This rural California county lost its only hospital, leaving residents with dire health care choices

MADERA, Calif. — It was dinnertime when Sabrina Baker, a mother of six, felt the familiar twinge of contractions.

At first, she brushed it off as Braxton Hicks, false labor pains not uncommon in the late stages of pregnancy. But after dinner that night in early January, the pain sharpened and radiated to her back. The contractions intensified, and Baker knew this baby girl was coming fast.

She had a decision to make — and the options weren’t good.

Two days earlier, Madera County’s only general hospital had shut its doors. The abrupt closure of Madera Community Hospital and its affiliated medical clinics capped years of financial turmoil. Still, most residents in this rural county in California’s geographic center were caught off guard, unaware of just how much was at stake until their hospital was gone.

Baker knew she couldn’t make it to the next closest hospital, in Fresno, a roughly 45-minute drive.

Twenty-five minutes after the first contraction and two pushes later, she delivered her daughter, alone, on her tan love seat. The baby was breech, which upped the anguish and the risk during delivery. When it was over, Baker tied the umbilical cord with new shoelaces and wrapped Onax in a San Francisco 49ers blanket. An