The evolving concept of safety in midwifery-led care: A scoping review

Background: Safety is central to midwifery care, although its meaning and context varies significantly across different periods, cultures and geographic contexts. This scoping review explores how safety is conceptualized within midwifery-led care models, with an emphasis on temporal and cross-cultural differences. Methods: A scoping review was conducted using PubMed, Scopus, Web of Science, and selected organizational sources to identify conceptual and theoretical studies on safety in midwifery-led care. Results: A total of 10 eligible studies were included and thematically synthesized. Through the synthesis of these studies, the findings reveal a transition from a predominantly biomedical model, focused on avoidance of harm and standardized procedures, to a broader, person-centered perspective. This evolving understanding frames safety as a dynamic, multidimensional concept shaped by emotional, relational, cultural, and socio-political factors, including humanitarian crises and the legacy of colonialism. Conclusion: Overall, safety in midwifery care emerges through the interplay of clinical, cultural, and contextual dimensions. To enhance maternal and neonatal outcomes, health systems and midwifery education must adopt this expanded, more inclusive understanding of safety and apply it in the design of care models and policy frameworks.