HOME BIRTHS UNDER THREAT?

Court rules woman can be sedated and taken to hospital against her will

A High Court judge sitting in the court of protection ruled this month that a pregnant woman lacked mental capacity and could be removed from her home against her will.

It would be unfair to suggest that this decision was taken lightly or that anything but her best interest was considered but it is nonetheless quite worrying if one considers the circumstances.

Although the woman is mentally unwell, her labour was merely “failing to progress”, meaning there was no emergency at that point, only the potential that things could go wrong later. 15% of pregnant women suffer from depression, according to NICE.

The mother believed that the risks would not materialise and that if she was left at home and trusted her body, all would be well. This was held against her but it is hard to think what other response she could have given. In the event she was proved right as she gave birth to a healthy baby at home before the court’s judgment could be implemented. This fortuitous timing was all that stood between her and her forcible removal to hospital under the Mental Capacity Act 2005.

Anecdotal evidence suggests that most parents attempting their first home birth are at some point urged to transfer to hospital for failing to progress. Yet statistics prove home births to be no more risky than giving birth in hospital. For a second birth only 1 in 100 need to transfer to hospital. The problem appears to lie more in the application of a fixed timetable to all pregnancies.

The detail of the case does not suggest that every home birth will necessarily be treated in such a way but the application to the court by East Lanarkshire NHS Trust seems to suffer from a significant logical flaw. They argued that the unnamed woman lacked capacity to evaluate the risks to herself adequately when in fact she simply came to a different conclusion to them. Even had she been wrong, an unwise decision is not enough for the law to intervene.

There was no suggestion the mother lacked the ability to parent her existing child or the new baby and she was well supported by her partner throughout the pregnancy.

East Lanarkshire NHS vs GH