Frontier Nursing Service Medical Surveys

These records appear to be a study on the efficacy and possible side effects of Enovid, an oral contraceptive. All 156 individual birth control records are listed in alphabetical order by the subject’s last name and range chronologically from October 1959 to March 1968. The contents of each file is organized in this order: a chart summarizing the data collected from each woman, including the prescribed monthly dose of Enovid; patient’s general history; monthly menstrual history; Enovid record forms (Boxes 1-3 only); and memos with diagnoses, if any. The Enovid record forms were provided by G.D. Searle & Co., the Chicago pharmaceutical company that poduced Enovid. The principal research investigator for the FNS was Dr. John Rock.

The Frontier Nursing Service’s Family Planning Study was administered in December 1971, largely in the Kentucky counties of Leslie, Clay and Perry. The study has both male and female respondents and centers on FNS-sponsored family planning methods and procedures dating back to 1963. What is striking about the results is the move from reversible means of birth control (most often birth control pills and/or IUDs) to sterilization. Records for 1971 alone show 69 tubal ligations and 26 vasectomies performed that year. In addition to this move toward sterilization, records for 1970 to 1971 show FNS clients far less likely to engage in long-term family planning compared to clients in the mid to late 1960s, opting instead to be sterilized (See boxes 3-4 for examples). Whether this reflects a change in FNS philosophy or simply the wishes of the client base is unknown. What is evident is that those seeking family planning advice in 1970 and 1971 exercised fewer options than earlier clients.

This study was administered to women whose most recent delivery was between 1960 and 1965. It gauges the client’s previous contraceptive history, duration of contraceptive usage and its success. An overwhelming majority of respondents used only an IUD; only about one out of every thirty respondents solely used an oral contraceptive. Statistics from this survey, complied by FNS, are in box 31, Folder 38.

This FNS survey of breast cancer was initiated June 1961, at the request of the American Cancer Society (ACS), and continued until November 1967. The ACS was investigating the hypothesis that mothers who breast fed their infants had a markedly lower occurrence of breast cancer. The voluntary survey was conducted through a questionnaire administered by mail. Nurse Anna May January of the Wendover outpost attempted to contact the first 1000 women whose babies were delivered by the FNS to document any occurrence of breast cancer in the patient or within her family. This data was presumably forwarded to the Kentucky Division of the ACS. Because this survey was taken, in some cases forty years after a delivery, many responses are vague or uncertain (especially in cases where the client died and a next-of-kin answered the survey). All files include a standardized data sheet provided by the ACS. The original questionnaire with client responses and comments is included when available. It should be noted that a high number of respondents had moved since their last contact with FNS, especially to southern Ohio and Indiana. The numbering of cases is based on a system of 1000 based on geographical area. 1000s numbers are for Wendover district; 2000s are for Hyden, Hyden Hospital, and Wooten; 3000s are for Beech Fork; 4000s are for Brutus; 5000s are for Red Bird; 6000s are for Atwood or Flat Creek; 7000s are for Possum Bend; 8000s are for Bowlingtown. The project was originally divided into 2 groups. One group had their first child before 6/9/45. The other group had their first child after 6/9/45. All cases with their first child after 6/9/1945 will have a 2- preceding the case number. Cases with a 4- preceding the case number have moved outside of the territory. More of these records can be found in (2005MS47) Boxes 280-286.