Midwives in Northern Ireland are to be balloted on strike action over pay.
The Royal College of Midwives' (RCM) 1,200 members will be consulted later this month and the action is expected to take place in early May. This would be the first industrial action of this kind in its history.
Cathy Warwick, chief executive of the organisation, said: "Midwives are at the end of their tether."
Northern Ireland is the only country in the UK not to have an agreement for pay in 2015/16. Scotland paid the recommended increase and England and Wales negotiated agreements.
Ms Warwick said the step had not been taken lightly.
She said: "The staff in Northern Ireland have been ignored."
Last year was the first time in the history of the RCM that it balloted for industrial action in England and this will be the first time in its history that it will ballot in Northern Ireland.
The senior trade unionist added: "Of course it goes without saying RCM members will not put the safety and care of women and babies at risk.
"Staff have to be valued and fairly rewarded for the work they do. Staff that are demoralised cannot deliver the quality of care that health and social care users, including mothers and babies, deserve.
"Investing in staff is an investment in better care. I hope the Northern Ireland Executive and health and social care employers join the RCM and other unions at the negotiating table, reconsider their position and seek a solution."
The RCM consultation with its members on pay in Northern Ireland came 11 months after the publication of the NHS Pay Review Body's (PRB) report. That report recommended a 1% rise for NHS staff in Northern Ireland.
The union said Stormont's health minister rejected the recommendations.
It added the minister has said staff who are at the top of their pay band will receive a temporary 1% pay award and those who are not at the top of their pay band will receive no pay award. There has been no announcement about pay for 2015/16.