She was sent to Monticello Seminary in Godfrey, Illinois for her education and later Hosmer Hall preparatory school in St. Louis.

Following graduation Akins began writing a series of plays, poetry and criticism for various magazines and newspapers[3] as well as occasional acting roles in St. Louis area theatre productions.

Two highlights of this period were the films Sarah and Son (1930) and Morning Glory (1933), the latter remade as Stage Struck.

In 1932, she married Hugo Rumbold (in the last year of his life) and, after several Hollywood films, she returned to writing plays and spending time with her family.

In 1935, she was awarded the Pulitzer Prize for Drama for her dramatization of Edith Wharton's The Old Maid, a melodrama set in New York City and written in five episodes stretching across time from 1839 to 1854.

In 1936, Akins co-wrote the screenplay for Camille, adapted from Alexandre Dumas's play and novel, La dame aux camélias The film starred Greta Garbo, Robert Taylor, and Lionel Barrymore, and earned Garbo her third Oscar nomination.