Plans by NHS Argyll and Clyde to reorganise maternity services have been approved by Scotland's health minister.
Travel times are at the centre of the argument
Maternity services will be centralised at the Royal Alexandra Hospital in Paisley, leaving midwife-only units in Greenock and Vale of Leven.
Campaigners have criticised Malcolm Chisholm's decision to endorse the proposals.
They believe emergency transfers to a consultant-led unit in Paisley during complicated births could risk the lives of mothers and babies.
Mr Chisholm said: "I have concluded that the model of service suggested by NHS Argyll and Clyde is the best available option for providing high-quality, safe and sustainable services for women and babies across Argyll and Clyde.
"It will mean midwife-led units in local areas for low-risk births, backed up by consultant -led clinics and a specialist consultant led-unit for high-risk births."
However, Mr Chisholm said he had not been convinced by the planning assumptions about the number of women who will choose to give birth in Paisley rather than Glasgow.
He has asked for a more detailed report on the pattern of patient choice between the two areas.
The minister said he was aware of the concerns about ambulance support and that he had received assurances that arrangements will be in place for short-term cover and the longer-term development of services.
Critics of the changes, including the Labour MSP for Greenock and Inverclyde, Duncan McNeil, have opposed the move since it was announced.
Mr McNeil has warned that it will lead to the centralisation of consultant-led inpatient services for more than 800,000 women and children in two hospitals just seven miles apart.