Agoraphobic mum-to-be forced to go to hospital for the birth

The midwifery and obstetric team have a duty of care for mother and baby. High risk births are generally not considered suitable for a home birth. Some regions have suspended home birth services during Covid. I have sympathy for the mother, but I don't think this is the big patriarchy at play here.

I didn't think they intubated people without sedation /or after the GA has kicked in?

It can be really difficult to 'get the tube down' even when the patient is conked out.

You're suggesting that people are intubated as a matter of course beforehand?

Just in case the references to dental sedation are referring to my post in an attempt to help me (If so then I'm really sorry for the derail caused by my fears caused by the article and any subsequent confusion I've stupidly caused by posting here!) I cannot have sedation as I'm too ill. I also cannot have local anaesthetic as it doesn't work with my medical condition.

My last appointment where I allowed one near me was almost ten years ago and they dislocated my jaw yanking it open because of my condition. She claimed to be a "specialist in phobias" and "had seen it all" and then made gagging noises and said how disgusting I was for allowing this to happen. Then she told me I'd be dead from infections. She knew I've severe depression and chronically suicidal so saying I was going to die wasn't going to make me "snap out of it" and her telling me she would have treatment forced on me again made it worse. I couldn't get out of the chair. She delibrately put my sticks in another room to stop me leaving.

I was in agony for weeks and looked like I'd been beaten up for days. I can put my jaw back in (again due to medical condition) but honestly in my opinion all medics cannot be trusted anymore. I did trust my GP but then she blamed me for covid and accused me of wasting their time.

I really need to attempt sleep now.

I'm REALLY sorry for derailing this thread and causing confusion. It wasn't intentional I just wasn't brave enough to post my own.

Ah is it?

That makes more sense- the report in the OP talks about taking her to hosp nearing her due date.

So it doesn't add up to do it when she was 72 hours into labour unless something changed in the meantime.

On the sedation thing, my concern is around the implication that it is always very invasive.

'Have you got any idea how dangerous and difficult it is to sedate someone against their will? It is far more invasive and requires far more restraint than simply removing someone from their house.

To sedate someone to the point that would be needed to take them to hospital, you need IV access - at least two cannulae, in case one falls out. You need heart, BP and oxygen saturation monitoring. You need to protect their airway by putting - at the very least - an airway support device into their mouth, and you may need to place a tube into their throat. How do you think that's going to go, if the patient is resisting?'

I never had all that when I was sedated. Dentists don't do all that.

One cannula is fine at the dentist. Not fine when you' re transporting a patient. They come out.

If you don't want to be patronised, don't make daft suggestions based on Dr Google.

Is that not a different one, the judges name is different.

The point about sedating her and taking her to hosp was about the original report where she was to be taken before she went into labour.

How much more dangerous is it than using force to take a mentally ill woman who is nearing her due date out of her house while she resists and then presumably having to restrain her in some way. That sounds like a recipe for disaster to me.

You cannot safely sedate a heavily pregnant woman to the point of being able to remove her from her house against her will or to the point where she is unaware of what is happening.

Yes, sedation is used at dental surgeries. Dental surgeries that use it have to be fully equipped clinical environments.

This is a completely different scenario from elective dental sedation.

Both pregnancy and obesity are risk factors for difficult airway management and reflux / aspiration. Labour exacerbates this, especially long labours.

Being overweight is a risk factor for difficult vascular access.

Entonox is a very unreliable agent and not a true sedative.

Giving genuine sedation to a woman who is obese, pregnant, in obstructed labour with no monitoring or vascular access, outside of a hospital environment would be indefensible in court.

Is this NHS page incorrect?

'If you're extremely nervous you may prefer sedation through an injection into your hand or arm (intravenously) during treatment. The drugs won't send you to sleep – you'll be awake and able to talk to the dentist – but they'll calm and relax you so deeply you probably won't remember much of what happened.'

I've been sedated loads and it did make me very woozy.

The dental sedation thing says the same.

It's just not correct that sedation involves intubation and 1 maybe 2 cannula etc. Is it?

I mean maybe things have changed but they don't intubate at the dentist do they.

The idea that all methods of sedation involve cannula, intubation etc. That's not my experience.

I'd like to understand more but the bit of gas and air thing... Why so condescending?

Sure, you can use Entonox (50:50 nitrous oxide and air) for labour and old school dental sedation - but it’s mainly an analgesic not a sedative per se. (You can make people a bit giggly and suggestible with nitrous but not anaesthetise them unless you use it as a co-induction agent with something else - or really sedate them.

Also, a minority of people get very disinhibited with it and can become more agitated.

Not enough information.
I would assume there is more to it than a simple uncomplicated pregnancy, though.

The info we didn't have-72 hours in Labour- makes it a different situation.

Doesn't make sense why the judge said to take her to hosp before her due date though.

I know of the woman in question. There is a lot you don’t know about her and her past history. Lets just say this decision is definitely in her best interests. Also, I think MN should delete this post - discussing this case won’t add any value to her situation and might lead her not to use MN for support which is something she will probably need.

Oh fuck really sorry!

You can get sedated by the dentist.

I've been sedated prior to surgery.

Are you an anaesthetist? Just wondering. My mum is one. I can ask her.

The dismissive comment about gas and air. Why?

@Becca19962014 one more thing... The law is there to protect you and is generally reasonable... But... Not all professionals understand the law, if anybody ever wants to start care or treatment and you don't want them to and they try to coerce you by saying you lack capacity tell them they need to get a court order. Because they do.

Oops finished to soon. I didn't mean to suggest you were delusional but only that even in the case of delusional beliefs it is not a forgone conclusion that you will be forced into treatment or found lacking capacity.

I'm on my phone in bed but @Becca19962014 just to add more reassurance there has been at least one ruling I can think of were even with delusional beliefs the court ruled that the person could decline medical treatment. They thought declining treatment would lead to death in that case, it actually didn't in the end but the odds were he would have died.

It depends on a number of things. Another example is the lady who was detained under the mental mental health act (or sectioned in common parlence) and wanted a mid term abortion for a planned pregnancy. The court ruled she had capacity to make that decision because although some of her reasoning appeared to be based on disorderes thinking other aspects of her rationale were sound.

[quote Becca19962014]@MissLucyEyelesbarrow Thankyou for taking the time to try and reassure me, I really appreciate it.[/quote]
Having had a quick read of the full report, it looks as if it wasn't the phobia itself that was the issue - it was the fact that she had a delusional belief about her home. It was the delusional belief that made the court decide that she lacked capacity.

As I say, I don't want to comment on your personal phobia, so I'm going to use a different example. I hope it doesn't sound trivialising - I'm just trying to stay away from commenting on your phobia in case it is triggering.

Say you had a terrible phobia of spiders. If you needed medical help but said that you didn't want to go to hospital because you might see a spider in the hospital grounds, that wouldn't be delusional, because it is clearly true that you might. Just because most people don't have the same phobia doesn't mean that you lack capacity because you do have it - same as with JWs: most people don't share their beliefs about blood products, but that doesn't mean that they lack capacity.

However, if you believed that you couldn't go to hospital because the nurses had all been replaced by spiders, that would be a delusion. But the number of people with phobias who also have delusions on the same theme must be tiny - probably only a handful in the whole country. The poor woman in the OP is very unlucky and not at all typical of people with a phobia.

So basically, most of the reporting was pretty inaccurate - it was a second baby, she was 26 not 21, it was an emergency application matter 72 hours into labour, and she'd had zero scans.

And although the application was granted, she did actually give birth at home, and the order wasn't needed in the end.

After reading the judgment, i think the right decision was made.

Before covid I was told it was impossible to have a phone consultation or appointment, it was impossible to wait outside and be called in when it's my turn. Apparently that's not the case when everyone else is scared of a germ too. Allowances and assistances can be made, they just don't like to make them. If you need them try to ask for them. But, it's so hard to battle about that whilst battling mental health problems. I've been able to access more medical help now that telephone appointments are allowed than I could when I had to find a carer to take me to the GP.

You are allowed to request a home birth for any reason. As I understand it, the NHS can't refuse although they can strongly advise you against it.

Which is presumably why they asked the court to rule.

I would question, though, that if the woman has been judged "lacking in the mental capacity to decide where to give birth" - could it be reasonably argued that she lacks the mental capacity to consent to unprotected sex and the consequences of that?

Unlikely, given that that was presumably a decision she took several months ago and he mental state may have changed since the.