The 100 births in 2025 were down from 145 in 2020.
Any urgent transfers to mainland Scotland are carried out by air, determined by the availability of aircraft, crew and weather conditions.
Transfers rose from 45 in 2020 to 54 in 2025.
The Balfour’s maternity ward was said to be clean, organised and maintained to a high standard.
“Throughout our inspection we observed staff providing person-centred, compassionate and responsive care to women and their families,” HIS chief inspector Donna Maclean said.
The report added: “Good teamwork was evident throughout the inspection between obstetricians, midwives and the health care support team. The senior midwifery and senior obstetric leadership teams were visible with respectful, friendly and supportive interactions observed.
“Staff described being supported by senior managers and felt able to raise concerns.”