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

[UppityPuppity]

Judge states she doesn’t have the capacity to decide to have a home birth.

Not enough information to form a view about the supposed risks, except that I am so sad for her and wish her and the baby well.

www.bbc.co.uk/news/uk-57108649

Her partner and her mother may give her a little bit of a hand, possibly?!

Gerbil, chill out a bit fs.

Well possibly @NiceGerbil but possibly if she is acrophobic the partner has to work and it's not really down to grandmothers to have to care for babies is it? Maybe she has her own life, job, other responsibilities ?

I think the judge has made the right decision in this difficult case. I hope the safety of the child is ensured once its born. Maybe it should be taken into care immediately if there is not enough support from relatives.

@Viviennemary

I think the judge has made the right decision in this difficult case. I hope the safety of the child is ensured once its born. Maybe it should be taken into care immediately if there is not enough support from relatives.

An agoraphobic would not have her child taken away. Later on, someone can be employed part time to take the baby out every day if possible, to clinic appointments, etc. Groceries and toiletries can be ordered for delivery.

All the woman needs is reliable support. That should be arranged by therapy services. She must be more scared than anyone! However, her having a baby, which I agree is a surprising outcome, may be a turning point for her. Agoraphobia is a dreadful affliction and those with it long to lead a normal life, they spend so much time in fear about some things that might happen, and some that definitely will.

Chill out?

What an odd comment.

There have been 2 comments that I've seen that seem to imply that women with serious MH issues -but not so serious they are in hosp etc- should not be having boyfriends or getting pregnant.

How can she look after a baby.

All we know is what's in the article. Her mother and partner support her and yet even the idea that they might help and support the baby will be fine is met with dismissal.

I find that strange.

Some women have mental health episodes in their lives. PND is common and can be serious. Some women become very disabled due to sudden accident or injury.

Loads of families cope with all sorts of situations.

Seem to be some very hard line and unnuanced views on here. None of us know what's really going on at all.

The assumptions made by some are interesting.

A very distressing case indeed.

But let's get this straight - we have two similar cases - one in February and one ruled on in May both regarding agoraphobic mothers to be? is this perhaps rather more common than one might have thought? Genuinely interested if anyone knows or other similar cases.

Someone upthread suggested that with lockdown agoraphobia may have become more common, which feels possible to me.

@NiceGerbil

I think that's very plausible - have never suffered with it myself and wouldn't say I'm actually suffering from it now, but Lordy, the first few steps I took outside after a few weeks of lockdown gave me the merest hint of that sort of fear and I had to really force myself to get over it. I can't imagine how horrendous it is for genuine sufferers. The more I was "encouraged" to take those first steps, the less I wanted to do it - I really had to do it in my own time. If it had been suggested I should be forced against my will, I'd probably still be locked in the bathroom tbh.

I'm rather on the side of better support being put in place

Damn this computer - weird backwards scrolling thing happens from time to time.

Meant to say, depending on how close the original mother is to her due date, I find it hard to believe that all other avenues had been completely exhausted.

I hope Suespiciousminds covers this on her blog though, once the judgement is handed down - if it ever is, her perspective would probably be enlightening.

I have mental health issues myself gerbil, what’s your point? Would you like a list of what I suffer with? PTSD from two separate traumatic events that both lasted over a year, severe anxiety and depression along with suicidal thoughts and I struggle to leave my own home and rarely do.

My point is that two posters who have no more idea of the situation than anyone else have assumed that her MH problems automatically mean that her child will not be cared for properly.

That's a massive assumption when only the bare bones of the situation are known.

One poster seemed to find it unsettling she had a partner and had got pregnant.

I don't understand those posts.

Loads of women with MH issues post birth don't seek help as they are worried what the consequences will be. That's not good.

And there's also the point that babies are aok with being at home with mum for the first few months of their life.

And I never asked you to disclose anything.

You don't know my own situation.

My only point is that it's wrong to state, based on hardly any info, that the baby will not be cared for properly.

User, Becca and Quiet

The Guardian also reported on this www.theguardian.com/uk-news/2021/may/14/agoraphobic-pregnant-woman-can-be-forced-into-hospital-judge-rules

This decision should be only about the woman, not considering the good of the baby. Once the baby is outside her body, she no longer has veto and rightly its about the baby’s best interests regardless of her wishes, if she can’t make decisions in the baby’s best interests. We have to accept that also means in whatever poorer condition the baby may be in because of her rational (even if very disagreeable) decisions made prior.

That has to be how it is or pregnant women are only vessels without the same assumption of capacity to decide and that is completely unacceptable. We can’t say we want pregnant women not to be treated like vessels and then say ‘but not if that harms the baby’ or ‘not it that takes up extra resources’, can we?

HCPs should appropriately professionally treat, support and inform and engage with the woman in the situation she’s in. I’m sure it is frustrating and difficult for HCPs sometimes where a patient has capacity but acts irrationally against their own interests or their own baby’s interests.

But while the baby is inside her body, and she hasn’t been shown to lack capacity her autonomy over what happens to her, including her refusal of treatment should be absolute. Like any other patient who isn’t pregnant should have that same autonomy. Unless, like any other patient lacking capacity she lacks the capacity to decide. It just feels scarily easy given the cultural attitudes about baby brain and irrational hormonal pregnant women for authority figures to use a low bar to deciding that pregnant women lack capacity. The judge said she can’t decide about issues to do with the birth which seems very wide, given the consequences. It’s not the case that the answer to every question about a birth in a women’s best interests (especially taking into account this young woman’s specific issues) is ‘she has to be in hospital’
If that judicial decision is ever justified by the good of the baby then we need to be given assurance that looking at the mother’s best interests has been the relevant guide to her treatment while she lacked capacity.

We don’t know enough to know what’s happening here in this case but I think it’s definitely not irrational to worry about how pregnant women with mental health problems are treated and pregnant women in general are treated in terms of their decision-making. We can this see this even from examples like labouring women being forced to wear masks (against recommendations) which is also currently in the news. The rules aren’t always right and the right rules aren’t always followed.

I agree 100% about increased prevalence of agoraphobia after lockdown in the general population which will obviously include pregnant women.

@NiceGerbil Am in agreement with your last posts.

The Children Act now includes the category "future risk of emotional harm" and it was hotly debated in 2018 by people recognising how delicate the assessment of that and how damaging ham-fisted application can be to children and their families, so concerned posters can rest assured that the mother in this case is extremely likely to have been assessed as to her future parenting skills in the context of her MH issues and will continue to be so.

@ChattyLion

Also in agreement with your posts.

The charity Birthrights seem to have a sensible take on the other case mentioned on the thread (not the scantily-reported case of the 21 year old who is the subject of this thread and no judgment available to read) see blog: www.birthrights.org.uk/2021/04/07/blog-agoraphobia-and-mental-capacity-a-new-obstetric-intervention-case/

They say: Yet it is perturbing to once again read a judgment that explicitly takes account of the interests of the unborn baby in drawing conclusions about GH’s best interests on the grounds that she was “desirous of a safe birth”, regardless of the impact on her of being forcibly transported to hospital and potentially given a Caesarean under general anaesthetic. Many people are desirous of a safe birth yet decline recommended care. GH did in fact go on to have the home vaginal birth she wanted “before it was possible to execute the arrangements authorised by the court”.’

I just think there but for the grace of God, when I hear about women in terrible distress around birth and how this can be handled, and with a wider cultural narrative surrounding women and birth in general that often (increasingly?) does not always support and respect women as autonomous human beings or see them as ‘birthing people’ - to use that stupid new euphemism in its true literal meaning.

As none of us know what the risk is (rightly so, none of our business really), its impossible to conclude whether the risk is solely to the baby, or to the mother as well.

This decision should be only about the woman, not considering the good of the baby

I can't agree with this. No doubt this makes me a "forced birther" but I will not support a woman's right to irrationally choose a route which has the likelihood of a dead baby over a live baby.

I agree. In some instances, there are necessary limits to rights and choices.

@MissBarbary

This decision should be only about the woman, not considering the good of the baby

I can't agree with this. No doubt this makes me a "forced birther" but I will not support a woman's right to irrationally choose a route which has the likelihood of a dead baby over a live baby.

Our of interest, if someone had a partner or family member who had an illness which needed hospital treatment (medical professionals had facilitated scans and tests at home, but there was a good chance they would die if they didn't go in- small chance they might be fine) but they were agoraphobic, would they just say ah well, your choice, even thought that choice cannot be an informed one as their illness cloud's the ability to do so?

That's a false equivalency as the hypothetical situation you outline affects only the adult who is making that decision. In this case, it is a pregnant woman whose refusal to leave her house may put both her life and the life of her unborn baby in danger.

@AlfonsoTheTerrible

That's a false equivalency as the hypothetical situation you outline affects only the adult who is making that decision. In this case, it is a pregnant woman whose refusal to leave her house may put both her life and the life of her unborn baby in danger.

I know, but even in the case above most people in reality would be keen for intervention to ensure their loved one got the medical care they needed.