The number of children born in Caithness has more than halved since emergency measures were introduced, following the death of a newborn baby.
Figures released to the Press and Journal revealed that 49 babies were born at Caithness General Hospital in Wick between September 2015 and March this year.
That was compared to 102 over the same period a year earlier.
The drop in births coincides with the lowering of the risk threshold for expectant mothers to be transferred to the more advanced pediatric facilities at Raigmore Hospital in Inverness, 100 miles from Wick.
The change was introduced in the aftermath of the tragic death of a baby girl from the e.coli sepsis infection just 40 hours after she was born.
NHS Highland has apologised to the girl’s family and a major review of maternity services at the Wick facility is ongoing.
Labour Highlands and Islands MSP Rhoda Grant expressed surprise at the decrease in babies being born and added that every effort had to be made to allow more women to give birth closer to home.
She said: “I’m surprised that it has made such a difference.
“I know that where there is any risk at all now, the appraisal of that is different to what it used to be.
“It is a significant reduction and it has taken me aback a bit. It’s a really difficult one because, of course, safety has to be the first priority, but steps need to be taken to resolve the situation.
“That [disparity in the] number of births can’t all be out of the ordinary.”
The figures, released under the Freedom of Information Act, showed that in September 2015, the month of the tragedy, 19 babies were born at Caithness General.
In the following months up to March this year, the numbers stayed in single figures, with just three babies born in both November 2015 and March 2016.
The number of babies born at Raigmore Hospital also dropped year on year, from 1,203 between September 2014 and March 2015 to 1,180 over the same period 12 months later.
A spokeswoman for NHS Highland said: “Interim changes to Caithness Maternity local birth criteria were implemented in October 2015 following the very sad death of a newborn baby.
“Changes to the local birth criteria have meant that risk assessment for birth in Caithness General Hospital is now similar to risk assessment for birth in a community midwife-led unit, where there are no paediatricians and no special care baby facilities on site.
“The reduction in birth numbers at CGH from October 2015 to March 2016 reflects the change to local birth criteria. The figures also show there has been a reduction in the number of births at Raigmore.
“Risk assessment criteria have been implemented in the interest of achieving the safest outcomes for mothers and babies.”
A final report into the tragedy is expected to be submitted to the Scottish Government by the end of the summer.