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For years, the clinic in Hildale had been where mothers there and adjoining Colorado City, Ariz, went to give birth. But in September of 2012, Helen Barlow says, the clinic staff were preparing to close the birthing center due to a drastic drop in pregnancies.
Barlow remembers how the supplies were packed. The birthing center was still just barely operable. The last mothers gave birth and were sent home immediately instead of being allowed to stay a few days to recover, Barlow said.
"It was just so depressing that my colleagues and I could barely stand to go down there," Barlow said.
The birthing center and recovery rooms had been on the first floor of the clinic. Barlow and her colleagues began to refer to the first floor as "the dungeon."
Hildale and Colorado City, collectively known as Short Creek, are home to the Fundamentalist Church of Jesus Christ of Latter-Day Saints. Statistics from health departments in the two states show how births among members of the polygamous sect have slowed to a crawl.
There were 467 live births in the two towns in 2009. But there were only 42 live births in Short Creek in 2013, the last year that data is available from both states.
On the Hildale side, where the clinic sits behind the walls of a compound on the town's north edge, the state of Utah recorded just six births during 2013. Half a decade earlier, there were 156.
Any statistic involving the FLDS yields suspicion, giving the sect's reputation for being reclusive. Yet, the numbers coincide with reports from people who have left the sect in recent years, as well as observations by a Tribune reporter and photographer following a recent flash-flood tragedy.
In the days after the Sept. 14 flood that killed 13 people in Hildale, many residents went to look at the storm damage. Tribune photographs captured many children who appear to be 5 and older with adults wearing traditional FLDS attire, but few preschool age kids and no babies.
There is no sign the towns are losing their adult populations. The United Effort Plan, the trust that owns many of the homes and property in Short Creek, reports that it has a waiting list for housing.
The Census Bureau in 2010 put Colorado City's population at 4,821 and Hildale's at 2,726. If the towns had just kept pace with the birth rates in Utah and Arizona, there should have been 111 births in Short Creek in 2013.
Multiple factors have been affecting families in Short Creek in the last decade. Since Warren Jeffs became FLDS President in 2002, hundreds of men and teenage boys have been evicted or have left the sect. Women and girls who haven't followed them have been reassigned to other men. Many of the men and boys who remain in the sect have left for work in other states.
Then in late 2011, after Warren Jeffs went to prison in Texas for child sex abuse convictions, his brother, Lyle Jeffs told followers during church meetings that spouses were no longer supposed to have sex, according to Barlow and others who have left the FLDS.
Lyle Jeffs didn't explain why.
James Broadbent was following the Jeffs family in 2011. Broadbent already had his suspicions about Lyle when the ban on marital relations was issued. The ban helped solidify Broadbent's mistrust of Lyle.
"I just knew better," Broadbent said. "As far as I was concerned, [the ban] went against what I understood was in the scriptures."
Barlow said everyone assumed the ban on marital sex was meant to help free Warren Jeffs from prison.
"The perceived reasons was everyone was supposed to conserve their energies for the deliverance of the prophet," Barlow said in an interview Friday.
The sharp decline in births doesn't concern Craig Hammer, the executive director of secondary schools for the Washington County School District. The district last year reopened Water Canyon School in Hildale.
The district used to pay for 140 kids to attend school in Arizona, but the Water Canyon School now has almost 300 students. He's confident more students will keep arriving at the school from somewhere.
"They move back in [to Hildale] and we take them," Hammer said. "And it's probably been one of the most positive things I've seen in my 33 years as an educator."
Lyle Jeffs legal wife, Charlene Jeffs, filed an affidavit this year saying FLDS leaders chose "seed bearers," who were the only men allowed to impregnate women. A 2014 paper published by two researchers at the University of Utah, based on interviews they conducted, described how only 15 men in the FLDS were deemed worthy to be seed bearers.
Barlow, who said that she and her family stopped following Jeffs at the end of 2013, said she has heard only rumors of the so-called seed bearers and has seen no evidence they are true.
She said she has never met a woman who said she had been impregnated by a seed bearer.
Barlow worked at the Hildale clinic in various capacities from 1994 until last year, and has been working as a midwife since then.
She delivers babies to clients in Short Creek and the surrounding areas. She assumes the few babies being delivered in Short Creek are being born to women who don't follow the Jeffs family and are delivering either at home or at a clinic on the Colorado City side that is open to the public.
Before Warren Jeffs took control of the FLDS in 2002, followers were left to decide for themselves whether to have children or how many, Barlow said. There was an inclination toward larger families.
Barlow, 46, has nine children of her own. Seven of her children were delivered at the Hildale clinic. She remembers the years before 2012 when the staff worked hard to care for patients and the first floor was a joyful place full of mothers and babies.
"I never worked anywhere as much as I enjoyed when I worked there," Barlow said.
The number of live births in Hildale, Utah, and Colorado City, Ariz., have plummeted over a decade. The two towns are home to the Fundamentalist Church of Jesus Christ of Latter-Day Saints.