ANCHORAGE, Alaska (AP) — Kristin Paniptchuk’s water broke on Christmas Eve at her home in the western Alaska Inupiat village of Shaktoolik, and then she began to bleed profusely.

The local clinic in the tiny village of 200 people on the Bering Sea couldn’t stop the bleeding or the contractions brought on by a baby that wasn’t due for another two months. With harsh winds grounding an air ambulance from nearby Nome, medical staff called on their only other option: the Alaska Air National Guard. Five days after a military helicopter and then a cargo plane whisked Paniptchuk to an Anchorage hospital, she delivered her daughter Kinley, premature but healthy.

Over the past year-and-a-half, Paniptchuk, whose daughter is now a toddler, has been thinking about how lucky she was.

“I’m just really thankful that they were able to come and get me,” she said. "Who knows what would have happened if they didn’t?”

The Alaska Air National Guard conducted 159 such missions last year in largely roadless Alaska, many during vicious storms. In one instance, a military helicopter flew nearly 660 miles (1,062 kilometers) to pick up a pregnant woman with stomach pains from an Alaska island 2 miles (3 kilometers) from Russia's waters. Last month, two airmen armed with pints of blood parachuted into another western Alaska community to care for a woman experiencing internal bleeding because it was the fastest way to get there.

Now, those rescues could be drastically curtailed as personnel changes take an outsize toll in a state more than twice the size of Texas, Guard leaders and members say. A nationwide move to balance the number of the top-earning positions among the Air National Guard across 54 state and territorial units means the Guard will soon convert many of Alaska's highly paid Active Guard and Reserve members — who are essentially the equivalent of full-time active-duty military — to dual status tech positions, a classification with lower wages, less appealing benefits and different duties. Many say they will quit rather than accept the changes.

The transition, leaders say, could cut the number of the Alaska Guard's medical rescue missions to about 50 a year and also affect critical national security work in the state, located just across the Bering Strait from Russia. That work includes scanning for missile launches from Russia, North Korea and China; tracking spy balloons over U.S. air space; and flying a refueling plane for U.S. fighter jets that respond to Russian bombers near American airspace — something that's already happened five times this year.

“If we’re only watching the skies Monday through Friday and they launch a missile on Saturday, well, that’s failure,” said Alaska Guard commander Brig. Gen. Brian Kile.

Alaska is slated to convert 80 members, or about 4% of its 2,200 personnel, to tech positions — the most in the U.S. The problem is that much of the Alaska Guard's unique role — missions that require being on alert 24 hours a day, seven days a week — can't be done by the tech positions, the Guard said.

“They’re trying to make all of the units look equal, and the problem with that is they took no consideration of location and of mission into account when they did this," Kile said. “To do that for Alaska is incredibly impactful.”

Local leaders have met with National Guard leadership, hoping to change their minds about the cuts in Alaska.

In a statement to The Associated Press, the Air National Guard said the staffing reset was “driven by the desire to achieve equity across all units resourced by the same program.”

In past statements, Guard officials have said they attempt to address staffing imbalances where some National Air Guard units have more of the highly paid Active Guard and Reserve members than others. Alaska has spent years adding these personnel to support its work.

Officials did not respond to emailed questions.

Rather than take a pay cut, more than 80% of the 80 Alaska members whose jobs are being converted to tech positions have indicated they will leave the Guard, some for private sector jobs. Some of those who stay will lose more than 50% of their salaries, which in some cases translates to more than $50,000 a year plus benefits, making living in expensive Alaska a huge challenge.

“You’re living in fear for the future,” said Sgt. Sharon Queenie, a Yup’ik Eskimo and Guard member who monitors the skies for errant aircraft or spy balloons. The single mother of three will see her $104,000 annual salary cut in half, which she said could force her to sell her house.

Maj. Mark Dellaquila lives in North Pole, a small community near Fairbanks, with his wife and five children. He said he would lose $60,000 a year when his job — already unfunded — is converted to a tech position.

The Pennsylvania native said he and his wife decided early on that Alaska would be their forever home.

“We're in Alaska trying to grow roots and raise our kids here and now have this seemingly arbitrary decision just yank all of those roots right out of the ground," he said, choking back tears. “It's hard.”