Only three U.S. states have policy referring to the use of telemedicine in pregnancy, delivery and postpartum care, according to a new study published in the American Journal of Obstetrics and Gynecology. That less-than-ideal access to healthcare may be costing the lives of mothers and their babies.

Telemedicine has seen growing use for people living in remote or medically underserved areas. Patients can use electronic communication services (apps, computer portals, even just email or video calls) to stay in touch with doctors, who can help diagnose, treat and monitor from afar.

Most U.S. states and territories have adopted laws dealing with the regulation of such practices. According to the study, 32 states (plus Washington, D.C. and three other territories) have passed legislation dealing with the idea of diagnosis, consultation and treatment in regards to telemedicine.

Even though the American College of Obstetricians and Gynecologists and other organizations have outlined policies aimed at expanding access to healthcare through telemedicine, according to the study, they are not explicitly about perinatal care.

The study authors referenced a previous study showing that increasing access to maternal fetal care to five specialists per 10,000 live births decreased the risk of maternal death by about 27 percent—it’s possible increasing telemedical care could yield similar benefits.

Most U.S. jurisdictions, however, have not yet focused on standardizing telemedicine practices around pregnancy, delivery and postpartum care.

Even the three states that do acknowledge perinatal telemedicine care within state laws (New York, North Carolina and Ohio), they don’t always make it easy or feasible for telemedicine providers to use telemedicine to its fullest ability, the study found.

“For instance, the North Carolina statewide medical board recognizes telemedicine as a useful tool in increasing access to health care; however, it released a position statement cautioning that practitioners utilizing telemedicine be held to the same standard of care as those who conduct in-person care, a position with potential to adversely affect development and expansion of telemedicine program,” the study authors discovered.

And in Ohio, the law only asks Medicaid to develop standards and regulation for such maternal and neonatal care but doesn’t enumerate those standards itself.

The study researchers found that in areas without such specific guidelines, hospitals and other healthcare providers are developing their own.

The authors cited programs in Florida, Iowa, Idaho and Arkansas that allow for perinatal care through telemedicine channels. In Arkansas, the Antenatal & Neonatal Guidelines, Education and Learning System is working to get a video-based, interactive perinatal consultation with a high-risk specialist within 20 miles of every pregnant woman in the state.

Based on their results finding that most states have some kind of telemedicine-regulating laws on the books, “the majority of states and territories have the infrastructure for perinatal telemedicine implementation,” and that it wouldn’t take much effort to expand existing telemedicine standards to include maternal and pre- and post-natal care that could improve health outcomes and potentially save lives.

In other words, there’s no reason the U.S.’s 56 other states and territories shouldn’t implement such perinatal telemedicine care, according to the authors’ analysis.