Changes to maternity services at hospitals in north Wales are needed, according to a review.
Betsi Cadwaladr University Health Board says it will draw up and consult on a range of options but no decisions had been taken.
There are fears maternity services may be cut at Ysbyty Gwynedd, Glan Clwyd, and Wrexham Maelor hospitals to provide midwife-led units.
The health board said services would remain as local as possible.
It said the first stage of its maternity and child health review had concluded the way services were planned and delivered had to change.
Unless they did, the number of specialist nurses, midwives and doctors would not meet national standards, it said.
It also said more needed to be done to help people to stop smoking, reduce obesity, improve mental health, reduce unwanted pregnancies and increase the number of children and babies being immunized.
Meetings with staff, patients and other interested parties to discuss changes will be held in the coming weeks.
It said no plans had been put to the project board and if there was any significant service change it would discuss public consultation it with the community health council.
"Patient safety is the health board's number one priority, improving the health of the population and making sure we live within our public resources are also important," it said.
"Where we can and it is safe to do so, services will be as local as possible."
The health board first announced its plans for a review last year.
It led Prestatyn GP Eamonn Jessup to warn cuts in services to Ysbyty Glan Clwyd, Bodelwyddan, Denbighshire, would mean mothers would have to travel for emergency caesareans and some babies would die.
A online campaign to maintain acute services at the unit has attracted over 18,000 members.
Another group is calling for the retention of all maternity services at Wrexham Maelor Hospital.