After a roadside birth on Sunday morning near Lumsden - where maternity facilities were downsized recently - Southern District Health Board says it is "important for mothers and midwives to plan well ahead of their delivery".
An ambulance taking an expectant mother to Southland Hospital had to pull over and let her give birth, minutes out of the town.
The midwife on board said it was a dangerous incident and the direct result of the decision to downsize Lumsden's maternity facilities to an unstaffed hub, and redirect births to Southland Hospital one hour down the road.
Southern District Health Board chief executive Chris Fleming said the move to a hub was part of enhancing health services across the district - and the downgrade in Lumsden is a decision that he stands by.
"We had the model reviewed independently and then we had the final outcomes reviewed further by the Ministry of Health before we went ahead," he said.
"We will be investigating the specifics in this case, however the system worked very well. There was safety equipment at the hub, and an ambulance is a very safe place to have a baby, if it is an emergency."
He said downsizing in Lumsden had allowed four unstaffed hubs in the region to be established in Wanaka, Te Anau, Tuatapere and Ranfurly.
"One of the things that we're really clear about is we didn't make a decision about Lumsden, we made a decision about strengthening primary opportunity right across our district. With the initiatives that we've put in place in the Central Otago Lakes area alone, we've attracted five new midwives into the area. Getting robust workforce is the number one safety measure that I can that we can achieve," Mr Fleming said.
Asked what would happen if another roadside birth happened and things didn't go so well for the mother or baby, Mr Fleming said it was important to consider planning and care.
"That the midwife and the expectant mum and partner discuss the options and plan well ahead for delivery," he said.
"Urgent births happen all around the country, not just in rural settings. We need to make sure that we're focusing on providing appropriate equipment, safety equipment, drugs, and making sure that we're building that relationship with emergency transport.
Clutha-Southland MP Hamish Walker has been against the move from the start, and is calling on Health Minister David Clark to urgently intervene.
Last year he presented Dr Clark with a 5000-signature petition opposing the downgrade in Lumsden, and as recently as this month had written him letters asking why the safety of women and babies in Lumsden was being put at risk, while the Te Anau hub was yet to become fully operational.
"With the birth yesterday there's even more support than ever to have the birthing unit reinstated. The public now sees just how critical it is to have a birthing unit in Lumsden. The rural community, we work completely different to urban centres and we can't exactly ride our pushbike to hospital like the associate health minister did last year to give birth," he said.
Today Mr Walker delivered a letter to the Prime Minister today asking her to fully re-instate Lumsden's maternity services before loss of life occurs.
He said it would only cost them $200,000 a year, "money well worth it".
Mr Fleming denied it would cost anything less than $370,000 and said the maternity centre had indicated they would have needed increased funding in order to continue.
"The other issue is the funding model for lead maternity care is broken and we've been able to put a sustainability funding package together - which doesn't solve the problem ... for LMCs (lead maternity carers), but goes some way towards addressing some of the challenges about sustainable incomes for these people as well.
"So overall we've invested more in primary maternity, it's just that we've tweaked the model and we've introduced maternal and child hubs," he said.
Health Minister David Clark said he had told all district health boards they must provide high-quality care for mothers and babies, and Southern District Health Board had assured him it had the right plans in place.
"Last year, following community concerns over the recommendation that Lumsden transition to a Child and Maternal Hub, I asked the Ministry of Health to review Southern DHB's plans for an Integrated Primary Maternity System of Care across the Southern District," he said.
"I received an assurance those plans were sound."
He said it was ultimately up to DHBs to prioritise resources where the need was greatest, because they knew their communities best.