C-section baby judge urges changes

The case of a mentally-ill Italian woman forced to give birth by Caesarean section in the UK has led to the country's top family judge calling for "radical changes" and greater "transparency" to let the public know what is going on in the family courts.

A mentally-ill Italian woman was forced to give birth by Caesarean section in the UK

The case of a mentally-ill Italian woman forced to give birth by Caesarean section in the UK has led to the country's top family judge calling for "radical changes" and greater "transparency" to let the public know what is going on in the family courts.

Sir James Munby, president of the Family Division of the High Court, said today too much of the reporting was inaccurate, but that was not entirely the fault of the media, which initially did not have access to court judgments on the case.

Sir James said: "We simply cannot go on as hitherto. Many more judgments must be published."

The judge was reacting to the story of Alessandra Pacchieri, 35, which has made international headlines.

He was also giving his reasons for imposing an anonymity order to keep the identity of her child, now almost 16 months old, secret after being placed for adoption.

The judge said when the story "broke" there was very extensive coverage in the print and, to a lesser extent, the broadcast media.

Coverage earlier this month included comment and criticisms of various orders made by the English courts, and much of it was strident and some of it inaccurate.

It was wrongly asserted that Essex Social Services took the baby girl, known as Child P, into care in August last year after forcing the mother to have a Caesarean, said the judge.

In fact a health trust looking after the mother since June 2012 under the Mental Health Act made the application because of concerns about risks to mother and child.

The judge said it was also asserted that he himself had ordered social workers "behind the forced Caesarean" to explain to him why they had "snatched the baby at birth", and that he had demanded to know why the girl should not be reunited with her mother.

"That simply was not so," said the judge. All he had done was to direct that any further application to the courts should be heard by him - "if" any application was made either in the family court or Court of Protection, which protects the interests of vulnerable people.

But when the story broke "none of the relevant information was in the public domain in this country", said the judge.

He asked: " How can the family justice system blame the media for inaccuracy in the reporting of family cases if for whatever reason none of the relevant information has been put before the public?"

He added: "This case must surely stand as final, stark and irrefutable demonstration of the pressing need for radical changes in the way in which both the family courts and Court of Protection approach what, for shorthand, I shall refer to as transparency."

The case of Ms Pacchieri demonstrated this applied not merely to High Court judgments but also the judgments of Circuit Judges, said the judge.

Ms Pacchieri, who suffers from bipolar disorder, is reported to have come to Britain whilst pregnant to attend a training course with an airline at Stansted Airport in Essex.

After she stopped taking medication she had a panic attack and was sectioned under the Mental Health Act.

The Court of Protection gave a health trust permission for doctors to carry out a Caesarean section in August last year, and the newborn child was taken into care by Essex social services.

Ms Pacchieri, who can only be identified by her maiden name, told an Italian newspaper she had been left traumatised by the incident, adding: "I want my daughter back. I'm suffering like an animal."

For a long time the reasons for the Court of Protection decision remained secret, and it was only recently that it was disclosed that the judge, Mr Justice Mostyn, had declared that doctors should be allowed to force Ms Pacchieri to have a C-section because a natural delivery risked rupturing her womb.

The judge said there were also concerns that if Ms Pacchieri was unco-operative when she went into labour, doctors would be unable to monitor the baby's heartbeat and to see whether Ms Pacchieri's womb might rupture. He authorised "reasonable restraint" to perform the C-section safely.

In February, Ms Pacchieri, who had gone back to Italy, returned to Britain to request the return of her daughter, but a Chelmsford county court judge ruled that the child should be placed for adoption because of the risk that the woman might suffer a relapse.

Last week, the Italian authorities offered to assist the English courts "in every way possible" in any further legal proceedings, but indicated they will not seek to make submissions on behalf of "any particular party".

Sir James said the mother had not challenged any of the English court decisions in the Court of Appeal, and there were no other hearings currently planned.

Ms Pacchieri had started various proceedings in the Italian courts, but these had come to an end in September.

According to social services, the mother had two other children in Italy which she was unable to care for due to orders made by the Italian authorities.

It is understood that, among her other legal options, Ms Pacchieri could still launch a legal challenge against any future decision to make an actual adoption order for her child.

Ms Pacchieri has two older children being cared for by her mother in Italy. British authorities said they liaised extensively with Ms Pacchieri's extended family and that adoption was only considered after all other options were exhausted.