British court to rule on sterilisation

LONDON - The mother of a pregnant woman with learning difficulties pleaded with a court yesterday in Britain for her daughter to be sterilised to stop her having any more children.

The woman's 21-year-old daughter, both of whom cannot be named for legal reasons, was due to give birth today to her second child by Caesarean section.

She has significant learning difficulties which make it impossible for her to look after her own children, so they are being brought up by her mother.

The mother, known in court documents as Mrs P, hoped that a sterilisation could be carried out after the Caesarean, a proposition that was supported by her local NHS trust. But the Court of Protection ruled yesterday that a decision could only be made after expert evidence had been obtained.

Fighting back tears, Mrs P told Justice Hedley why she wanted her daughter, known as P, to be stopped from having any more children.

"From my point of view, I want what is best for my daughter," she said.

"We are supporting her and helping her bring up her children and we keep them together as a family unit. But we can't carry on supporting more children."

The court heard how P was sexually healthy and active, but lacked the mental capacity to care for her children or understand the repercussions of falling pregnant again.

"She doesn't see anything wrong in her behaviour," Mrs P said. "She hasn't got the capacity to realise her actions. If she has more children we can't make a commitment to bring them up any more. I tried to explain that any future babies will go to a new mum and dad. She doesn't understand. She thinks she will see them on weekends and at birthdays and Christmas. She doesn't understand they will get a new mum."

The highly controversial case is being heard in the Court of Protection, a specialist court that deals with the financial, medical and personal affairs of those who lack the mental capacity to make decisions about their lives.

Most cases are held behind closed doors but Mrs P's application is being heard in open court because of the public interest in the court's decision.

Mrs P is seeking a declaration that a sterilisation procedure would be lawful and in her daughter's best interests. The court will now have to decide whether P lacks the mental capacity to make decisions about contraception and, if so, whether she should be sterilised by means of a tubal ligation, in which her fallopian tubes are cut and tied. The court will also decide whether less invasive options such as an injection or contraceptive implant could also be used to halt any further pregnancies.

The judge said that although the best time to perform sterilisation surgery would have been after the Caesarean birth there was not enough evidence to decide whether P lacked capacity and what her best interests would be.

He called for a further set of hearings in April and May.

- Independent