The Department of Health has approved the Northern Health and Social Care Trust recommendation to consolidate hospital births on the Antrim Hospital site.
The decision has been taken by the Department of Health's Permanent Secretary Peter May to ensure safe, consistent and sustainable care for mothers and babies in the Trust area.
The Permanent Secretary today said: "An overriding priority for our health service must be the provision of safe care for our population.
"This decision is in the best interests of mothers and babies in the Northern Trust area.
"Maintaining the current service across both the Causeway and Antrim sites would not be sustainable. Avoiding planned change would simply lead to unplanned and forced change."
The recommendation to consolidate births at Antrim Hospital on a permanent basis was made by the Northern Trust Board following a public consultation.
The service change relates only to births. Antenatal and postnatal clinics will not only be retained on the Causeway site but will be enhanced.
The unsustainability of the current Causeway maternity unit relates to falling birth numbers at the hospital and associated difficulties of recruiting and retaining consultants and other staff.
As has been well documented, working in hospitals with lower patient numbers can create significant issues for staff. These include rota/on-call pressures inherent in smaller clinical teams and insufficient case mix to support specialisation, experience and skill development.
Reflecting these staffing issues, Causeway maternity unit has become reliant on locum and temporary staff, making the provision of consistent care more difficult.
Crucially, it has become increasingly challenging to maintain adequate consultant cover at the maternity unit - including consultant cover for the transfer of seriously ill babies to a neonatal unit with staff who are specialised and skilled in providing care for sick newborns.
The Permanent Secretary's approval has been conveyed to the Trust in a letter to its Chief Executive Jennifer Welsh. Conditions of the approval include making planned capacity changes at Antrim Hospital as outlined in the public consultation. The Trust will also be required to prioritise the development of an interim three bedded Alongside Midwife Led Unit at Antrim. This will offer additional capacity in advance of longer-term plans for a new build Women and Children's unit.
Setting out the Department's decision-making process, Mr May continued: "I have reviewed the Trust's consultation outcome in line with the 2019 Department of Health Guidance Change or Withdrawal of Services - Guidance on Roles and Responsibilities.
"I have also received advice and assessment from the Department of Health's Strategic Planning and Performance Group and the Public Health Agency.
"I am satisfied that my decision is in accordance with Northern Ireland Executive Formation legislation and the associated Guidance published by the Secretary of State for Northern Ireland.
"It is also consistent with the wider health transformation agenda which acknowledges that changes need to be made to ensure sustainability of services."