Mid Yorkshire Teaching NHS Trust v SC & Anor
[2024] EWCOP 69 (T3)
North Middlesex University Hospital NHS Trust & Anor v MB
8 June 2023
[2023] EWCOP 23
Court of Protection
A pregnant mom is mentally unwell and can't decide how to give birth. The court said it's okay to have a C-section if needed, but to try a natural birth first, because that's what she wanted before getting sick. The court also decided not to tell her that the government might take her baby away right after birth because it could make her worse.
Key Facts
- •MB is a 26-year-old, 37-week pregnant woman with a first episode of psychosis detained under Section 3 of the Mental Health Act 1983.
- •The case concerns a birth plan, including authorization for a Cesarean section if necessary.
- •MB lacks capacity to make decisions regarding her obstetric care.
- •The application was criticized for its late issuance and lack of sufficient notice to the Official Solicitor.
- •The court considered MB's capacity, best interests, and the potential infringement of her human rights.
- •A local authority intends to apply for an interim care order to separate MB from her child after birth.
Legal Principles
Presumption of capacity in medical treatment decisions.
Mental Capacity Act 2005 (MCA), s.1(2)
Circumstances where treatment can be imposed without consent (lack of capacity under MCA, Mental Health Act 1983 detention, inherent jurisdiction).
MCA 2005, Mental Health Act 1983, A Local Health Board v JK [2019] EWHC 67 (Fam)
Best interests determination under s.4 MCA 2005, considering past and present views, wishes, and feelings.
MCA 2005, s.4
Court has no jurisdiction over the unborn child.
Paton v British Pregnancy Advisory Service Trustees [1979] QB 276
Preservation of human rights (Articles 3, 5, and 8 ECHR). Least interventionist approach.
European Convention on Human Rights, NHS Trust 1 v G: Practice Note [2014] EWCOP 30
Outcomes
MB lacks capacity to make decisions about her obstetric care and to conduct legal proceedings.
Based on expert medical evidence, including Dr. M's assessment.
Birth plan approved, prioritizing vaginal delivery unless Cesarean section is medically necessary.
In MB's best interests, aligning with her expressed wishes when capacitous and ensuring safety of mother and child.
MB will not be informed of the local authority's intention to seek separation from her child before birth.
To protect MB from further distress and potential relapse, considering the risks to her mental health and the pregnancy.