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.

[2] 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.

[1][3] 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.

Her autobiography[3] 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.

Up to the age of 13, she lived in Washington, D.C., during the winter and spent most summer months at Hazelwood, a country house in New York, with her great aunt, Mrs. James Lees.

It is there she learned at a young age to ride horseback, a necessary skill and signature mode of travel among the nurse-midwives of the Frontier Nursing Service.

[2] In 1912 she married Richard Ryan Thompson, a Kentucky native who was serving as the president of Crescent College and Conservatory in Eureka Springs, Arkansas.

[2] Prior to having children, Breckinridge taught French and hygiene classes at the Conservatory, teaching experiences that would position her to serve in France after the war.

[3] Breckinridge was governess- and tutor-educated through her primary years and sent to the boarding school of Rosemont-Dezaley at Lausanne (1896–97) for secondary education with the goal that she would learn to speak and write with social grace upon marriage.

The French immersion experience and the years in the Swiss Alps would prepare Breckinridge to administer a nursing program in France after World War I and instill a love of mountains that included the Scottish Highlands, the Ozarks, and the Appalachian Range.

[3] She finished her secondary education at Miss Low's School in Stamford, CT, where she had to make social adjustments to fit in with American students and where she struggled with the Latin and mathematics for which she had no prior preparation.

[3] Three years with the American Committee for Devastated France helped Breckinridge imagine a plan for public health in rural Kentucky with nurse-midwives situated at the center of the system.

[1] While awaiting deployment to Northern France at the end of World War I, Breckinridge accepted a contract with the Children's Bureau (Child Welfare Department of the Council of National Defense).

[3] Following the Armistice, Breckinridge volunteered for the American Committee for Devastated France, where her group provided direct relief in restoring supply chains of food, seed, and medicine.

She began to focus on children under 6 and pregnant and nursing mothers, caring for patients with pneumonia, impetigo, eczema, scarlet fever, and diphtheria.

Breckinridge wrote to thank all donors, share a story of the child they had helped, and call for additional funds for beet roots to feed the goats.

[3] In addition to direct relief, the American Committee for Devastated France began to rebuild a public health system in the years following the war.

During this time, Breckinridge envisioned the service as a demonstration project, and so she kept detailed records and data to form the basis of her organizational plans.

While in Europe, Breckinridge had met French, English, and Scottish nurse midwives and realized that people with similar training could meet the health care needs of rural America's mothers and babies.

Though Breckinridge's professional and largely autonomous nurse service demonstrated efficacy in reducing maternal and infant death at a time when reformers sought to remedy a recognized public health crisis, physician opposition, professional nursing ambivalence, and federal legislation (Sheppard-Towner Act) steered family health toward specialized interventions and rural hospitals.

Breckinridge received the Medaille Reconnaissance Francaise for organizing a visiting nurse association while working with the American Committee for Devastated France.