Holding the Unseen in Mind: Professional Judgement and Uncertainty in Pre‐Birth Assessment

ABSTRACT Pre‐birth assessment is an increasingly significant yet under‐examined area of child and family social work. It requires practitioners to make high‐stakes safeguarding decisions about children who cannot yet be seen or known, without direct observation of parenting or parent–child interaction and often without clear policy guidance. This study explores how social workers construct and justify professional judgement in this distinctive context. Drawing on qualitative interviews with 10 social workers in the North East of England, data were analysed using reflexive thematic analysis. Findings indicate that pre‐birth assessment operates as a form of anticipatory safeguarding structured by uncertainty, inference and predictive judgement. Practitioners described reaching and defending decisions in advance of birth, relying heavily on parental histories, projected futures and defensible reasoning in the absence of observable evidence. Judgements involved negotiating tensions between hope for parental change and responsibility to prevent future harm, often within organisational cultures oriented towards risk and accountability. Participants also highlighted ambiguity in professional focus, as they sought to represent an unborn child while working relationally with expectant parents. The study conceptualizes pre‐birth assessment as an anticipatory and interpretive form of safeguarding, with implications for reflective supervision and ethically attuned practice.