A NHS Foundation Trust v An Expectant Mother [2021] EWCOP 33

This case concerned the best interests of a pregnant mother with severe agoraphobia who lacked capacity to make decisions about whether her baby should be born at home or in hospital.

The medical evidence was clear that the mother does not have capacity to make decisions about the location of the birth. Holman J agreed stating “The mother’s agoraphobia is so overwhelming that it exerts a significant effect on her ability to weigh matters in the balance if the activity in point entails her leaving her home.”

He then went on to consider her best interests using East Lancashire Hospitals NHS Trust v. GH [2021] EWCOP 18 as a guide. In that case, a woman had been in labour at home for nearly 72 hours and was suffering an obstructed labour. There was considered to be an urgent need for transfer to hospital and urgent inpatient treatment, including a possible emergency Caesarean section. However, like the mother in this case, that mother suffered from acute agoraphobia and was refusing to go. An emergency application was made to MacDonald J who made an order declaring and authorizing that the mother could, in her best interests, be transported to hospital using reasonable and proportionate force if necessary. Holman J commented that:

“the case illustrates, in my view, the need to anticipate problems of this kind and to face up to them as best one can in advance, even if that involves speculation and/or reliance upon statistics.”

Holman J considered the very thorough analysis of the relevant law in the earlier case and the expert medical evidence and concluded that it was in the best interests of this particular mother and her baby that she should give birth in hospital in a planned way. He also considered the issue of the use of reasonable force and set out what forms of restraint the hospital trust proposed to use and declared that he is:

“on balance, satisfied, albeit in disagreement with the Official Solicitor, that it will be in the overall best interests of this mother if - if the necessity for it arises on the day - some trained and professional force and restraint are used to transport her to hospital.”

It later transpired that P the expectant mother went into spontaneous labour at home and gave birth in hospital where fortunately no restraint was required. She was safely delivered of a health baby boy and returned home with the baby within the next day or two.

The full judgement can be read here

If you have any questions regarding this summary case law please contact Julie Fitzpatrick here

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