Caesarean section & mental illness

The NHS Acute Trust v C [2016] EWCOP 17 concerned an application by a hospital for orders in respect of the management of the pregnancy of “C”.

C had a longstanding bipolar disorder and was in the late stages of her pregnancy. She had been  detained under mental health legislation. The court accepted that she lacked relevant capacity: [8].

Based on medical opinion about the difficulty of labour for C, the court noted that it was likely that, absent any dramatic change in the position, that the mode of delivery would need to be by way of an elective caesarean under general anaesthetic.

When C was visited by a solicitor  shortly before the hearing she stated she wished to have a natural birth in accordance with the birth plan made about three months previously. She wished for minimal intervention, unless there was an emergency when she would have an emergency caesarean, if she had to. If she was to have a caesarean section she would like to stay awake, would like the baby given to her immediately for as much skin to skin contact as possible and for her birth partner to be with her: [41].

Having regard to C’s best interests, orders were made as applied for by the hospital – though with flexibility for non-surgical delivery if that proved to be feasible at the time.

Orders were also made restricting publication of the judgment, in effect until after the delivery of the child.


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