The history of Frontier Nursing University cannot be told without discussing the contributions, vision, and leadership of Kitty Ernst.
Eunice Katherine “Kitty” Macdonald Ernst was born on July 21, 1926, in Waltham, Massachusetts, and became a dynamic and committed pioneer in midwifery education and practice. She was passionate about ensuring that all families receive the best possible care during pregnancy and birth.
After graduating from the Waltham Hospital School of Nursing in Massachusetts, Kitty made the decision to embark on an adventure by working at Frontier Nursing Service (FNS) in Kentucky. During her time as a nurse at FNS, she was introduced to nurse-midwifery and inspired by the nurse-midwives who travelled on horseback in the rural mountains of Kentucky to deliver care to mothers and families. This led to her decision to attend the Frontier Graduate School of Midwifery, a part of the FNS, in Hyden, Kentucky, in 1951.
During her time as a student at FNS, Kitty realized the impact of midwifery on the health of women and families. Throughout her life, Kitty often told the story of how awestruck she was when she first witnessed the power of a woman birthing in her own mountain home. Those first births Kitty witnessed as a midwifery student set her on a lifelong course of promoting and supporting normal birth, in a safe and comfortable setting, and educating midwifery students in these principles. Kitty knew that educating new nurse-midwives was essential to transforming health care not only for mothers but for their families as well.
Following her time at FNS, Kitty went on to earn a bachelor’s degree in education from Hunter College in 1957 and a master’s degree in public health from Columbia University in 1959. From 1954-58, Kitty served as a nurse-midwife for the Maternity Center Association (MCA) in New York City. She started her own family, marrying Albert T. Ernst in 1961. Together, they had three children, Rosemary, Albert “Ted” Jr., and Kate. During this time, Kitty worked as a parent educator, teaching some of the first childbirth education groups of the International Childbirth Education Association. As a field consultant for MCA, she developed family-centered maternity care provided by an obstetrician nurse-midwife team at the Salvation Army Booth Maternity Center in Philadelphia.
Kitty was passionately committed to birth centers as a key solution to challenges in maternity care. Generations of midwives learned from Kitty that birth centers are safe options to practice midwifery model of care and must be a part of the health care system. Kitty co-founded the National Association of Childbearing Centers (NACC) in 1983 now the American Association of Birth Centers. As Director of the NACC, she steered the development of the Commission for Accreditation of Freestanding Birth Centers in 1985.
In the 1980s, Kitty became particularly concerned about two issues: the small number of nurse-midwives being educated each year, and the fact that the majority of nurse-midwives being educated in large tertiary care centers had a lack of out-of-hospital experience. To address these issues, she led the design and implementation of the first distance education program for nurse-midwives, which was adopted by the Frontier School of Midwifery and Family Nursing, now known as Frontier Nursing University. Over many years, Kitty graciously shared her personal story, her passion, and her vision with every single class of incoming FNU students.
Kitty, who often quoted one of the key beliefs of FNS that “all health care begins with the care and education of the mother,” maintained strong ties with FNU throughout her life. She served on FNU’s Board of Directors from 1975-2021, was awarded an honorary doctorate from FNU in 2011, and occupied the Mary Breckinridge Chair of Midwifery.
“Kitty’s impact was significant and everlasting upon every person she met and every organization she served,” said Dr. Susan Stone, FNU President Emerita and Distinguished Chair of Midwifery and Nursing. “For me, she was a dear friend, mentor, and mother figure. For Frontier, she was the innovator who led the creation of our distance learning model, our loyal supporter, inspirational leader, and was kind and gracious to all. We are thankful for her countless contributions to FNU and to midwifery. She will forever be part of the Frontier Nursing University community and will live on in our hearts and many traditions.”
Kitty served as the president of the American College of Nurse-Midwives (ACNM) from 1961-63 and again from 2007-2008. Since 1998, ACNM has annually presented the Kitty Ernst Award to “an exceptional, relatively new CNM/CM who is an ACNM member, has been certified for less than ten years and has demonstrated innovative, creative endeavors in midwifery and/or women’s health clinical practice, education, administration, or research.”
The criteria for the ACNM Kitty Ernst Award are befitting of Kitty’s contributions to the profession. She was a leader in education and administration, conducting the first wave of accreditation for nurse-midwifery education programs and developing the first “What is a Nurse-Midwife” brochure. Over the course of her career, she published valuable information defining the role of a nurse-midwife and played a crucial role in the first accreditation of nurse-midwifery programs in the U.S. As the Director of the pilot Community-based Nurse-Midwifery Education Program (CNEP), she developed a model for meeting the overwhelming need for experienced birth center nurse-midwives committed to innovative family-centered maternity.
Kitty’s impact spread far and wide. She traveled across the U.S. and abroad to Germany, Scotland, Hungary, Belgium, Russia, and Haiti to provide consultation and workshops on the midwifery model of care in birth centers.
“Kitty Ernst led with passion, perseverance and commitment, and perhaps most importantly, by her presence,” said Dr. Joan Slager, former FNU Dean of Nursing (2018-2025). “She always made herself available and tirelessly shared her wisdom and advice with students, alumni and friends. As we celebrate her legacy, it is important that we continue to learn from her example and adopt the same vision for the future that she had.”
Kitty’s many accolades included the Martha Mae Elliot Award for Exceptional Health Service to Mothers and Children from the American Public Health Association. ACNM presented Kitty with the Hattie Hemschemeyer Award, which honors an exceptional certified nurse-midwife or certified midwife who is an ACNM member who has provided continuous outstanding contributions or distinguished service to midwifery. She received the Childbirth Connection Medal for Distinguished Service and was awarded the Maternity Center Association’s Carola Warburg Rothschild Award, which recognizes outstanding contributions to the health and well-being of women and their families.
Kitty’s impact was significant and everlasting upon every person she met and every organization she served. She was a dear friend, loyal supporter, inspirational leader, and was kind and gracious to all. She will forever be part of the Frontier Nursing University community.
