Proposals to close maternity units at four Greater Manchester hospitals have been backed by the health secretary.
Rochdale Infirmary is one of the hospital's set to lose its unit
Alan Johnson endorsed plans to close units in Rochdale, Salford, Trafford and Bury after an independent review.
It means consultant-led maternity care will be concentrated in eight hospital sites across the region.
The Independent Reconfiguration Panel (IRP) also backed plans to downgrade Rochdale's A&E unit and axe emergency surgery at Fairfield Hospital, Bury.
In north-east Greater Manchester, A&E departments will be concentrated at the Royal Oldham, North Manchester and Fairfield hospitals.
Mr Johnson's decision to back the modernisation plans, dubbed Making It Better and Healthy Futures, has angered Rochdale Lib Dem MP Paul Rowen.
Mr Rowen, who claimed Rochdale would now effectively become a "cottage hospital", said: "I am devastated for the people for Rochdale who have fought so hard against this.
"We have done everything possible to save these services and I am furious that we have been ignored."
In maternity care, consultant-led services will be spread across eight sites, with intensive care on three - St Mary's in Manchester, the Royal Bolton and the Royal Oldham Hospital.
Wigan Infirmary, Stepping Hill in Stockport, Wythenshawe, North Manchester General and Tameside General will house the other units.
The Department of Health said the IRP had looked carefully at the plans and concluded that the changes were necessary.
Alan Johnson backed the review of the controversial shake-up
A spokesman said the changes to emergency services would be supported by an extra £38m investment. An additional £60m will be invested in maternity.
Anthony Emmerson, a consultant neonatalogist at St Mary's hospital and lead clinician for Greater Manchester Neonatal network, said that the hospitals shake-up would in fact save lives.
"The changes will create stronger and safer services for all and we believe they will help to save the lives of up to 30 more babies every year.
"Doctors and nurses have been asking for these changes for 30 years," he said and added that that no jobs would be lost.
Dr Derek Fletcher a GP and vice-chair of the Healthy Futures Joint Committee of PCTs said: "Change is never easy.
"These plans have come about because there was overwhelming agreement among clinicians in the area that things needed to change."
Communities and Local Government Secretary Hazel Blears joined a demonstration calling for maternity care to continue at Hope Hospital in her Salford constituency, despite supporting the national policy of maternity changes.
Shadow Health Secretary Andrew Lansley said he was concerned about the basis on which the consultation went ahead.
"It was clearly driven by pressures from the European Working Time Directive [to limit doctors' working hours] and it failed to adequately reflect how access to services impacts the overall quality of care.
"Our contention is that with suitable support, good risk assessment and a neo-natal critical care transport service, more of the existing locally based obstetric units can be maintained."
And the Royal College of Midwives warned that midwifery staff might not cope with the work demands.
The IRP report did recommend that health bosses explore the feasibility of standalone maternity units in Salford, Bury and Trafford.
Although these units would allow women to give birth at their local hospital, they would be midwife-led, rather than consultant-led, services.