By Bracey Harris — NBC News
At 6:58 a.m. on Thursday, Dr. Angela Adams Powell addressed nurses at the hospital in southern Alabama where she had been bringing babies into the world for 25 years.
"I was afraid I wouldn't be able to speak," she said, her voice breaking.
Two minutes later, Monroe County Hospital's Birthing Department would close, leaving the rural community of about 20,000 without a birthing hospital. Two minutes later, pregnant women in a county where 22% of residents live below the poverty line would be forced to travel 35 to 103 miles to find a solution.
The last-minute solution Powell hoped for didn't come.
Adams Powell tried to keep his voice steady as those gathered around him wiped their eyes. "That decision was not ours," she said, "but for the women and children we have cared for, we have done the best we can."
Adams Powell in the hallway of the delivery wing of Monroe County Hospital in Monroeville, Alabama.Charity Rachelle for NBC News
Her hospital is the latest in a growing line in Alabama where delivery teams have had to say goodbye. In October, maternity units in Birmingham and Shelby County closed.
In rural areas like Monroe County, a shutdown can leave an entire community without childbirth services. More than one-third of Alabama's counties are maternity care deserts and lack hospitals with obstetric care or birthing centers, according to a report by the March of Dimes.
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Liz Kirby, director of Monroe County Hospital, said the cause of the closure was a shortage of doctors. After the Supreme Court decision that ended federal abortion protections, some hospitals in states with strict bans on abortion warned that it might be harder to recruit obstetricians and gynecologists, though Kirby said he wasn't aware that was a factor in this case. Residency applications for the specialty have also declined more in states with abortion bans than nationally.
Powell believes managers could have done more to address issues he felt were hurting recruitment and retention.
Kirby said the hospital has worked with three recruiters to try to staff the labor and delivery department.
"Nobody wanted this," he said, "it certainly wasn't an easy decision."