <a href="/w/index.php?title=Edna_Rockstroh&action=edit&redlink=1" class="new" title="Edna Rockstroh (page does not exist)">Edna Rockstroh</a> and <a href="/w/index.php?title=Freda_Caffin&action=edit&redlink=1" class="new" title="Freda Caffin (page does not exist)">Freda Caffin</a>, Breckinridge opened the group's first clinic in <a href="/wiki/Hyden,_Kentucky" title="Hyden, Kentucky">Hyden, Kentucky</a> in 1925. The demand for the clinic grew rapidly, and within the first month of operation, Breckinridge and two nurse-midwives served 233 patients.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> By December of that year Breckinridge had raised a log house in <a href="/wiki/Wendover_(Kentucky)" class="mw-redirect" title="Wendover (Kentucky)">Wendover, Kentucky</a>, called the Big House, that became her home and the Frontier Nursing Service's headquarters. The <a href="/w/index.php?title=Hyden_Hospital_and_Health_Center&action=edit&redlink=1" class="new" title="Hyden Hospital and Health Center (page does not exist)">Hyden Hospital and Health Center</a> opened its doors in 1928 and was followed by nine outpost nursing centers in <a href="/wiki/Leslie_County,_Kentucky" title="Leslie County, Kentucky">Leslie County</a> and the <a href="/wiki/Red_Bird_River" title="Red Bird River">Red Bird River</a> section of <a href="/wiki/Clay_County,_Kentucky" title="Clay County, Kentucky">Clay County, Kentucky</a>. To center the outposts, Breckinridge did not use the county boundaries, instead, she located the outposts nine to twelve miles away from each other on the waterways and the natural routes of travel and trade. By that time, FNS covered 60 miles of territory.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>Because of the remote location of the service and the communities it served, nurses had to travel by horseback. During these early years, nurses with equestrian experience had to be recruited from Great Britain, where Breckinridge had learned about modern midwifery, because there were no midwifery schools in the United States. She did send interested American women abroad tor education, paying for all of their expenses, provided they agreed to work for the Frontier Nursing Service for two years.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The women who worked for the service traveled to remote locations, many without running water or electricity, providing care to people who were considered wild or even "foreign" to Americans in more populated areas.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Development_of_the_Frontier_Graduate_School_of_Midwifery">Development of the Frontier Graduate School of Midwifery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=3" title="Edit section: Development of the Frontier Graduate School of Midwifery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Upon the outbreak of <a href="/wiki/World_War_II" title="World War II">World War II</a> Breckinridge no longer could send American nurses to Britain where they had been going for midwifery training. To prevent this from slowing its operations, the Frontier Nursing Service quickly established the Frontier Graduate School of Midwifery. The first class matriculated in November 1939, and the school has operated ever since. The 6-month course was based on the curriculum of the Central Midwives Board of England and Scotland, and every student was required to participate in 20 midwifery cases. The first two classes were paid for by scholarships.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Reva_Rubin" title="Reva Rubin">Reva Rubin</a> who was one of the first specialists in maternity nursing worked here<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2018)">citation needed</span></a></i>]</sup>.FNS trained students and for other agencies. By 1952, 122 graduates worked in the U.S. and foreign countries such as the Philippines, Japan, Alaska, India, Thailand, Africa, South Africa, and Latin America. By 1966, 285 qualified nurse-midwives worked in the U.S. and abroad, including The Philippines, New Guinea, Thailand, South Korea, Canada, France and some parts of Africa and South America.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> In 1970, the school's name was changed to the Frontier School of Midwifery and Family Nursing (FSMFN). Now named <a href="/wiki/Frontier_Nursing_University" title="Frontier Nursing University">Frontier Nursing University</a>, it offers <a href="/wiki/Distance_education" title="Distance education">distance education</a> to train its students. The Frontier Nursing Service was the subject of the 1931 documentary film, <i><a href="/wiki/The_Forgotten_Frontier" title="The Forgotten Frontier">The Forgotten Frontier</a></i>. </p> <div class="mw-heading mw-heading3"><h3 id="Addition_of_Family_Nursing_Education">Addition of Family Nursing Education</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=4" title="Edit section: Addition of Family Nursing Education"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As the number of births decreased in Leslie County during the 1980s it became difficult to support a traditional midwifery program. During this time period, the Community-based Nurse-midwifery Education Program (CNEP) began as a pilot project funded by the PEW Foundation. The development of the CNEP was originally a cooperative effort of the <a href="/wiki/Maternity_Center_Association" class="mw-redirect" title="Maternity Center Association">Maternity Center Association</a> (MCA), the National Association of Childbearing Centers (NACC), Frances Payne Bolton School of Nursing, Case Western Reserve University (FPBSON/CWRU) and the Frontier Nursing Service (FNS). The goal was to enable nurses to remain in their communities while obtaining graduate education as nurse-midwives and ultimately increase the number of practicing nurse-midwives working in underserved areas. Through an affiliation with FPBSON/CWRU students completed a certificate education with FSMFN and attained a master's degree in nursing by completing nine credits on the FPBSON/CWRU campus in Cleveland, Ohio. The pilot project was very successful. In 1990, the FSMFN recognized that the CNEP model of education matched its own goals and mission. The President of the School and the Board of Directors voted to adopt the CNEP as its nurse-midwifery education program in 1991. Since then, FSMFN has graduated over 1000 nurse-midwives.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2011)">citation needed</span></a></i>]</sup> </p><p>In the late 1960s, the Frontier Nursing Service recognized that as health care options became more complex, a broader based education was necessary for nurses to be able to provide comprehensive primary care to all family members. At this time the FSMFN developed the first certificate program to prepare family nurse practitioners. In 1970, the name of the school was changed to the Frontier School of Midwifery and Family Nursing (FSMFN) to reflect the addition of the FNP program. The last class to graduate from the combined family nurse-midwifery program was in August 1990. The Community-based Family Nurse Practitioner (CFNP) education program was reestablished in 1999 using the CNEP distance education model. With the acceptance of CFNP class 1 in 1999, the Frontier School of Midwifery and Family Nursing comes full circle in its mission to educate nurses to provide primary care that is comprehensive, safe, and <a href="/wiki/Culturally_sensitive" class="mw-redirect" title="Culturally sensitive">culturally sensitive</a>. </p><p>The <b>Frontier Nursing Service Complex</b> was listed on the <a href="/wiki/National_Register_of_Historic_Places" title="National Register of Historic Places">National Register of Historic Places</a> in 1991.<sup id="cite_ref-nris_1-1" class="reference"><a href="#cite_note-nris-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The listing included four <a href="/wiki/Contributing_buildings" class="mw-redirect" title="Contributing buildings">contributing buildings</a> and nine <a href="/wiki/Contributing_structures" class="mw-redirect" title="Contributing structures">contributing structures</a>.<sup id="cite_ref-nrhpdoc_18-0" class="reference"><a href="#cite_note-nrhpdoc-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Frontier_Nursing_University">Frontier Nursing University</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=5" title="Edit section: Frontier Nursing University"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2000, recognizing that students desired to complete their entire education at FSMFN using distance education methods, the board of directors approved a plan for FSMFN to pursue full accreditation as an independent graduate school which would grant a Master of Science in nursing. There was much work to be done including a complete curriculum revision and the preparation of the faculty at the doctoral level. On December 6, 2004, the school was accredited by the Southern Association of Colleges and Schools to grant a Master of Science in Nursing Degree. The American College of Nurse-Midwives granted institutional accreditation as well as programmatic accreditation for the nurse-midwifery program in February 2005. National League for Nursing accreditation followed in March 2005. In 2011, the school changed its name to Frontier Nursing University to emphasize its capacity to offer graduate degrees in nursing.<sup id="cite_ref-history-of-fnu_19-0" class="reference"><a href="#cite_note-history-of-fnu-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>Today the university offers several programs geared towards nurses who desire to pursue preparation as a nurse-midwife or nurse practitioner. These include a Master of Science in Nursing degree with tracks as a nurse-midwife, family nurse practitioner and <a href="/wiki/Women%27s_health_nurse_practitioner" title="Women's health nurse practitioner">women's health nurse practitioner</a>. FSMFN also offers post-masters certificates in these specialties. In July 2016, the university added an online program for nurse-midwives and nurse practitioners for post-graduate certification in psychiatric-mental health nursing.<sup id="cite_ref-history-of-fnu_19-1" class="reference"><a href="#cite_note-history-of-fnu-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> FSMFN now has graduates representing every state in the United States and seven foreign countries.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2011)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Impact">Impact</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=6" title="Edit section: Impact"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>During its first thirty years of operation, all of the Frontier Nursing Service's maternal and infant outcome statistics were better than for the country as a whole. For example:</li></ul> <p>The maternal mortality rate for Frontier Nursing Services was 9.1 per 10,000 births, compared with 34 per 10,000 births for the United States as a whole. Only 3.8 percent of babies tended by the Frontier Nursing Service had low birth weight, compared with 7.6 percent for the country overall. </p> <ul><li>From 1938 to 1939, FNS field nurses carried 8,377 people, 4,978 of which were children. There were 25,135 visits at nursing centers.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li>By 1959, Frontier Nursing Service nurse-midwives had attended over 10,000 births</li> <li>From 1964 to 1965, FNS nurses attended 10,446 patients in 12 districts. The nurse-midwives and students provided prenatal, childbirth care during labor and delivery, and postpartum care to 369 women.</li></ul> <p><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <ul><li>In 1972, the Service opened the forty-bed Mary Breckinridge Hospital and Health Center in Leslie County.</li> <li>In 2011 after years of operating in the red and stopping services, Frontier Nursing Service sold Mary Breckenridge Hospital to <a href="/w/index.php?title=Appalachian_Regional_Healthcare&action=edit&redlink=1" class="new" title="Appalachian Regional Healthcare (page does not exist)">Appalachian Regional Healthcare</a>, completed on October 10, 2011.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup></li> <li>In 2017, the Frontier Nursing Service purchased a campus in Versailles, KY. Since then, Frontier Nursing has talked about moving its entire nursing school to Versailles.<sup id="cite_ref-James_23-0" class="reference"><a href="#cite_note-James-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup></li> <li>On September 26, 2019, a post on social media from a board of directors meeting created a major public backlash when the meeting minutes showed the board was considering moving the cabin where Breckenridge used to practice nursing and live, the Breckenridge House.<sup id="cite_ref-James_23-1" class="reference"><a href="#cite_note-James-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Relocation_of_Frontier_Nursing_University">Relocation of Frontier Nursing University</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=7" title="Edit section: Relocation of Frontier Nursing University"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2018, the Frontier Nursing University (FNU) fully moved out of Leslie County and to Versailles, Kentucky, despite its founder's mission to serve the mountain people of rural Kentucky.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Their institutional mission statement reads, "Our mission is to provide accessible nurse-midwifery and nurse practitioner education that integrates the principles of diversity, equity, and inclusion. We transform healthcare by preparing innovative, ethical, compassionate, and entrepreneurial leaders to work with all people with an emphasis on rural and underserved communities."<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p><p>In a statement about the move, FNU claimed "the new 67-acre campus in that FNU purchased in Versailles will continue to keep the University in a rural county but is also less than ten minutes from the Lexington Bluegrass Airport and accessible from major highways." Woodford County, Kentucky, the county where Versailles resides, is classified as a metro area according to the <a href="/wiki/Economic_Research_Service" title="Economic Research Service">USDA Economic Research Service</a>, not rural.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p><p>In addition to moving all FNU operations to metro Versailles, Kentucky, FNU attempted to remove a stained glass window belonging to the St. Christopher's Chapel in Hyden, Kentucky to be installed at their new campus in Central Kentucky leading to Congressman Hal Rogers to make this statement, "Quite frankly, the action taken by this board to quietly remove the stained-glass window, as well as the educational operations from Leslie County, does not align with Mary Breckinridge’s legendary heart of service and courageous action for the Appalachian people."<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> A petition on change.org called for the return of the stained glass window to the chapel and had garnered over 3,700 signatures. Return of the stained glass window to the original chapel in Hyden, Kentucky has not been confirmed. </p> <div class="mw-heading mw-heading2"><h2 id="Kentucky_Law">Kentucky Law</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=8" title="Edit section: Kentucky Law"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2019, the General Assembly of the Commonwealth of Kentucky passed Senate Bill 84 to provide certification and regulation for midwives, as well as creating a new public council to implement new licensure requirements. Kentucky stopped certifying midwives in 1975, and there have been no clear regulations on the practice for more than thirty years. The advisory council is set up under the Board of <a rel="nofollow" class="external text" href="https://kbn.ky.gov">Nursing</a>, which will promulgate regulations to establish standards for training programs, licensing, transfer of care from a midwife to a hospital, disciplinary actions, and more, as well as define a list of conditions that require the collaboration, consultation or referral of a client to a physician or other appropriate healthcare provider.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>The law also criminalizes unlicensed midwife services, although it does provide exceptions for traditional birth attendants for religious or cultural purposes and for family members and friends providing uncompensated care. It is unclear how these statutory terms will be interpreted and enforced.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=9" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-nris-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-nris_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-nris_1-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://npgallery.nps.gov/NRHP">"National Register Information System"</a>. <i><a href="/wiki/National_Register_of_Historic_Places" title="National Register of Historic Places">National Register of Historic Places</a></i>. <a href="/wiki/National_Park_Service" title="National Park Service">National Park Service</a>. 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Retrieved <span class="nowrap">2023-03-31</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Circulating+Now+from+the+NLM+Historical+Collections&rft.atitle=The+Forgotten+Frontier%3A+Nursing+Done+in+Wild+Places&rft.date=2018-09-20&rft.aulast=Now&rft.aufirst=Circulating&rft_id=https%3A%2F%2Fcirculatingnow.nlm.nih.gov%2F2018%2F09%2F20%2Fthe-forgotten-frontier-nursing-done-in-wild-places%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFrontier+Nursing+Service" class="Z3988"></span></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCrowe-Carraco1978" class="citation journal cs1">Crowe-Carraco, Carol (1978). <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/23378979">"Mary Breckinridge and the Frontier Nursing Service"</a>. <i>The Register of the Kentucky Historical Society</i>. <b>76</b> (3): 179–191. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0023-0243">0023-0243</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a> <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/23378979">23378979</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11618018">11618018</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Register+of+the+Kentucky+Historical+Society&rft.atitle=Mary+Breckinridge+and+the+Frontier+Nursing+Service&rft.volume=76&rft.issue=3&rft.pages=179-191&rft.date=1978&rft.issn=0023-0243&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F23378979%23id-name%3DJSTOR&rft_id=info%3Apmid%2F11618018&rft.aulast=Crowe-Carraco&rft.aufirst=Carol&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F23378979&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFrontier+Nursing+Service" class="Z3988"></span></span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDammann1980" class="citation journal cs1">Dammann, Nancy (1980). <a rel="nofollow" class="external text" href="https://scholarworks.waldenu.edu/dissertations/250">"The Frontier nursing service as an agent of change"</a>. <i>Walden Dissertations and Doctoral Studies. 250.</i>: 32<span class="reference-accessdate">. Retrieved <span class="nowrap">March 31,</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Walden+Dissertations+and+Doctoral+Studies.+250.&rft.atitle=The+Frontier+nursing+service+as+an+agent+of+change&rft.pages=32&rft.date=1980&rft.aulast=Dammann&rft.aufirst=Nancy&rft_id=https%3A%2F%2Fscholarworks.waldenu.edu%2Fdissertations%2F250&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFrontier+Nursing+Service" class="Z3988"></span></span> </li> <li id="cite_note-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-7">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFvan_Blarcom1925" class="citation journal cs1">van Blarcom, Carolyn (1925). 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Retrieved <span class="nowrap">2024-07-23</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=U.S.+Congressman+Hal+Rogers&rft.atitle=Congressman+Rogers+Says+Historic+Stained-Glass+Window+Should+Be+Returned+to+Leslie+County&rft.date=2020-08-21&rft_id=https%3A%2F%2Fhalrogers.house.gov%2F2020%2F8%2Fcongressman-rogers-says-historic-stained-glass-window-should-be-returned-to-leslie-county&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFrontier+Nursing+Service" class="Z3988"></span></span> </li> <li id="cite_note-30"><span class="mw-cite-backlink"><b><a href="#cite_ref-30">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBennett2020" class="citation web cs1">Bennett, Emily (2020-08-20). <a rel="nofollow" class="external text" href="https://www.wymt.com/2020/08/20/frontier-nursing-moves-historic-stained-glass-window-from-leslie-county-to-versailles/">"Local politicians seek legal action after Frontier Nursing moves historic stained glass window"</a>. <i>www.wymt.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2024-07-23</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.wymt.com&rft.atitle=Local+politicians+seek+legal+action+after+Frontier+Nursing+moves+historic+stained+glass+window&rft.date=2020-08-20&rft.aulast=Bennett&rft.aufirst=Emily&rft_id=https%3A%2F%2Fwww.wymt.com%2F2020%2F08%2F20%2Ffrontier-nursing-moves-historic-stained-glass-window-from-leslie-county-to-versailles%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFrontier+Nursing+Service" class="Z3988"></span></span> </li> <li id="cite_note-31"><span class="mw-cite-backlink"><b><a href="#cite_ref-31">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFussell2019" class="citation web cs1">Fussell, Mike (3 April 2019). <a rel="nofollow" class="external text" href="https://www.wave3.com/2019/04/03/kentucky-home-birth-families-celebrate-midwife-law/">"Kentucky home birth families celebrate midwife law"</a>. <i>wave3.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2019-10-01</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=wave3.com&rft.atitle=Kentucky+home+birth+families+celebrate+midwife+law&rft.date=2019-04-03&rft.aulast=Fussell&rft.aufirst=Mike&rft_id=https%3A%2F%2Fwww.wave3.com%2F2019%2F04%2F03%2Fkentucky-home-birth-families-celebrate-midwife-law%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFrontier+Nursing+Service" class="Z3988"></span></span> </li> <li id="cite_note-32"><span class="mw-cite-backlink"><b><a href="#cite_ref-32">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWalker2019" class="citation web cs1">Walker, Andrew (3 April 2019). <a rel="nofollow" class="external text" href="https://www.wkyt.com/content/news/Gov-Bevin-signs-law-to-certify-professional-midwives-508059451.html">"Gov. Bevin signs law to certify professional midwives"</a>. <i>wkyt.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2019-10-01</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=wkyt.com&rft.atitle=Gov.+Bevin+signs+law+to+certify+professional+midwives&rft.date=2019-04-03&rft.aulast=Walker&rft.aufirst=Andrew&rft_id=https%3A%2F%2Fwww.wkyt.com%2Fcontent%2Fnews%2FGov-Bevin-signs-law-to-certify-professional-midwives-508059451.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFrontier+Nursing+Service" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=10" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Goan, Melanie Beals. <i>Mary Breckinridge: The Frontier Nursing Service and Rural Health in Appalachia</i> (University of North Carolina Press, 2008) 347 pp. <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-8078-3211-0" title="Special:BookSources/978-0-8078-3211-0">978-0-8078-3211-0</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Frontier_Nursing_Service&action=edit&section=11" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="http://www.frontiernursing.org/">Frontier Nursing Service website</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20061004031730/http://frontiernursing.org/">Archived</a> 2006-10-04 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="http://www.ana.org/hof/brecmx.htm">American Nurses Association</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20061004124821/http://www.ana.org/hof/brecmx.htm">Archived</a> 2006-10-04 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="http://exploreuk.uky.edu/catalog/xt7c862b9k4x/guide">The guide to the Frontier Nursing Service Medical Surveys, 1959-1971</a> housed at the University of Kentucky Libraries Special Collections Research Center.</li> <li><a rel="nofollow" class="external text" href="http://exploreuk.uky.edu/?commit=search&f%5Bsource_s%5D%5B%5D=Frontier+Nursing+Service+Quarterly+Bulletins&q=frontier+nursing+service&search_field=all_fields">Digitized copies of the Frontier Nursing Service Quarterly Bulletins</a> housed at the University of Kentucky Libraries Special Collections Research Center.</li> <li><a rel="nofollow" class="external text" href="http://exploreuk.uky.edu/catalog/xt7kwh2d8d6d/guide">Guide to the Frontier Nursing Service Collection, 1902-2006, 2005MS47</a> housed at the University of Kentucky Libraries Special Collections Research Center.</li> <li><a rel="nofollow" class="external text" href="http://exploreuk.uky.edu/catalog/xt74qr4nkj62/guide">Guide to the Frontier Nursing Service records, 1789-1985, 85M1</a> housed at the University of Kentucky Libraries Special Collections Research Center.</li> <li><a rel="nofollow" class="external text" href="http://kdl.kyvl.org/cgi/f/findaid/findaid-idx?c=kyead;cc=kyead;view=text;rgn=main;didno=kukohfns">The Guide to the Frontier Nursing Service Oral History Project</a><sup class="noprint Inline-Template"><span style="white-space: nowrap;">[<i><a href="/wiki/Wikipedia:Link_rot" title="Wikipedia:Link rot"><span title=" Dead link tagged May 2024">permanent dead link</span></a></i><span style="visibility:hidden; color:transparent; padding-left:2px">‍</span>]</span></sup> at the <a href="/wiki/Louie_B._Nunn_Center_for_Oral_History" title="Louie B. Nunn Center for Oral History">Louie B. Nunn Center for Oral History</a> at the University of Kentucky.</li> <li><a rel="nofollow" class="external text" href="http://exploreuk.uky.edu/catalog/xt7c862b9k4x/guide">Guide to the Frontier Nursing Service Medical Surveys, 1959-1971</a> housed at the University of Kentucky Libraries Special Collections Research Center</li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output 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<li><a href="/wiki/Contributing_property" title="Contributing property">Contributing property</a></li> <li><a href="/wiki/Historic_districts_in_the_United_States" title="Historic districts in the United States">Historic district</a></li> <li><a href="/wiki/History_of_the_National_Register_of_Historic_Places" title="History of the National Register of Historic Places">History of the National Register of Historic Places</a></li> <li><a href="/wiki/Keeper_of_the_Register" title="Keeper of the Register">Keeper of the Register</a></li> <li><a href="/wiki/National_Park_Service" title="National Park Service">National Park Service</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_property_types" title="National Register of Historic Places property types">Property types</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color:#A8EDEF;color:black">Lists by state</th><td class="navbox-list-with-group navbox-list navbox-even" 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Historic Places listings in California">California</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Colorado" title="National Register of Historic Places listings in Colorado">Colorado</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Connecticut" title="National Register of Historic Places listings in Connecticut">Connecticut</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Delaware" title="National Register of Historic Places listings in Delaware">Delaware</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Florida" title="National Register of Historic Places listings in Florida">Florida</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Georgia" title="National Register of Historic Places listings in Georgia">Georgia</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Hawaii" title="National Register of Historic Places listings in Hawaii">Hawaii</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Idaho" title="National Register of Historic Places listings in Idaho">Idaho</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Illinois" title="National Register of Historic Places listings in Illinois">Illinois</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Indiana" title="National Register of Historic Places listings in Indiana">Indiana</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Iowa" title="National Register of Historic Places listings in Iowa">Iowa</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Kansas" title="National Register of Historic Places listings in Kansas">Kansas</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Kentucky" title="National Register of Historic Places listings in Kentucky">Kentucky</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Louisiana" title="National Register of Historic Places listings in Louisiana">Louisiana</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Maine" title="National Register of Historic Places listings in Maine">Maine</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Maryland" title="National Register of Historic Places listings in Maryland">Maryland</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Massachusetts" title="National Register of Historic Places listings in Massachusetts">Massachusetts</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Michigan" title="National Register of Historic Places listings in Michigan">Michigan</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Minnesota" title="National Register of Historic Places listings in Minnesota">Minnesota</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Mississippi" title="National Register of Historic Places listings in Mississippi">Mississippi</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Missouri" title="National Register of Historic Places listings in Missouri">Missouri</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Montana" title="National Register of Historic Places listings in Montana">Montana</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Nebraska" title="National Register of Historic Places listings in Nebraska">Nebraska</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Nevada" title="National Register of Historic Places listings in Nevada">Nevada</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_New_Hampshire" title="National Register of Historic Places listings in New Hampshire">New Hampshire</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_New_Jersey" title="National Register of Historic Places listings in New Jersey">New Jersey</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_New_Mexico" title="National Register of Historic Places listings in New Mexico">New Mexico</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_New_York" title="National Register of Historic Places listings in New York">New York</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_North_Carolina" title="National Register of Historic Places listings in North Carolina">North Carolina</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_North_Dakota" title="National Register of Historic Places listings in North Dakota">North Dakota</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Ohio" title="National Register of Historic Places listings in Ohio">Ohio</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Oklahoma" title="National Register of Historic Places listings in Oklahoma">Oklahoma</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Oregon" title="National Register of Historic Places listings in Oregon">Oregon</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Pennsylvania" title="National Register of Historic Places listings in Pennsylvania">Pennsylvania</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Rhode_Island" title="National Register of Historic Places listings in Rhode Island">Rhode Island</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_South_Carolina" title="National Register of Historic Places listings in South Carolina">South Carolina</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_South_Dakota" title="National Register of Historic Places listings in South Dakota">South Dakota</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Tennessee" title="National Register of Historic Places listings in Tennessee">Tennessee</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Texas" title="National Register of Historic Places listings in Texas">Texas</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Utah" title="National Register of Historic Places listings in Utah">Utah</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Vermont" title="National Register of Historic Places listings in Vermont">Vermont</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Virginia" title="National Register of Historic Places listings in Virginia">Virginia</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Washington_state" title="National Register of Historic Places listings in Washington state">Washington</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_West_Virginia" title="National Register of Historic Places listings in West Virginia">West Virginia</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Wisconsin" title="National Register of Historic Places listings in Wisconsin">Wisconsin</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Wyoming" title="National Register of Historic Places listings in Wyoming">Wyoming</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color:#A8EDEF;color:black">Lists by insular areas</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/National_Register_of_Historic_Places_listings_in_American_Samoa" title="National Register of Historic Places listings in American Samoa">American Samoa</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Guam" title="National Register of Historic Places listings in Guam">Guam</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_the_United_States_Minor_Outlying_Islands" title="National Register of Historic Places listings in the United States Minor Outlying Islands">Minor Outlying Islands</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_the_Northern_Mariana_Islands" title="National Register of Historic Places listings in the Northern Mariana Islands">Northern Mariana Islands</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Puerto_Rico" title="National Register of Historic Places listings in Puerto Rico">Puerto Rico</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_the_United_States_Virgin_Islands" title="National Register of Historic Places listings in the United States Virgin Islands">Virgin Islands</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color:#A8EDEF;color:black">Lists by associated state</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/National_Register_of_Historic_Places_listings_in_the_Federated_States_of_Micronesia" title="National Register of Historic Places listings in the Federated States of Micronesia">Federated States of Micronesia</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_the_Marshall_Islands" title="National Register of Historic Places listings in the Marshall Islands">Marshall Islands</a></li> <li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Palau" title="National Register of Historic Places listings in Palau">Palau</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color:#A8EDEF;color:black">Other areas</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/National_Register_of_Historic_Places_listings_in_Washington,_D.C." title="National Register of Historic Places listings in Washington, D.C.">District of Columbia</a></li> <li><a href="/wiki/American_Legation,_Tangier" title="American Legation, Tangier">American Legation, Morocco</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color:#A8EDEF;color:black">Related</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/National_Historic_Preservation_Act" title="National Historic Preservation Act">National Historic Preservation Act</a> <ul><li><a href="/wiki/Historic_Preservation_Fund" title="Historic Preservation Fund">Historic Preservation Fund</a></li></ul></li> <li><a href="/wiki/List_of_jails_and_prisons_on_the_National_Register_of_Historic_Places" title="List of jails and prisons on the National Register of Historic Places">List of jails and prisons on the National Register of Historic Places</a></li> <li><a href="/wiki/University_and_college_buildings_listed_on_the_National_Register_of_Historic_Places" title="University and college buildings listed on the National Register of Historic Places">University and college buildings listed on the National Register of Historic Places</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background-color:#A8EDEF;color:black"><div> <ul><li><span class="nowrap"><span class="noviewer" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8b/HistoricPlacesNationalRegisterPlaque.JPG/32px-HistoricPlacesNationalRegisterPlaque.JPG" decoding="async" width="32" height="25" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8b/HistoricPlacesNationalRegisterPlaque.JPG/48px-HistoricPlacesNationalRegisterPlaque.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8b/HistoricPlacesNationalRegisterPlaque.JPG/64px-HistoricPlacesNationalRegisterPlaque.JPG 2x" data-file-width="2498" data-file-height="1969" /></span></span> </span><a href="/wiki/Portal:National_Register_of_Historic_Places" title="Portal:National Register of Historic Places">National Register of Historic Places portal</a></li> <li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:National_Register_of_Historic_Places" title="Category:National Register of Historic Places">Category</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q5506028#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th 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