‘Essex council should be commended for speaking out on the forced caesarean case’

It's time for councils to reconsider their position of not commenting on individual cases, writes child protection consultant Joanna Nicolas

Credit: OJO Images/REX

“Baby taken from womb by social services”, so read the headline of a report in the Sunday Telegraph, which has led to outcries across the world. I am not surprised at the response.

To make matters worse, the mother in this case allegedly has a diagnosis of bipolar disorder, and is now fine, but social workers won’t give her baby back. It’s no wonder we social workers are constantly vilified when we apparently behave like this. In the words of some spewing venom on social media sites: “Social workers do the work of the devil”.

24 hours later we hear from Essex council and the facts, as always, are rather different.

It is unusual to have a case that combines the legal framework of working with vulnerable adults and the legal framework of child protection. Let us be absolutely clear that these are two completely separate systems, guided by different laws.

In the first instance, if there are grave concerns about a mother’s mental capacity and her physical and/or mental health, professionals will act. Just as in child protection, decisions are never made lightly and a decision for a birth to be enforced by caesarean section will be made by the High Court.

In this case, after the mother had been looked after under the Mental Health Act for five weeks, the application was made to the court because of concerns about the well being of the mother and the unborn baby.

The child protection process

It’s also important to be clear that mental ill health does not equal child protection concerns.There are many parents and carers who have a mental health diagnosis who care for their children perfectly well. When child protection becomes involved it’s because a parent is unwilling or unable to accept they suffer from an illness and will not accept the treatment needed to keep them stable and safe.

If the order is granted, that’s when child protection processes commence. It remains the case that an unborn baby has no legal status and therefore child protection social workers cannot go to court until a baby is born.

One would hope adult mental health services would have alerted social care to this situation when the mother was detained, because of the concerns about her mental ill-health and her ability to care for her baby.

There should be a pre-birth child protection conference to ascertain what needs to happen to keep the baby safe. In a situation where there are such grave concerns, the plan is usually that the hospital will alert children’s social care when the mother goes into labour and then when the baby is born. Social care will then go straight to court to apply for a court order, which gives the local authority shared parental responsibility, with the parents. That’s what happened in this case.

The mother took part in the proceedings, despite it being reported that all this happened without her knowing. Care proceedings are not heard “ex parte”, i.e. without the parents knowing, unless there’s a very good reason – usually if there are concerns a family is likely to disappear if they know social care is going to court and the authority can evidence that pattern of behaviour. Parents may be banned from the courtroom, but that will usually be because of their behaviour in the court.

This case is also unusual because the mother lived abroad. Best practice would dictate that professionals in the UK should look to family carers first, regardless of where they live.

‘It’s time to speak out’

Generally, councils do not comment on individual cases.The predicament they have is that if they do not they are usually left looking as though their actions have been draconian, or lax.

Those of us working in this field know there is always much more to a story than has been reported, but irresponsible reporting is not going to end. Therefore we need to be more robust in our response and not wait until we have been vilified to give a little reality to a situation.

In this case, one would hope that now we know the mother has two other children she was unable to care for, and Italian courts ruled this child should remain in England, there might be a slightly different reaction to the case. (Sadly, I doubt that bit will get reported).

It is time for local authorities to reconsider their position of not commenting on individual cases. Information such as Essex has given identifies no one but may increase understanding of how and why local authorities act. It is honourable that local authorities put the right of the service user to privacy first, but if that service user then speaks to the media they relinquish their right to complete privacy.

If we really value our most vulnerable children and we want good people to come into child protection we need to protect those professionals too and speak out about what they do and why decisions are made.

So, I commend Essex council for their braveness and hope that others will follow suit. Let us hear more often why local authorities and courts have made the decisions they have.

  • Joanna Nicolas is a social worker and child protection consultant

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6 Responses to ‘Essex council should be commended for speaking out on the forced caesarean case’

  1. jason byrne December 4, 2013 at 7:29 am #

    Joanna, I agree that the news headlines were purposefully provocative and it is important to be critical about these kinds of headlines and await the fuller facts befote making some kind of judgement. I think these kinds of cases do need to be
    open to public scrutiny as should most other cases. Unfortunately as we know the media often have their agenda but councils often have theirs and in my experience of working in many organisations in social care there is often a defensiveness from organisation when people begin to look below the surface. As a student social worker I am also aware that as I need to hold a healthy scepticism of service users I also need to take the same approach to colleagues, services and organisations that hold a level of power over those they support.

    • Joanna Nicolas December 4, 2013 at 8:07 pm #

      You definitely have a point, Jason. I have been trying to persuade local authorities to speak to the media and be more open for the 5 years I have been independent and working closely with the media but it is an uphill battle.

  2. Mark Rogers December 4, 2013 at 7:42 am #

    Well done to CC for publishing this. Safeguarding is rarely simple, although much reporting in the mainstream media would have us believe it so. And this case, of which we are only seeing the tip, is clearly complex. But I have no doubt that those involved in Essex County Council are doing their very best to make tough decisions where the exercise of judgement, not recourse to some mechanical algorithm, is at the heart of the work. So, it really doesn’t help when over-simplistic and partially informed reporting demonises a profession that, due to its respect for privacy and the need to observe reporting restrictions, cannot readily explain its actions or the wider context in which they are made. The enlightened would understand that, in social work, taking what you see on the surface as gospel is both naive and irresponsible. So, thank you CC for seeking to bring perspective.

  3. Andy Brammer December 4, 2013 at 1:39 pm #

    It might be helpful if someone could highlight the seperate process’s that have taken place with regard to the mental health act, mental capacity act and childrens act. Alot of fire is being trained on the local authority about the decision with regard to the court case relating the child and question of adoption etc. This it seems to me is being conflated with the original decision to detain the mother under the mental health act and the later use of the mental capacity act via the court of protection to undertake a ceasarian section against the mothers will. We dont know and may never know the circumstances of her detention or the reason why the court of protection agreed to this. But someone needs to clarify who made the application to the court of protection, to use the mental capacity act, i assume they thought that a medical intervention was necessary for the well being of the mother. In this case the application would come from health and not the local authority. It is my understanding that the unborn child itself is not covered by MCA. The press and politicians are doing there usual, dont let the truth get in the way of a good story or photo opportunity. But surely if an order to undertake a ceasarian had been granted to the local authority we would have a clearer ruling on this. Could someone clarify because I havent been able to find the definitive answer as yet.

  4. Andy Brammer December 4, 2013 at 1:41 pm #

    apologies just read my submission. I wasnt saying that the court of protection agreed to the detention under MHA,but agreed to the ceasarian section being undertaken against her will. Must proof read in future.

  5. iankemp December 5, 2013 at 1:05 pm #

    This is obviously a complex case . There are a range of problems that need to be addressed . First the C/S is a medical decision not a social work one .The reason why a more supportive approach to this woman is not clear … She has two other children who are being cared for by a grand parent .. .Bipolar is a mental health problem that can be managed very successfully in the community so the question is why was not longer term fostering with support not considered.? If it was then what was the problem . lack of resources financial pressure. The political rhetoric these days is about getting adoption done much more quickly . If this was the case it is a worrying trend , as adoption is irreversible and final whatever the result of the mothers final rehab may be .In my view it is, whatever the justifications may be,not good for the future of social work and mental health