In an anxious case which involved striking a difficult balance between individual liberty and medical necessity, the High Court has authorised doctors to deliver a baby by Caesarean section against the wishes of a heavily pregnant mother who was not herself capable of making rational choices.
All the woman’s previous five children had been taken into care and four of them had been placed with adoptive families. She had been diagnosed with autistic spectrum disorder and borderline learning difficulties and, in just over 10 years, had had three Caesarean deliveries and two ‘concealed’ pregnancies.
Two of her children had been born secretly at home, without medical intervention, and, after previous pregnancies, the woman had suffered serious complications, including seizures, haemorrhaging and even a stroke. Doctors were concerned that she might die in giving birth to her sixth child.
The Court found that the woman’s ‘undoubtedly unwise’ past behaviour established that she lacked capacity to decide what was best for herself and her unborn child. She had refused all offers of medical assistance and had failed to open her door to social workers and others who were anxious to help her.
In those circumstances, the Court authorised medical professionals to ‘take such necessary, reasonable and proportionate measures’ to arrange a planned Caesarean delivery. Those measures included ‘forced entry’ into the mother’s home and restraint and sedation if necessary to keep her in hospital for the birth.
Recognising that the woman’s wishes and feelings deserved respect, and that the order impacted on her ‘most precious and valued human rights’, the Court directed that it should be executed in such a way as to minimise her distress and ‘maintain her dignity’.