Holding the unborn baby and parents in mind: educational psychologist-led formulation in pre-birth safeguarding

Pre-birth safeguarding requires professionals to make consequential judgements about possible future harm before a baby is born, often amid legal ambiguity, incomplete information and emotional pressure. Educational psychologists (EPs) hold expertise in child development, attachment, trauma, consultation and systemic formulation, yet their contribution in this context is under-researched. This qualitative study explored four EPs’ experiences of facilitating formulation with a pre-birth social work team in one Welsh local authority. Semi-structured interview data were analysed using reflexive thematic analysis within a constructionist and interpretivist framework. Six themes were developed: co-producing multi-agency meaning-making; building shared psychological capability; using structure to hold complexity and emotion; keeping the unborn baby and parents psychologically present; pacing support to make change achievable; and shifting language from blame to understanding. The themes informed the tentative interpretive framework, Holding the unborn baby and parents in mind, which brings the six themes together within a single organising account. Formulation supported shared psychological understanding, reflective containment, relational attention, proportionate planning and curiosity in place of blame. The analysis identifies a consultation-based role for EPs in pre-birth safeguarding and indicate priorities for multi-perspective and longitudinal evaluation, while the single-local-authority context limits transferability.