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At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers and preceptors. Spotlight blogs feature members of our FNU community that are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

In 1928, Mary Breckinridge, founder of Frontier Nursing University established the Courier Program, recruiting young people to come work in the Kentucky Mountains and learn about service to humanity. Couriers escorted guests safely through remote terrain, delivered medical supplies to remote outpost clinics, and helped nurse-midwives during home visits and births. Frontier has benefited tremendously from the 1,600 Couriers who have served since 1928.

When she was 20 years old, Maggie traveled from Louisville, Kentucky to Wendover in the mountains. Being from Kentucky, Maggie and her family had heard of Frontier Nursing Service and the Courier Program long before she became a Courier. She had thoughts of joining the Peace Corps, and she saw some similarities in the Courier Program so she decided to join.

Although she was from Kentucky, Maggie had never been to the mountains of Eastern Kentucky. She knew nothing about Appalachia before she participated in the Courier Program. “At the time I went to FNS, no place had felt more different to me than Eastern Kentucky… I had my first sense of culture shock there.”

Although it seemed like a world very different from her own, by the time she left the program, she had a special place in her heart for Appalachia.

She spent her time as a Courier dropping off supplies at the clinics and hospitals, driving the infamous FNS jeeps, shadowing a social worker, and getting to know the other Couriers, midwifery students, and members of the community.  Maggie particularly remembers spending time with the Wooton family who lived down the road from Wendover–playing music and square dancing.

Although she was interested in poverty, women’s issues, and worlds outside of her own prior to becoming a Courier, her time in the Courier Program strengthened and grew these interests.

“Staying there and feeling very immersed, getting to know people there, midwives and people who lived there, I just felt part of this community.”

Her feelings and experiences as a Courier helped to influence her life in terms of what she wanted to do professionally in the future. The things that she experienced and witnessed as a Courier changed her direction from healthcare to journalism.

Maggie is now working as a freelance journalist who writes about race, poverty, and social justice issues. Since she has left the Courier Program, she has written a lot about health, specifically reproductive health. She would love to return to Eastern Kentucky to write stories, but she has not yet done so.

Her experiences and things that she learned during the Courier Program continue to have an influence in both her writing and her life today.

“One of the things that I liked the most about it is that it didn’t feel like we were just outsiders. It was a few months but it really had an impact on me… It was one of those life changing events and I am so glad that I did it. It was a rare experience.”

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers and preceptors. Spotlight blogs feature members of our FNU community that are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

In 1928, Mary Breckinridge, founder of Frontier Nursing University established the Courier Program, recruiting young people to come work in the Kentucky Mountains and learn about service to humanity. Couriers escorted guests safely through remote terrain, delivered medical supplies to remote outpost clinics, and helped nurse-midwives during home visits and births. Frontier has benefited tremendously from the 1,600 Couriers who have served since 1928.

While searching for her own life’s future direction, Marian Leibold saw the perfect opportunity to pursue a summer filled with adventure and service by traveling to help where her help could be used–Leslie County, KY. So in 1977, she, like many before her, embarked on her adventure in Wendover as a part of the Courier Program.

From her first day at Wendover, Marian felt as if she belonged. In a journal entry, Marian reflected:

“The veil of silver mist rising over the rich green mountains, the apples on the drive, the dusty pebbles on the road, the nasturtiums which leapt colorfully out of the cracks in the stone wall, the abundance of purple joe-pye weed behind the garden house, an old shed with sleeping tools, the chicken coup still offering up eggs for breakfast all invited me in…The first day we were introduced to our quarters and the ways of life here and our mission as Couriers.”

Although she never met Mary Breckenridge, Marian felt a strong connection with the spirit of her work. During her time in the program, she learned about Mary Breckenridge’s life, experiences, passions, and struggles. In fact, one of the many aspects of the Courier Program that attracted Marian was its foundation by a woman.

“I was moved by her willingness to leave her own comfort zone to bring a better life to others.  Such a courageous move is born out of tremendous character, conviction and compassion.”

As a Courier, Marian shared many experiences with other Couriers, nurses, and local residents, all of which left lasting impressions. She was at a point in her life where she was ripe with big questions about both herself and the world, so Marian stumbled upon the Courier Program at the perfect time.

Her time as a Courier impacted her career path as well. Marian met a nurse in the Midwifery program and later joined this nurse in Lesotho, Africa. In Africa, she learned about the nurse’s work and medical missions.

Later, Marian attended medical school at the University of Cincinnati. Just before finishing, though, she decided to turn her attention to her family; she now lives with her husband and four children in Cincinnati.

Marian continues to stay involved with Frontier Nursing University and the Courier Program by hosting and planning the annual Cincy committee dinner, personally supporting Frontier, and serving on the Courier Advisory Committee.

Marian strongly believes that it is important for young adults to have mentors, and she is grateful that Frontier Nursing University’s Courier Program was able to serve in that role for others, just as it had for her.

She speaks to how the Courier Program teaches the rewards of deep and lasting commitments, as well as the value of traveling outside of your comfort zone to experience other perspectives on life and using those experiences to better yourself and your communities. In this way, Marian believes, the Courier Program leaves lasting impacts on the Couriers who come to serve.

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers and preceptors. Spotlight blogs feature members of our FNU community that are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

In 1928, Mary Breckinridge, founder of Frontier Nursing University established the Courier Program, recruiting young people to come work in the Kentucky Mountains and learn about service to humanity. Couriers escorted guests safely through remote terrain, delivered medical supplies to remote outpost clinics, and helped nurse-midwives during home visits and births. Frontier has benefited tremendously from the 1,600 Couriers who have served since 1928.

In the late 1960’s, Phoebe Woods spent a summer in Wendover serving as a Courier for Frontier Nursing Service. The Courier Program was a family tradition: Phoebe’s mother and aunt had both been Couriers. Phoebe grew up being told stories of the Courier Program, Frontier Nursing Service, and Mary Breckinridge that had been passed down by generations of women in her family.

Phoebe remembers her first morning in Wendover, when she was awakened at 5 a.m. by someone in her room. It was a bit startling, as she recalled. As it turned out, it was an older gentleman named Henry. He and other FNS staff often did this to new Couriers as practical joke on their first morning there. Henry was doing his job and after that day, he came to her room every morning to light the coal fires so that Phoebe would stay warm.

At the beginning of the summer, Phoebe picked out her infamous khaki pants and white polo from the “Courier grab bag” in the Garden House basement–something that had been around since the time that her mother was a Courier.  There were khakis in the grab bag that dated back to the 1940’s and 1950’s. The Couriers were able to choose whatever clothing they needed from the grab bag and returned the items at the end of the summer.

As a Courier, Phoebe drove the FNS jeeps, cared for the horses and other animals, ran errands to prepare for tea and sherry hour, and even remembers shooting rats in the town dump, which was not something all Couriers did. Her favorite part of the day was exercising the animals. One day, Phoebe used Molly the Mule to plow a very steep hill by the garden, one of the most tiring tasks that Phoebe volunteered to do as a Courier.

She spent a lot of time transporting patients and nurses to and from the clinics and hospitals.  She also was able to work at these outpost clinics and hospitals in the community, assisting with whatever odd jobs may need to be done.  

There was no veterinarian at Wendover, so when there were emergencies with any of the animals, Phoebe volunteered to fill this role. She remembers giving medication to a sick cow and a shot to a farmer’s pig.

“I was always willing to do any weird, unusual thing…I was loving this life out there and anything I could do that was different or unusual, I was happy to do it,” she recalls.

After her summer as a Courier, Phoebe stayed at Wendover to serve as the Christmas secretary, a position that her mother had once held, as well. She remembers receiving truckloads of presents from all over for new mothers and families. Phoebe organized the presents by gender and age and loaded the truck according to what the members of the community might need.  

Phoebe became close friends with a fellow Courier, Effner Tudor, who also spent a large amount of time at Wendover as a Courier. When both Phoebe and Effner had finished their service at Frontier Nursing Service, they traveled around the United States and Canada together for three months, driving from state to state and camping out.

As she was growing up, her mother and other women around her did not work. Wendover was Phoebe’s first exposure to women working, and not only were the women working, they were running things. People came from all over the world to see how well the women at Wendover ran Frontier Nursing Service. This astonished Phoebe and made a lasting impression on her!

Phoebe’s time as a Courier profoundly influenced her life in many ways. In fact, Phoebe reflects, “There are very few things in my life that affected me more than FNS.” The Courier Program empowered Phoebe as a woman personally, professionally, and even inspired her continual love for Khakis.

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers and preceptors. Spotlight blogs feature members of our FNU community that are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

In 1928, Mary Breckinridge, founder of Frontier Nursing University established the Courier Program, recruiting young people to come work in the Kentucky Mountains and learn about service to humanity. Couriers escorted guests safely through remote terrain, delivered medical supplies to remote outpost clinics, and helped nurse-midwives during home visits and births. Frontier has benefited tremendously from the 1,600 Couriers who have served since 1928.

Sallie Bingham was a Courier in the year 1957. Sallie’s parents sent her from Louisville to Wendover as a way of avoiding a local traditional summer. She had just finished her junior year in college, and although it was the custom of that time, she did not want to make her “debut” like the rest of her classmates. Instead, they packed up the car and her father drove her down to be a Courier for the Frontier Nursing Service.

Sallie experienced a rough transition at Wendover. She struggled with feeling useful to the midwives. She recalls that there was not always something to do and in fact, there would be long stretches of time where there was nothing to do at all.

However, she was able to go on a couple of calls with the midwife and stood outside to hold the horse while she worked in the cabin. She also escorted a few guests and did some mucking out of the stables.  Although she did not see a delivery of a baby, Sallie was able to see a calf born in the middle of the night with one of the nurses!

During free time, she remembers riding on the mountain roads, singing along the way so that the moonshiners could hear her.

Sallie had the opportunity to meet Mary Breckinridge a few times at tea, although Mary was usually fairly quiet. Sallie was fascinated by her. She was deeply touched by the plaque that was in town commemorating Mary Breckinridge’s children.

Although her time as a Courier was not what she had expected, Sallie was exposed to a way of life that she had not previously experienced. She was amazed by the life of poverty and Appalachian culture of that time, which opened her eyes in many ways to other aspects of the world.  

Her love for the health and wellbeing of women has continued, and she has remained interested in the history of FNS and Mary Breckinridge and their role in Kentucky’s history.

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers and preceptors. Spotlight blogs feature members of our FNU community that are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

In 1928, Mary Breckinridge, founder of Frontier Nursing University established the Courier Program, recruiting young people to come work in the Kentucky Mountains and learn about service to humanity. Couriers escorted guests safely through remote terrain, delivered medical supplies to remote outpost clinics, and helped nurse-midwives during home visits and births. Frontier has benefited tremendously from the 1,600 Couriers who have served since 1928.

From Blog Post July 1, 2009 entitled “birth number ONE” (written Wednesday, June 4th) (khakiandwhite.blogspot.com)

Everyday I get a little clearer sense what the life of a nurse midwife looks like. Today I opened an entirely new door, the exhaustion of laboring. Yesterday I attended my first birth. Today I can feel it.

On some level, I feel there was some fate in it, well fate and luck. I showed up at the wrong clinic and ended up shadowing a different midwife than I’d been scheduled with.

As I was walking into the hospital clinic, I saw a woman who had agreed to allow me at her birth, sitting outside, cigarette in hand, hair recently washed and done. It didn’t take the looser belly to know the deed had been done. I approached her to see a new whiteness in the irises and an exhaustion laid heavy in the pupils of her eyes. The baby came out the previous night and she was doing well.

Inside the Labor and Delivery Ward, another mother, E, who I had seen on a couple of prenatal visits in the clinic was in the initial stages of labor. The midwife suggested I visit her and ask if I could attend her birth. First thing in the morning, I opened the door, to see this young, beautiful woman laid flat on a hospital bed breathing with great concentration. She was holding onto the bars on the sides of the bed, bracing herself. Long brown curls (which are a rarity around these parts) fell onto either side of her chest. Nervously, I asked if I could be at the birth, she said “everyone else will be here I don’t see why not” and gave me a sweet, teasing smile.

As soon as the midwife told Eve it was better not to stay in the bed, she was up and around the majority of the day. When I left the building for lunch, she was breaking from lapping the hospital parking lot to lean on your partner during a contraction. When I left for dinner, E, in hospital gown and bright red corduroy, velour pants, was seated on a bench in front of the hospital surrounded by what seemed to be an entire family.

The midwife told me that E wanted to go through labor without any drugs. Many of the pregnant women in this midwifery practice had been recreational drug users. Most pregnant drug users cannot get prenatal care or any help getting off the pills. This clinic runs a program that puts these women on Subutex, an opiate blocker, to help them stay clean through the pregnancy (and hopefully permanently). They also monitor the babies very closely.

Eve was one of these women. When she first came to the clinic the midwives weren’t sure she’d make it through the program. All sorts of terrible events occurred during pregnancy – her car was broken into, she was assaulted, her car broke down, she got kicked out of her apartment. The whole time she stayed clean and followed the rules of the program. I can’t help but think that her ability to stay off drugs over the nine months was the inspiration and motivation to go through labor without medical intervention.

The midwife was committed to helping her succeed. She said we’d stay in the room as much as possible to help E stay calm and on track.

After dinner E’s labor picked up, the contractions were stronger and closer together. Her mother, aunt, mother-in-law, and partner were all her hospital room. The first stage of “extremely” active labor lasted for 3-4 hours, in which the contractions are crampy. She mostly sat on the “birthing ball” (blow up exercise ball), rolling her hips around in a circular motion, with her head on bed next to her. She hated lying on the bed, swearing the pain was 10 times worse. Following the midwives lead, we rubbed her back and whispered encouraging words into her ears: “You’re doing great”, “This contractions is almost over”, “You are so strong”.

Before long she was in transition, which is when the contractions are extremely close together and intense. It pushes the woman to her edge. This period is borderline intolerable. E stated she’d never get pregnant again, that she couldn’t do this, that she was dying. Tears rolled down her face. She clenched her partners hand with desperation, her green tipped acrylic nails shaking.

And then it was over. E was 10 centimeters, or her cervix was fully dilated. The contractions calmed down. E was still frazzled and scared of what was to come next. She was especially afraid of pushing the baby out, the pain it would bring. The midwife helped her relax. She told her what it would feel like. She explained that an epidural would take away some of the pain, but that it was better for the 1st stage of contractions, which she had already made it through with brilliant courage. The midwife never told her what to do. She gave E options, explanations, and enough information for E to make the decision herself. E chose to keep going without medication.

In Stage Two of labor, the contractions shift from cramping to pressure. It was 2-3 hours of pushing before the baby came out. E started on the ball and moved to a hands and knees position on the bed. We were all around her, cheering her on through massage, kind words, holding her up, giving her our necks to grasp around and hands to squeeze. First, she pushed the membranes out. The midwife suggested she rotate onto her back. At this point, the midwife put her sterile gown and gloves on and rolled the table of delivery equipment into the room. Her intact water sack was at the lips of her vagina. The midwife broke it with a tool similar to a plastic crochet needle. The baby’s head crowned, hints of its black hair peeking through.

E breathed the baby out into the world. With each exhale the head moved 2 steps forward, and with each inhale the head returned to the womb 1 step. Slowly, with great control, over the course of 4 contractions a child emerged from the vagina. Once the head was fully out, the body followed in one smooth, goop-covered, movement, like coming down a slide. It was 11:45pm, just moments before the next day. Within seconds, the room was in tears. The midwife worked with calmness and precision, smiling assurance into the room. As she bulbed liquid from the baby’s mouth, he made his introduction to this room with strong stream of urine up into the air. The purple and white candy-canned umbilical cord reached from mom’s vagina to the baby’s belly. Still connected, the midwife handed the tiny purplish boy to his mother. Extending her arms forwarded, with a look of surprise and uncertainty, she reached for him, bringing him to her chest. For a few moments they were joined in two incredibly profound connections.

The midwife handed the father the scissors and clamped the umbilical cord in two places. Dad cut between them.

The final step of labor is delivering the placenta. With one push, E urged the purple-red mass out of her body. The midwife laid it out on the table and showed the mother her healthy placenta.

The mother’s body quivered from the loads of lactic acid built up in her body. The nurses checked the baby with the dad looking over their shoulders. A fine little boy. Before I left for in the early morning, E and the baby were practicing breastfeeding. A perfect culminated to long sought union.

I’ve looked forward to my first birth for some time now. It was the ideal delivery for me to participate in – all natural, spontaneous, vaginal. I saw the stages of labor clearly over the course of the day. I experienced the power of a birth in the company of loved ones. I observed a midwife work in an ideal condition. I had expected to be most blown away from by the moment the baby emerges from the vagina, into the world. Although I shed a tear or two, what impressed me the most were the steps the midwife took to keep the mother clam and fully inform her of all her options. Throughout the birth, the midwife was the mother and child’s advocate.

My alarm went off this morning after 4 hours of sleep. Signs of darkness where still in the air and rain was pouring down making that sound that streams “stay in bed”. Knowing, if I was a midwife I’d have to get up, I hit the snooze button twice and jumped out of bed with no complaints. I structured my crazed curls into a semi-appropriate style and hopped in the car at 7am to head to the elementary school to assist a health education lesson. Now I sit, sipping soda to keep my eyes open at the Habitat for Humanity Thrift Store in town. I was planning to start painting the walls. The weight of birth has slowed me. Rocking back in forth, old time mountain music singing over the radio, and rain ringing patterns on the sidewalk, I am grateful.

– Amanda