The number of rural birthing units being closed or downgraded has reached crisis point, Rural Women New Zealand says.
The group's health spokesperson, Margaret Pittaway, says the shortage of midwives and birthing support for rural communities is alarming.
There are at least 72 vacant positions for midwives in hospitals across the country.
Only one qualified midwife is left in Wanaka, while in the Coromandel the number of midwives has dropped from 11 to just three in the past three years.
Meanwhile, Southland parents have vowed to fight a plan to downgrade the Lumsden Maternity Centre, with a protest scheduled for tomorrow.
The whole system was stretched too far, Ms Pittaway said.
"We have grave concerns about our rural communities because with each closure that we get it's more jobs gone and [it's] just shrinking rural communities."
Many rural midwives had married people already living in rural areas or had moved for a lifestyle change, she said.
"But a lot of midwives seem to want to live in urban areas where perhaps the pressures aren't so great and they can choose to live the lifestyle they want, without having to do the enormous hours and traveling that our rural midwives are up against."
The latest changes to Lumsden and Wanaka had made expecting mothers apprehensive and fearful, she said.
"It's really unfair ... to go through a pregnancy and to have the knowledge that you just don't know where you're going to be giving birth or what the conditions are going to be like."
In some areas, midwives had such a heavy caseload already that they could not take on any more local clients.
"There's a lot of people who have no options, and realistically they deserve better services than what they're getting."