Doctors can use force to remove an agoraphobic pregnant woman from her home so she can give birth in hospital, a judge ruled.
Judge Holman concluded that it would be best for the 21-year-old to allow staff trained in restraint techniques to use minimal force if the woman refused to leave the house.
The judge issued the ruling in London on Thursday after overseeing a protection court hearing, where issues involving people who may lack the mental capacity to make decisions are considered.
He said the woman should be restrained only if necessary and any force should be proportionate.
Judge Holman said that everyone involved in the case agreed that it would be best if the woman left home, on a specific day close to her due date, so that she could give birth in the hospital in a “planned” manner.
The question was whether the use of force should be allowed, in circumstances where no emergency had arisen, he said.
Lawyers representing the heads of hospitals responsible for their care had said the use of force should be approved.
But the lawyers representing the woman disagreed, saying that she should be allowed to give birth at home if she did not leave and that she could not be persuaded to leave unless an emergency arose.
The woman was “overwhelmed” by agoraphobia, had barely left her home for about four years and had undergone a home scan, the judge heard. She had said that she wanted to give birth at home, due to her agoraphobia.
The judge said the couple and the woman’s mother thought she should give birth at the hospital. He said he was also pleased that the woman would want to give birth in the hospital if not for her agoraphobia.
Judge Holman, who is based in the Superior Court’s Family Division, said the “scenario” of the woman being forcibly removed from her home was “of course unattractive.”
Specialists said he could suffer psychiatric harm if force was used. But the judge said the evidence showed that there was a risk that something would go wrong if the woman gave birth at home, and said that if something did go wrong, there could be a “catastrophe.”
He said, “I am satisfied that it will be in this mother’s best interest if, if the need arises that day, some trained force and restraint is used to transport her to the hospital.”
The woman had watched the hearing, via video link, from her home with her partner.
“I think I should go to the hospital and have this baby,” Judge Holman told him. “It will avoid possible risks and disasters if something goes wrong.
“I think it’s better than a terrible rush job in the middle of the night.”
He added, “I know it will be a test for you.”
Judge Holman said the woman could not be identified in media reports on the case.
The NHS trust officials responsible for her care had asked her to make decisions about which moves would be best for her. He said the trusts could not be named, in case the publication of their names led to the identification of the woman.
The judge said the woman lived “far from London.”
Judge Holman concluded that the woman’s agoraphobia meant that she did not have the mental capacity to make decisions about the birth of her baby.
Judge Holman said any restraint should not include “mechanical restraint”, the use of a “prone restraint position” or any technique that would apply “pressure to the diaphragm or abdomen.”
Specialists had developed a four-page care plan to deliver the baby, the judge heard.
George is Digismak’s reported cum editor with 13 years of experience in Journalism