(Family Division, Moor J, 28 January 2014)
The 25-year-old woman, who was pregnant with her first child, suffered from affective bipolar disorder for which she was prescribed a range of antipsychotic mediation. She also had a history of substance and alcohol abuse, had only a limited insight into her medical condition and at times stopped taking medication.
At 38 weeks' gestation the woman became symptomatic and started suffering from hypomania and puerperal psychosis. She was described as being agitated, violent and exhausted from lack of sleep. She attended hospital when her membranes ruptured although she hadn't gone into labour and she was thereafter detained under s 5(2) of the Mental Health Act 1983. She remained highly agitated and largely unco-operative with almost every aspect of her obstetric care.
The NHS Trust sought declaratory relief under the inherent jurisdiction of the High Court that it would be lawful and in the woman's best interests to deliver the child via an elective caesarean.
A full hearing was listed for the following day but in the interim declarations were granted permitting medical treatment if the woman went into labour or for any reason required a caesaraean section or was showing signs of infection. In those circumstances the benefits of treatment significantly outweighed the disadvantages and justified the Trust in proceeding notwithstanding the deprivation of liberty.