A recommendation to consolidate all hospital births in the Northern Trust area at the Antrim Hospital site has been approved by the Department of Health.
Department permanent secretary Peter May said he had taken the decision to "ensure safe, consistent and sustainable care for mothers and babies in the trust area".
Maternity services are currently provided from the trust's two acute hospitals, Antrim Area and Causeway, but concerns have been raised over the sustainability of services at the Causeway facility in Coleraine, where the number of births is lower.
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The department also said there were difficulties in recruiting and retaining consultants at the Causeway maternity unit.
Mr May 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 earlier this year.
The service change relates only to births.
Antenatal and postnatal clinics will be retained and enhanced on the Causeway site.
The department said 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.
It said the Causeway maternity unit has become reliant on locum and temporary staff, making the provision of consistent care more difficult.
A statement said: "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."
Conditions of the consolidation of services at Antrim include making planned capacity changes at the hospital.
The Northern Trust will also be required to prioritise the development of an interim three-bedded Alongside Midwife Led Unit at Antrim.
Mr May said: "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."
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