The board today approved a recommendation to establish a primary birthing unit at Dunstan Hospital, near Clyde, and a second in Wānaka.
The Wānaka facility, and in fact the entire proposal, is dependent on the DHB working with local midwives to ensure the units are supported.
If the proposal is unfeasible the Southern DHB may still opt for a single birthing unit, either at Dunstan Hospital or in nearby Cromwell.
The decision comes after months of consultation, much of it centring on the lack of suitable facilities in Wānaka.
At present there are units in Queenstown and Alexandra, supported by hubs in Wānaka and Ranfurly, but it's clear the situation is no longer working for expectant mothers and residents of the area.
It is estimated about 380 births occur in the area, with 160 of those in Wānaka.
At a public meeting in September, Wānaka mother Kristi James said the delays meant Russian roulette was now being played with the lives of mothers and their children in the area.
"I had my baby on the floor of my midwife's office... nobody should have to do that. It's just so wrong. That's so, so wrong," she said.
"So many women are suffering. They've had their babies in places that aren't fit for purpose and what's it going to take. It's Russian Roulette, how much longer are we going to let this happen? We have to do something; it's not good enough, it's not fair and it's not sustainable.
"Let's make a change... please don't let somebody die."
At today's board meeting, it noted establishing two units for the area would require an operating model of collaboration with local midwives, to ensure the units were sustainable with the number of projected births in the region.
The board agreed it was worth exploring, given the distance women and families in Wānaka need to travel to the nearest birthing unit in the region, currently 85km away in Alexandra.
Southern DHB general manager primary and population health Mary Cleary Lyons said the Central Otago-Wānaka area was unique in New Zealand when it came to the provision of maternity services, given its distance from secondary services in such challenging geography.
"This has meant we have needed to explore creative solutions, as we find the right balance between providing more facilities, and ensuring those facilities are well utilised and sustainable," she said.
The details of any arrangement were yet to be agreed, but one option could involve collaborating with a community trust or Wānaka health care provider, and lead maternity carer midwives collaboratively, working as a team to deliver care.
Southern DHB director of midwifery Heather La Dell said establishing a primary birthing unit at Dunstan Hospital gave an opportunity to develop a purpose-built, modern facility with immediate access for helicopter transfer.
"We appreciate the enormous contribution of the team at Charlotte Jean maternity [Hospital, in Alexandra], over many years, and heard that many women appreciated the supportive environment there. We sincerely thank their team for their professionalism as we have worked through this consultation process with the community," she said.
"We now have an opportunity to design services for the future. We believe that developing these two units in these locations better meets the needs for the community in relation to the priorities that have been identified."
The DHB received more than 500 written submissions and survey responses during the consultation period, which started in February.
