A woman with learning difficulties, autism and “an extraordinary obstetric history” lacks capacity to make decisions about her healthcare and must have a caesarean, the Court of Protection has ruled.
The Mental Health and the Acute Trust v DD & Anor [2014] EWCOP 11 concerned DD, who is expecting her sixth child. Her previous children were taken into care after various alarming incidents. DD also hid her later pregnancies from social workers, refused entry to her home, and declined to attend doctor’s appointments. She had home births in secret, which caused her health complications, including haemorrhage and blood clots. One child was born very prematurely. Another child was discovered in a sickly, undernourished state. She did not maintain contact with her first child, who was adopted by a grandparent. DD was also assessed as having delusional beliefs.
Mr Justice Cobb held that it was in DD’s best interests for her to be conveyed to hospital against her wishes and for a planned caesarean section to be carried out. He authorised the health trust “to take such necessary, reasonable and proportionate measures to give effect to the best interests declaration above to include forced entry into her home, restraint (so that she does not leave the ward pending treatment and/or until it is clinically appropriate for her to be discharged) and sedation”.
He added that he required the trust “to take all reasonable steps to minimise distress to DD and to maintain her dignity”.
Cobb J declined an application to assess DD’s capacity to make decisions about contraception but advised that this be decided “as a matter of urgency and priority” once DD had given birth.
