Four members of an Amish family died after their hired van was struck by a cement truck as they traveled home from a funeral in central Pennsylvania.
The York County coroner's office said the fourth victim, Elizabeth Esh, 22, was pronounced dead Tuesday, a day after she delivered a stillborn boy.
Her relatives, brothers Emmanuel Esh, 73, and Melvin Esh, 66, were pronounced dead at the scene of the wreck Monday afternoon in rural southeastern York County.
State police said the victims were passengers in a van, operated by 49-year-old Connie Lally, that turned into the path of a concrete truck driven by John Ehrhart, 60. The truck then struck a third vehicle, a sedan.
The coroner's office said Emmanuel and Melvin Esh are related to Elizabeth Esh by marriage.
Autopsies were being performed on the three, as well as the baby.
Police said the van's three other occupants were injured and some required hospital treatment. No information was available from police about the condition of Ehrhart or the third vehicle's driver.
Police said any decision about possible charges in the crash will be made after the investigation is completed.
The Amish are a religious group that generally does not permit the use of automobiles or many other modern conveniences, instead traveling by horse and buggy. They often hire "jitneys" driven by non-Amish for longer trips.