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Madeline (Madge) McDowell Breckinridge (May 20, 1872November 25, 1920) was a leader of the women's suffrage movement and one of Kentucky's leading progressive reformers. She lobbied for women's right to vote in board elections and for state and federal election voting rights. Kentucky ratified the constitution amendment for women's right to vote on January 6, 1920 and the federal Nineteenth Amendment to the United States Constitution was passed that year, which allowed women, including Breckinridge, to vote in the presidential election in November 1920.

She was instrumental in the adoption of legislation to establish the juvenile justice system, which was enacted in 1906. She also lobbied for child labor laws and compulsory school attendance legislation. Breckenridge was the founder of many civic organizations, including the Lexington Civic League, Associated Charities and Kentucky Association for the Prevention and Treatment of Tuberculosis. She led efforts to create these organizations, implement model schools for children and adults, parks and recreations, manual training programs, and health care facilities for tuberculosis treatment. McDowell had suffered from tuberculosis since she was a young woman, and the amputation of part of one of her legs necessitated the use of a wooden leg.

In their book, A New History of Kentucky, Lowell H. Harrison and James C. Klotter, state that Breckinridge was the most influential woman in the state. She was named one of the Kentucky Women Remembered in 1996 and her portrait is permanently displayed at the state capitol. She was a descendant of 19th-century statesman Henry Clay and married editor and publisher Desha Breckinridge.

She was born in Woodlake, Kentucky and grew up at Ashland (Henry Clay estate), the farm established by her great-grandfather, nineteenth-century statesman Henry Clay. Her mother was Henry Clay, Jr.'s daughter, Anne Clay McDowell, and her father was Major Henry Clay McDowell (a namesake of Henry Clay), who served during the American Civil War on the Union side. They purchased the Ashland estate in 1882.

She was one of seven children. There were four boys, Henry Clay, William Adair, Thomas Clay and Ballard. Her two sisters were Nanette and Julia. Henry was a federal judge and Thomas was a renowned thoroughbred racehorse owner, breeder and trainer who won the 1902 Kentucky Derby.

Breckinridge was grandniece of Dr. Ephraim McDowell. Her distant cousin, Laura Clay, founded the Kentucky Equal Rights Association in 1888, of which Breckinridge later became president.

She was educated in Lexington, Kentucky, at Miss Porter's School in Farmington, Connecticut, and at State College (now the University of Kentucky) between 1890 and 1894. She suffered from illness during her college years and, due to tuberculosis of the bone, part of one leg was amputated and she received a wooden leg. The once athletic young woman became more studious. She wrote book reviews for the Lexington Herald and studied German philosophy and literature with other Fortnightly Club members.

On November 17, 1898, Madeline McDowell married Desha Breckinridge, the editor of the Lexington Herald. He was the brother of the lawyer and pioneering social worker Sophonisba Breckinridge, who wrote a biography of her sister-in-law entitled Madeline McDowell Breckinridge: A Leader in the New South.

The Breckinridges together used the newspaper's editorial pages to promote political and social causes of the Progressive Era, especially programs for the poor, child welfare and for women's rights. Desha was not a faithful man during their marriage, and as a result Breckinridge escaped her embarrassment by being busy with her civic activities. She was a patient in a Denver, Colorado sanitarium in 1903 and 1904. About 1904, when she was 32 years of age, she suffered a stroke.

She organized a social settlement at Proctor, Kentucky's Episcopal mission with the Gleaners of Christ Church Episcopal from 1899 to 1900. In 1900, she helped found the Lexington Civic League, which created public kindergartens, parks, and recreational opportunities for children, and she also helped found the relief organization, Associated Charities, that year. Breckenridge also worked to have laws enacted regarding child labor, compulsory school attendance, a development of a juvenile justice system in the state (law passed in 1906). She also worked to introduce manual training of domestic science and carpentry in schools, which was funded by the board of education beginning in 1907. Through the efforts of the Lexington Civic League, she founded a social settlement, similar to Chicago's Hull House, named the Lincoln School for Robert Todd Lincoln who donated $30,000 towards the building cost. The school, which opened in 1912, had classrooms for children's day and adult's night classes, swimming pools, gymnasium, a laundry, carpenter shop, cannery, and a community assembly hall. It served poor Lexington residents, including an influx of Irish immigrants, many of whom were illiterate.

Breckinridge began working on finding ways to provide services for individuals with tuberculosis in Lexington in 1905, first with the development of a free clinic. She led the efforts within the Associated Charities and Civic League. She founded the Kentucky Association for the Prevention and Treatment of Tuberculosis in 1912, helped establish the Blue Grass Sanitarium in Lexington, by also working with the Fayette County Tuberculosis Association, and served on the state commission until 1916. Breckenrdige chaired the legislative committee of the Kentucky Federation of Women's Clubs in 1908, 1910, and 1912.

Frustrated by the lack of influence that she and other women had with state politicians regarding social reform, Breckenridge began lobbying the right for women to vote so they would have a greater voice in the political process. From 1912 to 1915 and 1919 to 1920, Breckinridge served as president of the Kentucky Equal Rights Association. Women were given the right to vote in school elections in 1912, based on her lobbying efforts as legislative chair of the Kentucky Federation of Women's Clubs. Breckenridge was, between 1913 and 1915, vice president of the National American Woman Suffrage Association. She spoke about women's suffrage in several states. Breckenridge was also a member of the Fayette Equal Rights Association, which was a chapter of the Kentucky Equal Rights Association. Its goal was to gain state and federal legislation for women's right to vote. A "leading political figure", she was involved with the Woman's Democratic Club of Kentucky.

The most influential woman in the state, she used new tactics, such as suffrage marches, as well as her speaking ability and humor, to gain more support. In a strong voice coming from a slim and often weak body, she told audiences to look at male-led Kentucky, with its poor schools, violence, and corrupt politics, and asked if the question should not be whether women were fit for suffrage but whether men were. — Lowell H. Harrison and James C. Klotter, A New History of Kentucky

The Nineteenth Amendment to the United States Constitution ratified in Kentucky on January 6, 1920. Breckinridge campaigned across the country for the Democratic party and she voted in the November United States presidential election, 1920. She turned her efforts, then, on forming the state League of Women Voters from the Kentucky Equal Rights Association. Breckinridge was also a vocal supporter for the League of Nations.

Breckenridge suffered from health problems, including tuberculosis, during her lifetime. She had a stroke and died on Thanksgiving Day, 1920 at the age of 48. She was busy on that day preparing donations for the poor for the holiday. Her papers are held at the University of Kentucky Libraries. She was buried in the Lexington Cemetery in Lexington, Kentucky.

Breckinridge, named one of the Kentucky Women Remembered in 1996, was "regarded by some as militant, was one of Kentucky's most active suffragists and a fervent supporter of the nineteenth amendment. She married Lexington Herald Leader editor Desha Breckinridge and edited the women's pages, emphasizing civic and social issues over more conventional news. She also used the paper to advocate women's rights to vote." Her portrait is a permanently hung in the capitol's "Kentucky Women Rembembered" display.