In areas without local obstetric care, some families combine a doula for continuous support with a relationship with a clinician at a more distant facility. More than 52 percent of U.S. counties lack hospital-based labor and delivery services, and nearly 35 percent are maternity care deserts with no birthing facilities or obstetric clinicians. What is a maternity care desert? A county with no hospital or birth center offering obstetric care and no obstetric providers. Identify the nearest operating labor and delivery unit early, drive the route, and discuss risk factors and a delivery plan with a clinician.