A health watchdog and a politician have called on the assembly government to hold an urgent meeting amid planned changes to hospitals serving Powys.
Montgomery Welsh assembly candidate Wyn Williams has written to First Minister Carwyn Jones about his concerns.
Services at hospitals in Shrewsbury, Telford and Wrexham are under review.
The assembly government said Powys Local Health Board was responsible for treatment, and the board said it was aware of the need for local services.
This has to be balanced with the need to provide high quality services, the board added.
Powys has no district general hospital but is served by the Royal Shrewsbury Hospital (RSH), Princess Royal Hospital (PRH) in Telford, which are both in Shropshire, Wrexham Maelor, Bronglais in Aberystwyth, and Hereford County Hospital.
Proposals at Wrexham Maelor, the RSH and the nearby PRH include changes to the way maternity services are delivered.
Montgomeryshire Community Health Council (CHC) said the RSH and PRH served 55,000 patients from Wales.
Liberal Democrat Mr Williams said: "I am particularly concerned about the possibility that consultant maternity and neonatal care could be moved to Telford from its current location in Shrewsbury.
"If the services are moved, this will leave a huge swathe of very rural Shropshire and Wales with an extra 15-20 minutes to travel for care. Many will already be travelling over an hour at present.
"And if Wrexham's maternity services are moved to Glan Clwyd this will make the situation even worse."
He added: "The Welsh Government has made no effort to contact the Royal Shrewsbury Hospital to gain a full understanding of the implications of the proposed changes to hospital services for patients in Montgomeryshire and mid Wales."
He urged the Welsh government to call an urgent meeting of all key stakeholders.
John Howard of Montgomeryshire CHC said: "The implications for patients in Powys and mid Wales are huge if the plans in Shrewsbury and Telford go ahead. We need to discuss the options for health care in Powys."
He said a lot of children's services could be switched from the RSH to the PRH, which would extend travel times.
The assembly government said it was aware some services in England were being reviewed, and the "responsibility for securing appropriate care" was Powys health board's.
A spokesman said: "We support the health board's efforts to ensure that people from Montgomeryshire continue to get access to the full range of services they need with the least difficulty.
"No change in maternity services at either Wrexham and Glan Clwyd Hospital, are being proposed by Betsi Cadwaladr University Health Board."
Powys Local Health Board said the plans in Shrewsbury and Telford addressed the "on-going need to ensure access to high quality clinical services and have been developed with clinicians from within the trust and across the border with representatives from Powys".
The health board said it was also in talks with Betsi Cadwaladr Health Board over proposals for Wrexham Maelor.
Meanwhile, Montgomeryshire MP Glyn Davies said he had called on the RSH and PRH hospital trusts to hold two public meetings in his constituency about their proposals.
Mr Davies said one meeting had been arranged, but a date had not been fixed.