The Frontier Nursing Service: America's First Rural Nurse-Midwife Service and School
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MEDIA REVIEW The Frontier Nursing Service: America’s First Rural Nurse- Midwife Service and School By Marie Bartlett. Jefferson, NC: McFarland & Company, Inc., 2008. 264 pages. $39.95, paperback. Reviewed by: Kathryn Osborne, CNM, MSN. As she stepped off the train and onto the railroad platform on a hot July morning in 1928, Betty Lester found herself questioning the wisdom of her decision to leave Great Britain and travel to Leslie County, Kentucky, to work for the newly established Frontier Nursing Service (FNS). Many midwives that followed during the next sev- eral decades would share those same feelings of doubt as they arrived at that train station, responding to a call from Mary Breckinridge to provide health care for mothers and babies in southeastern Kentucky. However, little time passed before these nurses became familiar with the warm arms that welcomed them and the dire health care needs of the families they would serve. In The Frontier Nursing Service: America’s First Rural Nurse-Midwife Service and School, Marie Bartlett tells the story of the establishment and first several decades of operation of FNS from a human interest point of view. Almost immediately, the reader is drawn to stories about the founder of FNS, Mary Breckinridge, and many of the nurse-midwives who were dedicated to caring for families in a remote region of Appalachia. Through the use of eloquent storytelling, Bartlett creates a human con- nection between reader and subject that is both compelling and informative. Unlike many historical works that are laden with facts, names, and dates, Bartlett uses creative imagery in conjunction with the words of early FNS em- ployees and patients to provide readers with an insider’s view of the early years of the first nurse-midwifery service in the United States. The author of this book is not a nurse-midwife, nor is she known foremost for her historical writing. Bartlett has hundreds of publications to her credit, and this is her fourth nonfiction book. It is this reviewer’s opinion that Bartlett approached this work with the skill of a seasoned historical researcher. The sources of information accessed by Bar- tlett include the oral histories of 192 FNS staff members and residents of Leslie County collected between 1900 and 1985; personal interviews with FNS pioneers who are alive today; films, photographs, books, and correspon- dences on file at The Big House in Wendover (the home of Mary Breckinridge); issues of the FNS Quarterly Bulletin (the FNS newsletter) that spanned from 1925 to the present day; and many of the writings of Mary Breckinridge. Bar- tlett also made several trips to Leslie County, spending time in the home of Mary Breckinridge and in several of the FNS buildings that remain standing and in use today. She was clearly immersed in FNS and the lives of those who were touched by FNS. Bartlett tells the story of FNS against the backdrop of American history. She carefully weaves experiences of the FNS nurse-midwives through a fabric of historic events, showing the tenacity of Mary Breckinridge, who was determined to keep the service running despite the loss of the original British midwives who returned home during World War II and the difficult financial times faced during the Great Depression. Bartlett also describes the FNS response to changing social times, including the changing face of maternity care as childbirth moved from home to hospital, the emergence of the feminist movement, and the implementation of government-funded health care programs. The experiences of two prominent figures remain central throughout the story: Mary Breckinridge, who is portrayed as a stern yet compassionate leader who was as deeply com- mitted to continuing the operation of FNS as she was to the families served, and Betty Lester, one of the first British nurse-midwives recruited by Breckinridge to provide mid- wifery and family care as an FNS nurse. Many other mid- wives, couriers (midwife assistants), and administrative staff come and go throughout the book, each with their own story. Perhaps the most incredible stories told are those of the people of southeastern Kentucky—people who en- dured extreme poverty and often difficult living conditions, yet who remained proud of their accomplishments and grateful for the care provided by the FNS midwives. This book tells the story of a health care delivery system that provided affordable health care during financially dif- ficult times, drastically improving the health outcomes of an underserved population that was considered at risk both socially and medically. As such, it is recommended reading for health care providers, sociologists, health care economists, policy makers, and historians alike. In addition to learning the history of this pioneering service, readers are treated to hundreds of stories about the FNS midwives, the births they attended, the families they en- countered, the animals they cared for, and the nursing ser- vice they maintained. Midwifery students in particular are encouraged to read this book about the women who blazed the trail for midwifery in the United States, both literally on the difficult terrain they were required to navigate in or- der to reach their patients, and figuratively in a health care system that has been slow to embrace midwifery as the model of care for women in labor and birth. Journal of Midwifery & Women’s Health www.jmwh.org e15 Ó 2010 by the American College of Nurse-Midwives 1526-9523/10/$36.00 Issued by Elsevier Inc.
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Transcript of The Frontier Nursing Service: America's First Rural Nurse-Midwife Service and School
MEDIA REVIEW
The Frontier Nursing Service: America’s First Rural Nurse-Midwife Service and School
By Marie Bartlett. Jefferson, NC: McFarland & Company, Inc.,2008. 264 pages. $39.95, paperback.
Reviewed by: Kathryn Osborne, CNM, MSN.
As she stepped off the train and onto the railroad platformon a hot July morning in 1928, Betty Lester found herselfquestioning the wisdom of her decision to leave GreatBritain and travel to Leslie County, Kentucky, to workfor the newly established Frontier Nursing Service(FNS). Many midwives that followed during the next sev-eral decades would share those same feelings of doubt asthey arrived at that train station, responding to a callfrom Mary Breckinridge to provide health care for mothersand babies in southeastern Kentucky. However, little timepassed before these nurses became familiar with the warmarms that welcomed them and the dire health care needs ofthe families they would serve.
In The Frontier Nursing Service: America’s First RuralNurse-Midwife Service and School, Marie Bartlett tellsthe story of the establishment and first several decadesof operation of FNS from a human interest point ofview. Almost immediately, the reader is drawn to storiesabout the founder of FNS, Mary Breckinridge, and manyof the nurse-midwives who were dedicated to caring forfamilies in a remote region of Appalachia. Through theuse of eloquent storytelling, Bartlett creates a human con-nection between reader and subject that is both compellingand informative. Unlike many historical works that areladen with facts, names, and dates, Bartlett uses creativeimagery in conjunction with the words of early FNS em-ployees and patients to provide readers with an insider’sview of the early years of the first nurse-midwifery servicein the United States.
The author of this book is not a nurse-midwife, nor is sheknown foremost for her historical writing. Bartlett hashundreds of publications to her credit, and this is her fourthnonfiction book. It is this reviewer’s opinion that Bartlettapproached this work with the skill of a seasoned historicalresearcher. The sources of information accessed by Bar-tlett include the oral histories of 192 FNS staff membersand residents of Leslie County collected between 1900and 1985; personal interviews with FNS pioneers whoare alive today; films, photographs, books, and correspon-dences on file at The Big House in Wendover (the home ofMary Breckinridge); issues of the FNS Quarterly Bulletin(the FNS newsletter) that spanned from 1925 to the presentday; and many of the writings of Mary Breckinridge. Bar-tlett also made several trips to Leslie County, spending
Journal of Midwifery & Women’s Health � www.jmwh.org
� 2010 by the American College of Nurse-MidwivesIssued by Elsevier Inc.
time in the home of Mary Breckinridge and in several ofthe FNS buildings that remain standing and in use today.She was clearly immersed in FNS and the lives of thosewho were touched by FNS.
Bartlett tells the story of FNS against the backdrop ofAmerican history. She carefully weaves experiences ofthe FNS nurse-midwives through a fabric of historicevents, showing the tenacity of Mary Breckinridge, whowas determined to keep the service running despite theloss of the original British midwives who returned homeduring World War II and the difficult financial times facedduring the Great Depression. Bartlett also describes theFNS response to changing social times, including thechanging face of maternity care as childbirth movedfrom home to hospital, the emergence of the feministmovement, and the implementation of government-fundedhealth care programs.
The experiences of two prominent figures remain centralthroughout the story: Mary Breckinridge, who is portrayedas a stern yet compassionate leader who was as deeply com-mitted to continuing the operation of FNS as she was to thefamilies served, and Betty Lester, one of the first Britishnurse-midwives recruited by Breckinridge to provide mid-wifery and family care as an FNS nurse. Many other mid-wives, couriers (midwife assistants), and administrativestaff come and go throughout the book, each with theirown story. Perhaps the most incredible stories told are thoseof the people of southeastern Kentucky—people who en-dured extreme poverty and often difficult living conditions,yet who remained proud of their accomplishments andgrateful for the care provided by the FNS midwives.
This book tells the story of a health care delivery systemthat provided affordable health care during financially dif-ficult times, drastically improving the health outcomes ofan underserved population that was considered at riskboth socially and medically. As such, it is recommendedreading for health care providers, sociologists, healthcare economists, policy makers, and historians alike. Inaddition to learning the history of this pioneering service,readers are treated to hundreds of stories about the FNSmidwives, the births they attended, the families they en-countered, the animals they cared for, and the nursing ser-vice they maintained. Midwifery students in particular areencouraged to read this book about the women who blazedthe trail for midwifery in the United States, both literallyon the difficult terrain they were required to navigate in or-der to reach their patients, and figuratively in a health caresystem that has been slow to embrace midwifery as themodel of care for women in labor and birth.
e15
1526-9523/10/$36.00
