Midwives have warned of the pressures they are under from a lack of staff, rising obesity levels and women giving birth later in life.
The Royal College of Midwives urged the Scottish Government to ease the strain on the service, as vacancies increase from 1.3% in 2013 to 5% in 2018.
The chief midwife at NHS Tayside said teams there were seeing more women with complex conditions.
An RCM report found there is a majority of overweight and obese pregnant women in Scotland for the first time, reaching 51% last year.
The age of pregnant women is also increasing, with 54% of babies in 2017 born to women in their 30s or 40s, the state of maternity services report for Scotland found.
Tayside is short of about 12 midwives. NHS Fife did not provide the figure when contacted.
Justine Craig, chief midwife at NHS Tayside, said: “Our maternity staff are committed to providing all pregnant women with the care they need before, during and after their pregnancy, and ensuring that all children have the best possible start in life.
“We recognise that more women are choosing to have children later and we are seeing an increase in women with complex conditions who may require additional care and support during their pregnancy.
“NHS Tayside currently has about 11.5 whole time equivalent midwifery vacancies and we are actively recruiting to fill these posts.”
Mary Ross-Davie, RCM director for Scotland, said there are “great things happening in our maternity services”.
She added: “However, pressures on our midwives are increasing – the care needs of the women in our care are rising, while the number of unfilled midwifery posts is also rising.”
Health Secretary Jeane Freeman said the Scottish Government was retaining the student bursary, attracting former midwives back to the profession and advocating an increase in student uptakes from 191 to 226.
“While there has been an increase of 5.7% in the number of qualified nurses and midwives under this government, we’re determined to go further to ensure we have a sustainable midwifery workforce long into the future,” Ms Freeman added.