BACKGROUND:
Despite maternity service inquiries identifying vigilance as essential for safety, current conceptualisations focus narrowly on risk detection rather than exploring how vigilance can balance safety with positive birth experiences.

OBJECTIVES:
To examine safety paradigms in maternity care, explore how vigilance operates within risk-normality tensions, evaluate evidence on vigilance as a balancing tool, and identify pathways toward woman-centred vigilant practice.

METHODS:
Narrative review following Greenhalgh et al.'s storylines methodology, analysing 68 sources from 1992-2024 through systematic database searching and manual tracking. Literature included empirical studies, policy documents, theoretical works, and vigilance research across healthcare contexts. Iterative thematic analysis identified three key storylines.

RESULTS:
Three storylines emerged: Safety Paradigms showed Safety-I approaches (focused on failures) dominating maternity services, while Safety-II approaches (learning from successes) remain underutilised. Vigilance Through Risk Lens revealed how risk-focused vigilance becomes operationalised as surveillance technologies and defensive practices, potentially undermining physiological and relational conditions necessary for positive birth experiences. Vigilance as Watchful Attendance identified alternative conceptualisations emerging from phenomenological and feminist scholarship. Concept analysis revealed vigilance as fundamentally relational rather than surveillance-oriented, encompassing caring expressions enhanced through collaborative engagement.

CONCLUSIONS:
Vigilance operates at paradigmatic intersections where normality, biomedical, and risk frameworks create "fateful moments" requiring practitioners to navigate competing demands. Current approaches often reflect these tensions rather than achieving integration.

KEY MESSAGE:
Vigilance may benefit from reconceptualisation toward "relational vigilance" that could integrate safety consciousness with woman-centred care. Safety-II frameworks might illuminate how successful teams achieve safety while supporting positive birth experiences. Further research could explore how relational vigilance is experienced to inform training models that balance safety with well-being. Poster session 2 (Group A)