WOMEN in Caithness are delaying plans to have a baby because they are worried about making the 110-mile trip to Inverness to give birth, campaigners have claimed.
NHS Highland said the Caithness area averages 220 pregnancy bookings per year, but noted a "significant drop" to 152 in 2019.
Of those, only nine mothers gave birth locally with the vast majority making a two hour road trip to Raigmore Hospital in Inverness to have their babies.
Caithness Health Action Team (CHAT) said women have faced unacceptable risks since the controversial decision to close the consultant-led maternity service at Caithness General Hospital in Wick.
It was replaced in 2017 by a midwife-led unit which NHS Highland said would be able to handle the majority of births, with higher risk pregnancies and women requiring caesareans sent to Inverness.
READ MORE: Only two in 300 mothers in Scotland having a home birth
The health board said it was now "exploring the reasons" why women who could have given birth in Caithness had opted not to.
Ron Gunn, vice chairman of CHAT said: "I am aware of families who have put off having children because of the uncertainty of going to the local hospital in Wick and then having to go down the A9 in an ambulance.
"We are also aware of families who have moved away to have their children in Aberdeen, one girl went to stay with her sister for a few months before giving birth and another couple moved to Aberdeen to have their children."
First Minister Nicola Sturgeon promised to investigate after the case of a local woman who went into labour prematurely and ended up giving birth to her twins 52 miles apart.
The mother was en route to Raigmore from Caithness General when her contractions became too strong and paramedics took her to a community hospital in Golspie to deliver her first son, before a helicopter was scrambled to transport her on to Inverness where she delivered the second boy.
Now CHAT secretary Maria Aitken has written to Health Secretary Jeane Freeman calling for an urgent Government led review, claiming the present procedure is not safe due to the increased risks during travel and the uncertainties facing the transfer of women in labour.
Mr Gunn said dangers were exacerbated fears by the lack of an air ambulance at Wick for emergencies.
He said: "The women tell me that if it's close to your birth time you have to phone Wick but it isn't open 24 hours so a lot have got to go down to Inverness, more than 50 per cent are going down to Inverness in a private car."
Provisional statistics for 2019 show that the number of births in Scotland last year was down 8% compared to the five-year average for 2014-2018, with a slightly higher decline of 9.6% in Highland.
The midwife-led unit was established following a public health review in 2016 which identified safety concerns, including two "potentially avoidable" infant deaths.
READ MORE: Mothers 'not being listened to' during birth is leading cause of trauma, says charity boss
Maternity services had been led by consultant obstetricians, but there were no neonatal paediatric or adult intensive care on site.
NHS Highland's head of midwifery Mary Burnside said: "The birth rate for women in the Midwife-Led Community Unit (CMUs) in Caithness is comparable to the other CMUs in NHS Highland for 2017 and 2018.
"However we have seen a significant drop in birth numbers for 2019, where women who could have given birth in Caithness CMU are choosing to give birth in the Consultant Unit at Raigmore Hospital. NHS Highland is exploring the reasons for this.
"The induction of labour (IOL) rate is increasing on a national level which has coincided with the 'Saving Babies Lives' care bundle aimed at reducing stillbirth rates.
"In 2019, the IOL rate for Caithness women was 41% and the rate for Highland women (all births at Raigmore Hospital) was 44.5%. Audit and improvement work is underway with the aim of reducing this rate."
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