Born in New York to an abolitionist Quaker family, Abigail Gibbons grew up in a home that often harbored slaves on their way to freedom. Gibbons was also a medical nurse who brought the social convictions she learned at home to her medical and administrative duties. When the U.S. Sanitary Commission was established in 1861 to oversee the recruitment of much needed nurses and ensure adequate medical care to the Union wounded, Gibbons was selected to serve. The Commission set up a training base for the female recruits at David's Island Hospital in New York, and Gibbons was among them.

Gibbons traveled to Washington, D.C., to help at the Washington Office Hospital, where she soon took charge, helping the wounded and distributing supplies from the New York Relief Agency. She also established two field hospitals: in Strasburg and Falls Church, Va. When a site opened for the government at Point Lookout, Md., a hotel and 100 cottages were refurbished to create an elaborate hospital complex with accommodations for 1,500 soldiers. It was named the U.S. Hammond General Hospital, after Surgeon General William A. Hammond. At Hammond General, Gibbons clashed with a woman as aggressive and committed as herself; Superintendent of Nurses Dorothea Dix. Dix and Gibbons vied for control of the hospital, and Gibbons succeeded in being appointed its head matron.

Gibbons served conscientiously at the institution, punctuating her career once again with controversy. She was accused of siphoning hospital supplies to the "contrabands," or runaway slaves who came into the hospital. Further, she refused to return the runaways to their owners. She left Hammond General in 1863 when the site was converted into Point Lookout Prison.

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