A new report has cast more doubt on the future of Scotland's consultant-led rural maternity services.
Campaigners say lives will be at risk if the downgrade goes through
Professor Andrew Calder, from Edinburgh University, recommended that Caithness General Hospital be downgraded to a midwife-led service.
Low birth numbers and skills loss through decreasing workloads posed a threat to this and other rural hospitals throughout Scotland, he said.
But campaigners said lives would be at risk and vowed to fight the proposals.
Professor Calder wrote: "The future sustainability of the unit (even in its unsatisfactory state) is rendered virtually impossible by impending changes to employment legislation and contractual requirements and by the increasing scarcity of suitably trained specialists.
"The service already faces imminent disintegration which appears unavoidable even if funding and goodwill were limitless.
"These issues represent a threat to several other maternity hospitals in Scotland although they are at their most acute in Caithness.
"This situation presents enormous difficulties to healthcare providers and is the source of deeply felt anxieties and anger among the local community for
reasons which extend beyond health issues to include local economic and social concerns."
Professor Calder recommended a midwife-led service in Wick be set up in conjunction with a detailed support service co-ordinated by Raigmore Hospital in Inverness.
'Tooth and nail'
Caithness mother Kerry Mackenzie, 37, from Thurso, said that if it had not been for the consultant maternity service in Wick, she and her baby might have died in 2000 after she was rushed in with complications.
Mrs Mackenzie, who suffered a fit while pregnant with her daughter and had to have an emergency caesarian, said the recommendation of the Calder report left her almost speechless.
She said: "The report was along the lines that we had expected, but we are not going to take this lying down.
"Mothers and their babies will die if we lose the current service and we will fight tooth and nail to retain it."
Highlands and Islands MSP Rob Gibson said the centralisation of maternity services and the closure of the Caithness service would "place the lives of mothers and their new born children at risk".
Caithness General Hospital
He urged local people to unite in support of a consultant-led service and to try to change the Scottish Executive's "culture of centralisation".
Mr Gibson said: "The total lack of understanding of the geography of the far north and the need of NHS patients is there for all to see.
"Other nations facing the same issues of remoteness and rurality such as Norway and Canada have successfully designed the service around the patients and there is no good reason why Scotland cannot do the same."
NHS Highland, which set up the Calder inquiry, said it would study the report before making a final decision.
Mr Gibson is due to speak on the future of maternity services in rural areas in a parliamentary debate on Thursday.