Lt. j.g. Vanessa Bernales, a nurse assigned to U.S. Naval Hospital Rota, practices neonatal resuscitation during an emergency response exercise Nov. 6, 2024. The hospital in Spain is again delivering babies after referring pregnant women to off-base providers for more than a month. (Alicia Sacks/U.S. Navy)

A Navy hospital in Spain is again delivering babies after referring pregnant women to off-base health care providers for more than a month.

U.S. Naval Hospital Rota resumed labor and delivery services Thursday, the hospital announced in a statement the same day.

In September, Rota started referring all expectant mothers, including service members, to local doctors and hospitals for care.

That decision came after the hospital’s ambulance provider moved about five hours away, increasing neonatal emergency response times, officials said in October.

All told, 18 patients were referred to local hospitals for third-trimester care and delivery of their babies over a six-week time frame, the hospital said.

Complications during childbirth, such as prematurity or breathing difficulties, can require quick transfer to a larger medical facility able to offer specialized treatment to newborns and their mothers.

Rota reestablished rapid emergency transport capabilities in Cadiz and Seville, as well as the Spanish public emergency air transportation system, the hospital said in the statement. Appropriate response time varies depending on the emergency, officials said in October.

One of the few U.S. military hospitals in Europe able to care for pregnant women, Rota offers labor and delivery services for low- to medium-risk pregnancies and refers high-risk patients to local health care facilities.

The hospital delivers about 100 babies each year and offers medical care to about 8,400 service members, their families and other beneficiaries in the region, officials said.

Just three other military hospitals in Europe — Landstuhl Regional Medical Center in Germany, the 48th Medical Group in the U.K. and U.S. Naval Hospital Naples in Italy — have in-house obstetrics capabilities.

During the six-week diversion period, a team from the Rota naval hospital trained on neonatal airway and medication management, laboratory studies and emergency response care coordination, according to the statement.

The training kept staffers proficient in neonatal and obstetrical care management and patient transportation, the hospital said.