Patient safety incidents in childbirth: analysis of reported cases from 2015 to 2025.

BACKGROUND: Patient safety incidents occur globally, with one in ten hospitalized patients in high-income countries experiencing an adverse event, most preventable. In obstetrics, harm is rare but can have severe consequences, and research highlights human and system errors as key contributors. Incident reporting is essential for identifying risks, yet studies focusing on childbirth-related reports remain limited. AIM: This study aimed to describe the incidents related to childbirth at one birth unit to gain important information about the obstetric safety in Finland. METHODS: A retrospective registry study analysed incident reports from a regional hospital birth unit between January 2015 and May 2025. Reports were categorized by timing, reporter profession, incident type, and harm level. Quantitative data were analysed descriptively, and free-text descriptions underwent inductive content analysis to identify patterns. FINDINGS: A total of 279 childbirth-related incident reports were identified, representing 3.8% of all births during the study period. Most reports were submitted by midwives and occurred in delivery rooms. Content analysis of free-text descriptions revealed two main categories: incidents related to care and those linked to the operating environment. Care-related incidents included malpractice, inadequate information flow, medication and operational errors. Environmental issues involved equipment failures, electronic health record problems, and staffing shortages, all indirectly compromising safety. CONCLUSION: Childbirth-related safety incidents often stemmed from missed care, communication failures, and systemic vulnerabilities in technology and workflow. Improving safety requires a systems approach that integrates technological reliability, structured communication, and a strong safety culture to reduce preventable harm and enhance maternity care quality.