Twenty-four counties in Colorado have no hospital offering obstetric care  or no birth center , according to a new report on “maternity care deserts” across the country.

March of Dimes, a group that advocates for the health of mothers and babies, reports that seven million American women live in counties with no or limited access to maternity care, affecting 500,000 births per year.

“Every 12 hours a woman dies due to complications resulting from pregnancy. Additionally, 2 babies die each day. These numbers are disproportionately higher for moms and babies of color,” wrote Stacey D. Stewart, the group’s president and CEO, in the report. “Nothing sums up the state of the situation that we face in America as well as this one fact: In 2020 the U.S. remains among the most dangerous developed nations for a woman to give birth.”

Since 1987, the rate of pregnancy-related mortalities has more than doubled in the U.S., to nearly 17 deaths per 100,000 live births in 2016.

In Colorado, the counties labeled as maternity care deserts are generally on the Eastern Plains and in southern and northwestern Colorado. The state’s Maternal Mortality Review Committee analyzed pregnancy-related fatalities between 2008 and 2013, finding that 80% were preventable. Mothers who died were likelier to have only a high school education, lived in rural areas or were impoverished. The average age of those who died was 27.3 years.

Among the solutions that March of Dimes proposes are the expansion of access to midwifery, coordinating a care system within geographic regions, and use of telehealth.