Mary lived and worked long-term overseas in Somalia, Belize, Swaziland, Kazakhstan, and Indonesia. She was a specialist in safe motherhood, child survival, family planning, lactation management, and prevention of mother-to-child transmission of HIV (PMTCT). Mary consulted widely for UNICEF, World Bank, USAID and private funders in Belize, Cambodia, Ethiopia, Indonesia, China, Ghana, Nigeria, Uganda, Zambia, Malawi, Swaziland, Kazakhstan, Uzbekistan, Kyrgystan, Turkmenistan and Jordan. Her international work found her frequently counter-parted with Ministry of Health program planners, educators and policy makers, and in this role she tried to bridge the gap between developing country realities and western norms and standards that are brought in under the "development model."
For two decades, Mary also remained clinically active and practiced midwifery in all settings: home, birth center and hospital delivery in and outside of the USA. Her first book, "Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum" released in July 2003, reflects her philosophy of keeping mother and baby together at all times.