RICHMOND Valley mayor Ernie Bennett still gets "regular complaints" from his constituents that they can't give birth at Casino Hospital.
The hospital's birthing unit closed some years ago, but Cr Bennett said it remained a sore point in the community.
The mayor said he was happy with the new emergency department, but disappointed with the loss of the birthing centre.
He was born in Casino, as were his parents, his children and his grandchildren.
Local birthing mums must now drive another 30 minutes east to Lismore Base Hospital.
"People ask me why is it? There's plenty of space in the hospital so why can't they come to have their babies?" Cr Bennett asked.
Northern NSW Local Health District chief Chris Crawford blamed the unit's closure on the lack of general nurses willing to handle births, noting it was now a specialised field and the hospital couldn't afford a 24/7 roster of specialist midwives.
He said Lismore's birth unit had all the modern "bells and whistles".