Statistics show that Kentucky lost 212 of 671 licensed obstetricians/gynecologists from 1999 to 2003. The state also has higher-than-average rates of doctors who have stopped practicing obstetrics or decreased the number of high-risk pregnancies they will handle, according to a survey by the American College of Obstetricians and Gynecologists.

The Kentucky Medical Association said there are 70 Kentucky counties without obstetricians.

High malpractice insurance premiums are at the root of the problem. Insurance company officials say they are rising because delivering babies is risky and generates lots of claims and lawsuits.

But even doctors who have never been sued are facing premiums that can reach $85,000 a year in Kentucky.

"We hate to think about patients having trouble accessing the medical care that they need. But people are going to have to travel greater distances for obstetrical care," said Dr. Greg Cooper, president of the Kentucky Medical Association and one of the doctors that's quit obstetrics recently.

In a liability study released this summer, the ACOG ranked Kentucky among eight "red alert" states where a crisis is coming.

A few Kentucky hospitals are stepping in to help, hiring doctors who used to practice privately and taking on their malpractice insurance costs. But some patients say more needs to be done.

Jinger Mann, whose two-year-old son was one of Cooper's last deliveries, said she wishes something could have kept him in obstetrics. "He's compassionate. If I cried because I was scared, he'd hold me," said Mann, of Paris, Ky. "It's unfair that doctors like him can't deliver babies."