Baby born after Caesarean approved

Salisbury Journal: Doctors have been given permission to perform an urgent Caesarean section on a mentally-ill woman who has diabetes Doctors have been given permission to perform an urgent Caesarean section on a mentally-ill woman who has diabetes

A mentally-ill woman who has diabetes today gave birth to a boy after a High Court judge had given doctors at a London hospital permission to perform an urgent Caesarean section, lawyers said.

Mr Justice Hayden gave specialists working for the Royal Free London NHS Trust the go-ahead to perform surgery after concluding that the woman lacked the mental capacity to make decisions at a hearing in the Court of Protection in London late on Friday.

Lawyers representing the trust today said the baby had been delivered without any problem in the early hours and the woman had hugged a surgeon after recovering consciousness. They said no restraint had been necessary.

The judge had said a decision "compelling" a Caesarean section was "draconian" - but he said he had heard evidence that the woman's life might have been in danger.

He said he had concluded the woman, who is 32 and was 32 weeks pregnant, lacked the mental capacity to make decisions about whether or not to have her baby delivered by Caesarean section.

Trust officials had applied for permission and said doctors thought an urgent Caesarean section necessary so that the woman's "unstable mental state" could properly be treated.

One specialist told the judge that the priority was "keeping this woman alive".

He heard that she was thought to be suffering from paranoid schizophrenia and had attempted suicide.

The judge said neither the woman nor the hospital could be identified. But he said the health authority could and should be named. The scrutiny of doctors' conduct could only "serve to reassure public confidence".

The Court of Protection is part of the High Court and analyses issues relating to sick and vulnerable people.

Mr Justice Hayden had given lawyers permission to let the media know when the baby had been born.

"The decision to compel a Caesarean Section on an incapacitous woman who is mentally and physically ill is an extremely draconian one," the judge had told the court.

"Doctors do not embark upon this lightly. It occurs extremely rarely. It is one that the lawyers also take very seriously indeed."

Mr Justice Hayden added: "I am perfectly satisfied that at the moment (the woman) is not able to make any reasoned evaluation

of the advantages and disadvantages of a Caesarean section."

He said he had also concluded that the woman - who had stopped eating - lacked the capacity to regulate her own diabetic medicine and monitor her own intake of food and water.

But doctors were not given permission to use force or restrain the woman.

Medics thought that the woman could be persuaded to agree to sedation and did not think that force or restraint would be needed, said the judge.

One doctor told the court that the woman's physical and mental problems should lessen, and be easier to treat, once the baby was born.

And the doctor said it was feared that the woman might have to be restrained, so that nutrients could be fed through a drip, if the baby was not delivered.

A specialist said the baby should not be at risk if delivered via Caesarean section at 32 weeks.

Mr Justice Hayden said the woman's husband also had mental health difficulties but was devoted to his wife.

The judge said the husband had initially opposed a Caesarean s ection at 32 weeks but had changed his mind and agreed to the surgery.

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