Board asked to approve midwife-led maternity unit at Wick
The board of NHS Highland has been asked to agree that maternity services at Caithness General Hospital in Wick should move to a midwife-led unit.
NHS Highland reviewed the services following the death of a newborn baby at the hospital's unit last year.
The report on the internal review suggests most births at the hospital do not require an obstetrician.
Where complications do arise during a pregnancy, women would be transferred to a "strengthened" unit in Inverness.
However, moving towards a midwife-led only unit is opposed by people living in Caithness and Sutherland.
About 40 people gathered in Wick to hold a demonstration against the plan earlier on Tuesday.
The maternity unit at Caithness General Hospital is currently led by consultant obstetricians based at the hospital, but it has no facilities for on-site specialist neonatal paediatric support or adult intensive care.
Nicola Sinclair, of campaign group Caithness Health Action Team which was involved in the demonstration, said obstetric services should continue to be available at Caithness General.
She told BBC Alba: "Our issue with a midwife-led unit is that we are a remote Highland community and at least 100 miles from Raigmore depending on where in Caithness you live.
"The Scottish Ambulance Service is already stretched to capacity with all the transfers to Raigmore.
"We feel if we don't have obstetric cover then in the event of an emergency C-section or any obstetric emergency we wouldn't have someone available to do this surgery."
NHS Highland's board will be asked at its meeting on 29 November to agree that work begins on establishing the midwife-led unit, and that Raigmore Hospital in Inverness be set up to handle complicated pregnancies from Caithness and Sutherland.
The transition to such a unit could be completed by April next year.
The report on the internal review was published last week.
It said recommended changes to the services would improve the safety of both newborn babies and mothers during labour and birth for the population of Caithness and neighbouring Sutherland.
The review estimated there were about three babies per week being delivered in Caithness General and that the majority of these could be supported by midwives and did not require the intervention of an obstetrician.
The report said "strengthening" of Raigmore Hospital, about 102 miles (165km) from Wick, as a hub would allow staff there to provide 24-hour-a-day obstetric, neonatal and senior midwifery support to all midwifery teams across NHS Highland's North Highland Health and Social Care Partnership, including Caithness and Sutherland.
Last year, NHS Highland said the death of the newborn baby was "potentially avoidable" if there had been "more timely and immediate access" to advanced support in Inverness.
NHS Highland said an initial review of the incident had found no failings in the care provided by individual staff.
But it added that "a number of issues concerning the current arrangements and protocols for neonatal paediatric risk assessment and support" needed to be reviewed "to ensure the safety of both mothers and newborn babies in the future".