Hospitals in Leicester need more midwives to meet the demands of an increasing birth rate, a report says.
The current maternity service was designed for 8,500 births a year, but is expected to be handling about 11,000 annually by the end of March 2011.
The review, by NHS Leicester City and NHS Leicestershire County and Rutland, also said more neonatal cots were needed.
In addition, changes to caesarean services have been proposed.
Catherine Griffiths, chief executive of NHS Leicester City and NHS Leicestershire County and Rutland, said: "Increasing the number of midwives and neonatal cots, and streamlining the way we deliver maternity services, means that we are better prepared for the increase in births we are seeing."
Under the plans, Leicester Royal Infirmary and Leicester General Hospital will aim to reach a target of one midwife to 33 births.
A dedicated theatre for planned caesarean sections is also being proposed, along with a separate theatre team for emergency caesareans.