Five counties in Northeast Ohio have no hospitals routinely delivering babies, forcing expectant mothers to look elsewhere. As local maternity wards shutter, the distance between county seats and delivery rooms is growing—along with concerns over access to care.

Porsha was 35 and expecting her third child when she began miscarrying at 11 weeks. By the next morning, she had died of hemorrhage in a Houston hospital—a tragedy observers say may have been prevented by a routine procedure known as a D&C.