Wednesday, 4 December 2013

The Shameful Case of the Italian Caesarean

My twitter followers will know that I've been very vocal this week on the case of the Italian lady who found out, in a horrendous way, just how bad we are at looking after those with mental health issues.

I have been abhorred, horrified and totally disappointed in Essex authorities in their handling of the whole case involving an Italian women who came here to study, was pregnant and had a caesarean forced upon her without her consent.

Some replied, not understanding the enormity of what had taken place, happy to see freedom and human rights exchanged for what they consider a thoughtful set of actions by those with the power to snatch your child away.

I know many will not agree with me when I say that I believe we interfere too much in peoples lives but this particular case goes beyond anything that I thought would ever happen in this country.

Brendan Fleming, the woman’s British lawyer, told The Sunday Telegraph: “I have never heard of anything like this in all my 40 years in the job.
“I can understand if someone is very ill that they may not be able to consent to a medical procedure, but a forced caesarean is unprecedented.
“If there were concerns about the care of this child by an Italian mother, then the better plan would have been for the authorities here to have notified social services in Italy and for the child to have been taken back there.”

My mother has Italian satellite and watches the news from Italy rather than from the UK news channels. I was interested to see what the view was from my other country.

As I trust doctors a lot more than I trust social workers, I had made an assumption that it must have been a necessary evil with good reason. I was more upset by the fact that the baby was not then sent back to Italy with her mother for them to decide what was best. I think I may have trusted too much. I have learnt today that the operation happened when this lady was only 34 weeks pregnant. Why?

Her other two children are looked after by their Nonna and the mother spends time with them every day, although does not live with them. She has been trying to rebuild her life and that is one of the reasons she came to Britain. Her sister in law is happy to take on all 3 children in America including the mother.
The family were never consulted properly and although the Nonna has said she has her hands full with the 2 children she already looks after, it seems there are other family members willing to take the new addition.

Italians are in uproar, and rightly so. They are probably not in receipt of all the facts - as we are not - but at the moment they think we are the devil incarnate. Our reputation is in shreds and I can't defend it.

The solution was simple.As the baby still had a few weeks to go inside the womb, this lady should have been sent back to Italy - AS SHE HAD REQUESTED - before she had the baby and left to the wider family and the Italian authorities to deal with, as they had done before and quite successfully. Who are we to think we could do a better job? The sheer arrogance of it. If the Italian authorities had wiped their hands clean, as has been suggested, then so be it.

Apparently the lawyers were told that the mother was too late in her quest to get the child back because adoption procedures were already in place - this was not true. Was this a lie? A mistake? Has this happened before? We need to know. 

Now there could be any number of factors that could put a different perspective on the whole tragic tale but one thing I will not change my mind about is this.

Social workers should not have had the power to keep this baby away and make a decision to adopt when there are other family members who are willing to care and look after. If this woman is trying to rebuild her life, she should have been given the support and the chance to prove she is capable, or will be in the future. We are spending money in the wrong places.

Imagine if this had happened to your daughter and your grandchild ended up in another country, with you having no say control whatsoever in it's future, or even being nearby in order to fight it properly.

We need grandparents rights across the whole of the EU, especially if now country boundaries count for nothing when it comes to snatching children off their parents. Does anyone think of their feelings when it comes to family courts? Sadly the answer to that is No, as I have witnessed for myself in a current case I am watching closely. Grandparents, often totally innocent in these affairs, have no say whatsoever in being able to even see their grandchildren for a couple of hours never mind on a regular basis. This needs to change immediately. The state loves the fact we look after them while our children work, help out financially etc etc but when it comes to our needs we are insignificant and ignored. When I met David Cameron, I asked him to make this a priority and he has promised that they are looking into it. I will hold him to that.

This is a shameful moment in the history of social work and reminds me of the film Philomena. I'm sure those nuns who stole from the shamed unmarried mothers at the time, thought they were doing God's work and the right thing for the babies. We are horrified now at this true story, and in the future people will be truly horrified at this one - if they are not already.

Shame on us..


  1. The lady in question was suffering from a severe psychotic episode, severe enough for her to have been compulsorily detained under the Mental Health Act.

    The NHS trust, acting on the advice of the obstetrician, determined that it was not advisable for her to give birth in a natural vaginal delivery as it posed an increased risk of uterine rupture. This is the same reason her previous two children were delivered by caesarean section.

    The court determined, in accordance with the evidence that was provided, including by the highly experienced QC arguing on her behalf, that she should undergo this procedure. Her mental capacity was such that she could not reasonably make these decisions herself – which is why she had been compulsorily detained in the first place

    The court also heard that Essex County Council’s Social Services were intending to ask the police to take the child on a 72 hour hold under s46 Children Act, because they had reasonable cause to believe that the baby, once born, would be a significant harm from the mother. The court determined that this was an unnecessary move and instead proposed that ECC should seek an Interim Care Order after the birth, pursuant to the normal procedures.

    I understand that, not being in possession of any of the facts of the case, you felt that AA was treated terribly badly, and that the media has made a huge amount from this case, again without being in possession of any of the facts. However I would challenge you to carefully read the case transcript in the link below and see if there is any element you would disagree with.

    I do just want to underline one other aspect of this case - AA was represented by a highly qualified barrister, at public expense, at every level of proceedings. The legal aid changes that this Government are bringing in could threaten just such provision.

  2. Thanks for that Ben - very useful
    However it does not answer the questions I have raised above. I have not focused on the procedure itself.
    Firstly I do not blame social services - the trouble is their hands are often tied. I am helping in a case at the moment where I feel the council in question made decisions based on 'cover my back' and the father's feeling are absolutely at the bottom of the pile. Secondly to totally think the judge is right is to work on the premise that the baby here is more important than the mother, grandparents and anyone else added together. I do not necessarily think that is so. The mother and her family are going through great pain at the moment because we are petrified to take any risks. i do not believe that the baby could not have stayed with the mother after the birth, with some supervision, we could have at least tried. Would the trauma of that be any worse than what she had to put up with since. i really dont accept that reason for dismssing that option The public have to take some blame for this. They villify people like Shoesmith so much that social workers following just daren't make a mistake and therefore over protect. Soon we wont have any social workers. I actually feel for them too. Its usually an officer above them that makes the decisions in cases like this
    But let's assume that the caesarean was absolutely the right thing to do - why was she not sent back to Italy, as she asked? Why were her family not properly consulted? Why was she told that the adoption had already gone past the point of her being able to make an application, when it wasnt? Why wasn't the baby just cared for while the mother was recovering and then have a meeting with social services and with family members? Why haven't we got grandparents rights yet?

    I'm sorry but no-one seems to care about this poor mother who now in her own words is suffering like an animal and that's before we even get to the wider family.
    There is no evidence that could be shown to me that will convince me this could not have been dealt with in Italy where the family are near. If this mother was such a danger, how come she can see her 2 children every day? This story started in Italy, should have continued in Italy and should finish in Italy. She needs help to rebuild her life, appears to be going in the right direction and needs her baby back with the wider family.

  3. OK so let me deal with the concerns in your response in order.

    Social services primary duty is to the child. The feelings of either parent are, and will rightly remain, secondary to the safety of the child. You say you don't believe that the baby is more important than the rights of the parents or grandparents. The judge has to act on behalf of the child, not least because the child isn't capable of making these decisions themselves. In this case it is clear from the hearing transcript that the mother has suffered from a serious psychotic break. Her mental health remains such that medical professionals are advising she cannot properly care for herself or the child, which is why she has been sectioned. You say you do not believe that the baby could not have stayed with the mother after birth, but the medical advice is that she poses a danger to the child and to herself. Just because she says she doesn't, doesn't mean she doesn't (and yes I do realise how One Flew over the Cuckoo's Nest that sounds).

    The reason the public vilify people like Sharon Shoesmith is that these stories are so often seen through the emotional filter of a cynical media desperate to fill column inches between advertising. It is no coincidence that the more emotional and hysterical the newspaper, the higher the readership figures. Unfortunately this type of cynical ratings driven journalism leads to facts being ignored for the production of "entertainment" based on the tragedies of others.

    That said, Sharon Shoesmith's biggest enemy was Sharon Shoesmith. Her appearances at the time of the Baby P case, which was just one of dozens of avoidable tragedies that happen every year, gave the public the impression that she didn't care that a child had died, so long as she had ticked all the boxes on her form. This is why she was vilified, in addition to the fact that at the time the newspapers couldn't name any of those actually responsible, so they focussed the nations anger on Ms Shoesmith.

    You seem to have missed the fact that the decisions in this case have been made on medical advice, and that the caesarean was carried out by the Mid Essex NHS Trust, after the NHS went to court. Why wasn't she sent back to Italy as she requested? Because the medical advice was that she was dissembling her state of mind, pretending that she wasn't in labour when she was, as part of her psychotic episode. She has serious mental health issues that came to a head when she was in this country. The decision by ECC Social Services to seek an Interim Care Order was prompted by the Court of Protection judge who felt that was better than a s36 seizure of the child by the police.

    I have no idea why her family were not properly consulted, or whether or not that is an accurate description. I have no idea why she was given information that was inaccurate, if indeed she was. I add those caveats because this is a case where, because of patient confidentiality, she can say what she likes about the actions of the medical and social services staff, but they cannot respond.


  4. I suspect there is a huge amount of facts in this case that we are simply not party to. I wonder if your empathy with this woman is to do with the fact that she is an Italian citizen in this country, combined with the filtered view you have received of the facts, through the prism of our and Italian media. I've not read anything on the case in the UK media, preferring to base my opinions on the actual judgments made by English judges, generally considered some of the best in the world.

    I will just question one thing in your last paragraph though. If she wasn't a danger, how come the children were taken into care by the Italian authorities? If the c-section wasn't necessary, how come her previous two children were delivered that way to avoid the same medical risk to life?

    This is a family tragedy and I don't believe it helps anyone for it to be dissected in national newspapers who refuse to produce the level of detailed fact necessary for the development of independent opinion by their readers...


  5. Hi Ben
    Thanks for your reply. I agree with quite a lot of what you're saying especially our judicial system being one of the best in the world but that doesn't mean all our judges make the right decisions. in fact some of them have made some downright stupid ones. There is a bit of truth in what you say about my Italian background making this more profound but actually its more to do wth the fact that I am now a grandmother and my grandchildren bring me more joy than I ever knew was possible. My heart is just full of pride, love, wonderment, happiness and curiosity and i really don't want any person to be deprived of the things I think are most worth living for.
    I also think that although we do need facts (and you will notice I have never condemned the caesarean act because I knew it was the NHS decision - my only problem is: was it at 34 weeks which is what I've been told because if that's the case, she could have been sent home or at least family had time to come over and see her, to discuss before it was taken from her?) we should not base all decisions and policies this way. there are values at play here and its only a matter or fopinion which is the most important.
    My top values are Freedom, Honesty, Family, Justice so you can see where I am coming from. Yes the baby is important because it cant speak for itself but that doesn't mean later on in life that person will think we were right. We have to balance it with the mother and wider family. This means we must take our time and not rush adoption when there is a contentious case like this. We will find out if the mother was incorrectly told that teh adoption had gone too far which stopped her from acting sooner. if thats the case i will be furious. and you can see in my next post yesterday that SCC did get it horribly wrong in the Cootes case. This is not a one off Ben - we have serious problems in our family courts, not least of all overwhelm at the number of false allegations against men in bitter custody battles - according to a good source. our system is far from perfect. Needs a overhaul and grandparents need rights. Millions dont get to see their grandchildren through no fault of their own and its just not fair or right.
    Yes this has made me a touch emotional and that's not how things should be dealt with but even if I take that part away I am left with a sense of the Philomena nuns - I cant help how it appears to me - best intentions of the nanny state, as long as everyone's back is covered.

  6. Oh and by the way, her children are with her mother and she sees them. She obviously is a danger at times but why does that mean all three children cannot go and live in America with her sister in law so that the siblings stay together with the mother visiting - as she does now with the grandmother. If she is able to spend regular time with her 2 other children, why can she not with this one? We need to wait and find out the truth about all of this but this really should have been done in Italy and we should've found a way to have made that happen.