On a frosty January evening, Nancy Kerr felt the first twinges of contractions.

Snow was piling up outside her house in the mountains of rural Spruce Pine, North Carolina, but the contractions were mild, and she was a week shy of her due date, so she assumed it was simply false labor. Kerr called her doctor, drank a glass of water and tried to relax.

At 11:30 p.m., Kerrs water broke and she was suddenly thrust into active labor. Her husband raced around the house, throwing everything the couple needed for the hospital into his dirty work truck, and they began the six-mile descent to the hospital on winding roads covered in 5 inches of snow.

Kerr did her best to breathe through the contractions that crashed down upon her, trying not to fixate on the two occasions theyd spun off the very same roads in similar whiteout conditions.

Because of the snowstorm, Kerrs regular physician did not arrive at the hospital in time to help her deliver. Instead, she gave birth under the guidance of the labor-and-delivery nurses who coached her through pushing being mindful of the fact that the babys heart rate was dropping while an emergency room doctor caught the newborn. Less than an hour after they arrived at the hospital, Kerr held a healthy baby girl in her arms.

If the drive had been even a few minutes longer, she is certain, she would have delivered her daughter on the side of a snowy, low-visibility road.

And if Kerr were giving birth this winter, the trip to the hospital would be significantly longer. The Spruce Pine labor-and-delivery unit will close at the end of September, the latest in a string of maternity ward closures that leave expectant mothers in the mountains of western North Carolina without access to maternal care within reasonable distances of their homes.

It was such a reassuring experience to be able to deliver in our local hospital, and receive great care and be able to be close to home, she said. I dont know what would have happened to me or our daughter had we had to drive [elsewhere].