Since local maternity services were downgraded, the number of expectant women who gave birth in Caithness last year was at its lowest level.
While 202 women gave birth in Inverness, more than 100 miles away, 202 women gave birth at Caithness General's midwife-led unit in Wick.
More than 160 women gave birth locally in 2015, when the unit was still run by consultants.
The local unit could shut down entirely, according to campaigners.
According to NHS Highland, women with low-risk pregnancies could choose to give birth locally.
The Raigmore Hospital in Inverness, where consultant obstetric and neonatal services are available, is where women with medical or pregnancy complications are referred, according to the health board. .
It claimed that a hard-working and committed team ran the Wick community midwifery unit.
By submitting freedom of information requests to NHS Highland, the Caithness Health Action Team (Chat) was able to compile birth statistics.
164 women delivered their babies at Caithness General in 2015, while 91 did so at Raigmore.
The following year, there were 37 patients at the hospital in Wick and 156 at Inverness.
There were nine births at Caithness General in 2019, which was the lowest number since the previous year.
Chat expressed worries about the unit's future and demanded an impartial investigation into the delivery of maternity care.
According to NHS Highland, there is no change to the way services are currently provided and no current external independent review.
However, in accordance with the quality and safety standards we must adhere to and the resources at our disposal, we are internally reviewing our services, performance, and improvement potential. ".
Earlier this month, NHS Highland's review of women's health services was confirmed by the health secretary, Humza Yousaf.