Mater Hospital maternity unit to be run by midwives
The maternity department at the Mater Hospital in north Belfast is likely to become a unit run entirely by midwives.
Currently, obstetricians are on site in the event of there being an emergency.
However, under new plans, it is proposed the unit will become what is known as a midwifery-led unit.
There are currently two of these operating in Northern Ireland hospitals - at the Downe in Downpatrick and Lagan Valley in Lisburn.
The move comes as no surprise.
Eighteen months ago the BBC reported that a midwifery-led unit was on the cards for the Mater, with the Royal Jubilee Maternity remaining as a consultant-led obstetric service.
Just as accident and emergency care is undergoing massive change in Northern Ireland, so too are maternity services.
While change isn't immediate, shaking up how maternity services are delivered is something the Health and Social Care Board is reviewing.
The BBC understands that consultant-led units will remain at Altnagelvin, Craigavon, Ulster, Antrim and Royal Jubilee Maternity hospitals, but there is less certainty over the Erne, Daisy Hill and the Causeway departments.
At the end of last year, the Compton Review of Health and Social Services hinted strongly that the current shape of many hospitals would change.
The five health trusts are now in the process of putting together business plans outlining how they intend to run, and most importantly pay, for their individual services, including maternity.
Road map for change
The BBC understands that if the Southern Health Trust can argue that doing business with their counterparts in the Republic would help foot the bill, that may be enough to convince the Health and Social Care Board to retain the department or explore the likelihood of it becoming a midwifery-led unit.
Almost four years ago, the Belfast Health Trust outlined in its document, "New Directions" the road map for change.
It said "the trust favours the provision of inpatient obstetric services including neonatal services on a single site (on the Royal Hospitals site), complemented by the provision of a midwifery-led unit (at the Mater Hospital)".
This proposal is one of three now being put out to consultation by the Belfast Health Trust.
Other proposals include maintaining the two maternity sites as they are and removing a maternity service from the Mater Hospital entirely, leaving the Royal Jubilee with both an obstetric and a midwifery-led unit.
The BBC understands that the Royal College of Midwives is in favour of the midwifery-led option at the Mater.
Midwives at the Mater are operating such a service anyway. While there is 24-hour anaesthetic cover, there isn't the same paediatric service.
At the Royal Jubilee Maternity there is 24-hour paediatric and anaesthetic cover.
If the Mater becomes a midwifery-led unit, women with high-risk births will be sent automatically to the Royal Jubilee. In the event of an emergency a woman in labour would be brought by ambulance to the Royal site.
Consultants who currently work at the Mater will transfer to the Royal Jubilee, expanding the obstetrics team that's already there.
A 12-week consultation period is now under way.
In a statement the Belfast Health Trust said it hoped the outcome would improve patient safety for all women by bringing together the labour ward consultant obstetric presence in one unit.