{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T17:25:09Z","timestamp":1748107509943},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,1,16]],"date-time":"2015-01-16T00:00:00Z","timestamp":1421366400000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:p>This article examines how the Frontier Nursing Service (FNS) utilized nurse\u2010midwives to respond to antepartum emergencies such as preterm birth, eclampsia, malpresentation, and hemorrhage in the women of Appalachia in the years 1925 to 1939. Particular attention is given to the preparation that nurse\u2010midwives received during their midwifery education to prevent and respond to emergencies. Using traditional historical research methods and primary source material from the FNS papers in the Special Collections, University of Kentucky Libraries, Lexington, Kentucky, this article describes the nurse\u2010midwives\u2019 experiences and how they implemented skills they had learned during their training in Great Britain. Working in the isolated mountainous area of Leslie County, Kentucky\u2014for the most part without direct assistance from physicians\u2014FNS nurse\u2010midwives decreased maternal and neonatal mortality rates. During their first 2000 births, they had only 2 maternal deaths, whereas the national average maternal mortality rate was approximately 7 deaths per 1000 births. The nurse\u2010midwives performed external cephalic versions on a routine basis. For pregnancy and birth emergencies, they administered sedation, gave general anesthesia, and performed invasive lifesaving techniques in order to protect the lives of the women in their care. During these 14 years, their cross\u2010cultural engagement, assessment skills, clinical judgment, and timely interventions improved maternal and child health throughout the region.<\/jats:p>","DOI":"10.1111\/jmwh.12212","type":"journal-article","created":{"date-parts":[[2015,1,16]],"date-time":"2015-01-16T16:07:52Z","timestamp":1421424472000},"page":"48-55","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Frontier Nurse\u2010Midwives and Antepartum Emergencies, 1925 to 1939"],"prefix":"10.1111","volume":"60","author":[{"given":"Donna L.","family":"Schminkey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene W.","family":"Keeling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,16]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"7","article-title":"Mountain obstetrics","author":"Kooser J","year":"1938","journal-title":"Medical Routine for the use of the Frontier Nursing Service"},{"key":"e_1_2_6_3_1","unstructured":"Metropolitan Life Insurance Company.Statistical tables from First Thousand Births Frontier Nursing Service 1925\u20101930 Box 12 Folder 7. Frontier Nursing Collection 1789\u20101985 85M1 Special Collections University of Kentucky Libraries Lexington KY."},{"key":"e_1_2_6_4_1","unstructured":"Frontier Nursing Service district records.Box 10 Folders 4 19 20 22 23. Special Collections University of Kentucky Libraries Lexington KY."},{"key":"e_1_2_6_5_1","volume-title":"Wide Neighborhoods: A Story of the Frontier Nursing Service","author":"Breckinridge M","year":"1952"},{"issue":"33","key":"e_1_2_6_6_1","first-page":"1","article-title":"National Center for Health Statistics","volume":"3","author":"Hoyert DL","year":"2007","journal-title":"Maternal mortality and related concepts"},{"key":"e_1_2_6_7_1","volume-title":"Income and Health in Remote Rural Areas; a Study of 400 Families in Leslie County Kentucky","author":"Willeford M","year":"1932"},{"key":"e_1_2_6_8_1","first-page":"8","volume-title":"Five Decades of Action for Children: A History of the Children's Bureau","author":"Bradbury DE","year":"1962"},{"key":"e_1_2_6_9_1","first-page":"49","volume-title":"Nursing and the Privilege of Prescription, 1893\u20102000","author":"Keeling A","year":"2007"},{"key":"e_1_2_6_10_1","first-page":"11","volume-title":"Midwifery in the Kentucky Mountains: An Investigation","author":"Breckinridge M","year":"1923"},{"key":"e_1_2_6_11_1","unstructured":"Rockstroh E.Oral interview with Dale Deaton tape 1 side 1 Frontier Nursing Service Oral History Project (OHFNS) Louie C. Dunn Center for Oral History University of Kentucky Lexington KY.1979."},{"key":"e_1_2_6_12_1","unstructured":"Veech AS Written correspondence to Mary Breckinridge dated October 31 1923. Box 348 Folder 3. Frontier Nursing Collection 1789\u20101985 85M1 Special Collections University of Kentucky Libraries Lexington KY."},{"issue":"4","key":"e_1_2_6_13_1","first-page":"485","article-title":"Mary Breckinridge, the Frontier Nursing Service and the introduction of nurse\u2010midwifery to the United States","volume":"57","author":"Dye NS","year":"1983","journal-title":"Bull Hist Med"},{"key":"e_1_2_6_14_1","unstructured":"Breckinridge M.Written correspondence to Kitty [Jessie \u201cKit\u201d Carson] dated November 24 1926 Box 328 Folder 13 Frontier Nursing Service Collection 1789\u20101985 85M1 Special Collections University of Kentucky Libraries Lexington KY."},{"key":"e_1_2_6_15_1","volume-title":"A Letter to the Expectant Mother","author":"Breckinridge M","year":"1933"},{"issue":"1","key":"e_1_2_6_16_1","first-page":"12","article-title":"The first centers of nurse\u2010midwifery","volume":"1","year":"1925","journal-title":"Front Nurs Serv Q Bull"},{"key":"e_1_2_6_17_1","volume-title":"Statistical Tables From First And Second Thousand Births Frontier Nursing Service, 1925\u20101930","author":"Metropolitan Life"},{"key":"e_1_2_6_18_1","first-page":"10","volume-title":"Medical Routine for the use of the Frontier Nursing Service Incorporated","year":"1928"},{"key":"e_1_2_6_19_1","first-page":"16","volume-title":"Medical Routine for the use of the Frontier Nursing Service Incorporated","year":"1930"},{"key":"e_1_2_6_20_1","volume-title":"Textbook for Midwives","author":"Fairbairn JSA","year":"1918"},{"issue":"3","key":"e_1_2_6_21_1","first-page":"7","article-title":"How does the frontier nursing service handle obstetrical complications","volume":"11","author":"Buck D","year":"1936","journal-title":"Front Nurs Serv Q Bull"},{"issue":"11","key":"e_1_2_6_22_1","first-page":"1183","article-title":"Saddle\u2010bag and log cabin technic: the Frontier Nursing Service, Inc","volume":"38","author":"Summers V","year":"1938","journal-title":"Am J Nurs"},{"key":"e_1_2_6_23_1","volume-title":"Delivery Bag Equipment lists","author":"Frontier Nursing Service, Inc"},{"key":"e_1_2_6_24_1","unstructured":"Dubline LI.Written correspondence to Mary Breckinridge dated May 4 1932 Box 12 Folder 9. Frontier Nursing Service Collection 1789\u20101985 85M1 Special Collections University of Kentucky Libraries Lexington KY."},{"key":"e_1_2_6_25_1","volume-title":"Frontier Nursing Service, 1925\u20141930","author":"Delivery Logs Beech Fork Collection"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1961.tb02747.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM194208202270802"},{"key":"e_1_2_6_28_1","volume-title":"Obstetrics; a Textbook for the use of Students and Practitioners","author":"Williams JW","year":"1917"},{"key":"e_1_2_6_29_1","volume-title":"Obstetrics: A Textbook for the use of Students and Practitioners","author":"Williams JW","year":"1930"},{"key":"e_1_2_6_30_1","volume-title":"Frontier Nursing Service, 1925\u20101930","author":"Metropolitan Life"},{"issue":"4","key":"e_1_2_6_31_1","first-page":"3","article-title":"The wealthiest nation in the world; its mother and children","volume":"4","journal-title":"Front Nurs Serv Q Bull"},{"issue":"2","key":"e_1_2_6_32_1","first-page":"3","article-title":"Betsy and Bobby","volume":"8","author":"Peacock GM","year":"1932","journal-title":"Front Nurs Serv Q Bull"}],"container-title":["Journal of Midwifery &amp; Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjmwh.12212","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjmwh.12212","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jmwh.12212","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T19:13:57Z","timestamp":1696274037000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jmwh.12212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1111\/jmwh.12212"],"URL":"https:\/\/doi.org\/10.1111\/jmwh.12212","archive":["Portico"],"relation":{},"ISSN":["1526-9523","1542-2011"],"issn-type":[{"value":"1526-9523","type":"print"},{"value":"1542-2011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1]]},"assertion":[{"value":"2015-01-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}