It was the middle of the night on April 2, 2024, when Teela Banister went into labor. She and her husband raced out the door of their rural home on the outskirts of Baker City in eastern Oregon, hoping to make the hour-long journey to a hospital before she delivered their daughter.

They could not go to the hospital just 15 minutes away, Saint Alphonsus Medical Center, which shuttered its labor and delivery unit in August 2023 — weeks before the couple found out they were expecting a second child.

Banister, 25, dreaded the prospect of giving birth without the Baker City obstetrics program. An aspiring labor and delivery nurse herself, she knew being so far from a hospital was risky, especially given how quickly she gave birth to their first child.

“My biggest fear … was that I was going

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