Health chiefs have voted to change maternity services at Neath Port Talbot hospital, the newest in Wales, despite a long campaign.
Neath Port Talbot Hospital suffered recruitment problems
The Neath Port Talbot Local Health Board decided by 18 votes to one on Thursday to adopt a midwife-led unit.
It will replace the current system, where consultants and doctors run the unit.
Under the new arrangements, non-routine and emergency births at Neath Port Talbot Hospital will be transferred to Swansea or Bridgend.
About a dozen campaigners opposed to the move protested outside the meeting, in Port Talbot.
The local health board said that the new arrangements represent the best option for maternity services in the area and added that it expects the new system to be in place soon.
Some people living locally have held protests since the proposals were first made public last December, claiming they represent a downgrading of services.
Protesters say the move downgrades services
A 5,000-signature petition was collected by campaigners against some mothers having to travel to give birth.
Public consultation on the proposals ended last month ahead of the health board's final vote.
The £64m hospital, which opened last November, at Baglan, Port Talbot, was unable to recruit enough medical staff for the maternity unit.
The staff problems led to the recommendation by a review group set up by the health board for the unit to move to a midwife-led facility.
The health board has previously denied that a midwife-led unit would amount to a downgrading of maternity care in Neath Port Talbot.