Consultant-led maternity care for Argyll and Clyde should be centralised at a single hospital, it has been recommended.
New midwife-led units will be created at two hospitals
A steering group said the facility should be sited at the Royal Alexandra Hospital in Paisley.
The proposals have angered campaigners fighting against the reduction of services at Inverclyde Royal Hospital in Greenock.
The move would see its Rankin Unit turned into a midwife-led facility.
A community maternity unit (CMU) staffed solely by midwives is also proposed for the Vale of Leven Hospital in Alexandria.
Maternity services at the Vale of Leven closed in October after the resignation of an on-call doctor.
Other midwife-led units will be retained in Dunoon, Rothesay, Lochgilphead and Oban.
The proposals will be considered by the NHS board later this month.
If the recommendations get the go-ahead they will be passed to Health Minister Malcolm Chisholm for final approval.
The steering group produced the proposals after consultation with politicians, public, patients and staff.
It said the recommendation was based on clinical safety, staff recruitment and retention, travel and transport issues, impact on other clinical services and suitability of facilities.
Steering group chairman Dr Lesley Wilkie, the director of public health, said: "This process is all about ensuring we have a safe and sustainable service for the future of maternity services in Argyll and Clyde."
She stressed that no final decision had yet been made.
Dr Wilkie also pointed out that national guidelines say as much maternity care as possible should take place locally.
"Midwives should lead care for normal pregnancies and deliveries and specialist care should be delivered in a single site to ensure that a safe and effective service can be maintained into the future," she said.
"The group's recommendation means that the majority of antenatal care for all mothers will continue to be provided in local hospitals.
"Midwives will look after mothers with normal pregnancies and deliver normal births in local community maternity units.
"The consultant-led unit (CLU) will provide care for mothers who require specialist care. Mothers will continue to have a choice between CMU and CLU for their care."
However, Greenock and Inverclyde MSP Duncan McNeil said the proposals were evidence of "careering NHS centralisation".
He said there was "a little comfort" in the news that the Rankin Unit would not close.
Maternity services at the Vale of Leven closed in October
He plans to meet the NHS board's chairman and chief executive to discuss the impact of the proposals on other services at the Inverclyde hospital.
Mr McNeil said there were proposals for a university-led maternity unit at the Southern General in Glasgow.
"This move could concentrate maternity services for up to a quarter of the Scottish female population in two hospitals which are seven miles apart," said Mr McNeil.
"It will force over 200,000 women over a 2,880 square mile area to travel to a single hospital for inpatient consultant-led services.
"Taking the road to centralisation is a wrong turning - and if this isn't centralisation, I'm a Dutchman."