At its quarterly meeting, held at Royal Blackburn Hospital on Wednesday, November 12, representatives from Burnley Birthing Suite explained they had seen a huge increase in the number of mothers opting for a Caesarean section.
Head of midwifery, Tracey Thompson, told the board the suite has capacity for 480 C-section slots, although current projections for the operation sat at 1,400.
She said: "There is significant pressure on the team.
"The team do an incredible job, and we did invest in this, but not enough for the demand.
"There is a theatre available at all times, and it is used quite a lot already for other things.
"We have asked that a paper come to executives and for a dedicated theatre for sections."
Liz Sedgley, non-executive director at ELHT, said this was a national issue and the landscape had changed, with doctors asked to respect the choice of mothers, making facilities less robust than in previous years.
Martin Hodgson, chief executive of ELHT, said he had visited Burnley Birthing Suite several times in recent months and there was a great culture, and that they were "a million miles on in the 14 services" that were placed under investigation in June.
He said: "I have visited numerous times, and there is a great culture.
"We will use the proper processes. This is a real clinical safety issue, and in addressing that there are ramifications with NHS England.
"It comes down to us. When it comes to brass tacks, it is about quality and safety."
Shazad Sarwar, chair of the ELHT board, said the investment had to be scrutinised and that the trust was continuing to increase services without asking if it was affordable.
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He said: "It used to be, what can we do for you, and this is what it will cost.
"Now it is the other way around, and we have to look at affordability and make difficult choices.
"You might want to do 840 [c-sections], we are not going to do 1,300.
"It is about affordability; if we cannot live on that affordability, then how can we look after other services.
"That is a discussion for the board, and this is a really difficult decision that the board will be making."