• Communicable Diseases
• HIV
• Intensive Care Units, Neonatal

Earlier this year, a National Health Service Trust applied for anticipatory declarations relating to an unborn child.1 C was 37 weeks pregnant, HIV positive for over 20 years and had refused antiretroviral treatment during this pregnancy. The obstetricians were concerned that the newborn could be HIV positive. C was due to have elective caesarean section the following day. The application intended to secure the court’s authority to administer antiretroviral treatment to the newborn baby within 4 hours of birth and for 28 days thereafter.

Justice Hayden was told that C had only once received antiretroviral therapy; in 1999 in Romania. She was convinced by her experiences that she was normal and that her baby would not be infected. She was worried that the therapy would harm her child. On multiple occasions, she had attended hospital over the last few months following offers of antiretroviral treatment during the course of her pregnancy, but on each and every occasion she had refused. Through interpretation, it was clear that C was ‘…very angry that she was being [coerced] to take antiviral medication for her child’s sake’.

It also became apparent that C had presented to other distant hospitals purportedly, with ‘…the objective of achieving a birth plan for her and the baby which accorded with her own perspective of what is necessary and proportionate’. This gave her clinicians serious concern; that even if she consented to provide her child with the necessary medication, ‘…there was a significant risk that …