Woman's abortion delayed partly due to NHS 'annual leave'

A vulnerable woman almost missed the legal cut-off point for an abortion partly because of annual leave at a health board, a court heard.

The mother of the woman, who has been sectioned a number of times, told a court she was "traumatised" by the "barbaric" treatment of her daughter as she watched her continue her pregnancy into the second trimester.

The Court of Protection judgment found the "unreasonable delay" by Cardiff and Vale University Health Board had a "serious negative impact" on the woman, who is in her 30s.

The health board has accepted there had been a delay.

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The woman had two days before it would not have been legally possible to have a medical abortion, which can be carried out up to 24 weeks gestation.

"This should've happened weeks and weeks ago and never been allowed to get to the stage where she is in the second trimester," her mother told the Royal Courts of Justice.

The patient, who has a history of substance abuse and has been detained under the Mental Health Act a number of times, was about eight weeks pregnant in June 2024.

The court in London heard the woman – who cannot be identified for legal reasons - was confused about basic details about her pregnancy and at one point did not believe she was still pregnant, despite having accepted a positive result.

Although she initially said she wanted an abortion, the patient constantly changed her mind about it.

The woman's mother told the court that her daughter's understanding was "sometimes good and sometimes bad".

But the patient told her mum she wanted to "get rid of the baby and have a tablet".

The mother told the official solicitor - someone that acts for people who are vulnerable because of their lack of mental capacity in some courts - that her daughter might think there was a "magic pill" that would "make it all go away".

Because of this, the health board asked for a "treatment plan" authorised by the Court of Protection, a court that makes decision on behalf people who lack the capacity to do so for themselves.

The health board said the treatment plan would make sure the woman remained safe throughout the termination - if she decided to proceed - and her life was not put at risk.

This would include a deprivation of her liberty - giving medical experts the power to restrain or sedate her if they felt it was needed.

From 2 August last year, her wish to have a termination remained consistent and proceeds were issued by the health board two weeks later on 16 August.

On 12 September, Judge Butler-Cole KC found the woman lacked capacity to make decisions regarding termination of her pregnancy and authorised Cardiff and Vale Health Board's suggested treatment plan.

The patient went ahead with a medical abortion immediately after the plan was agreed. The deprivation of liberty proposed in the plan wasn't needed in the end and clinicians say the woman is doing well.

But the health board, which describes itself as one of the largest NHS organisations in Europe, was criticised by Judge Butler-Cole.

"The health board explains that there were staff absences due to annual leave over the summer break which explain the delay in issuing the application," Judge Butler-Cole said.

"In the circumstances of this case, where every day that passed meant that the options for her narrowed, and she herself had to continue with a pregnancy she had decided she did not want, four weeks was simply too long.

"In my judgement, an application should have been prioritised and made at the very latest by 26 July 2024.

"If it had been, a decision would likely have been made by the court by mid-August, rather than mid-September.

"While that may not have made any difference to the type of termination she had, it would have saved her a month of waiting and wondering why her expressed wishes were not being acted on as her pregnancy progressed.

"It would have meant that the procedure she underwent had lower risks of physical or mental harm."

The judge considered it appropriate to reflect the court's "disapproval of the health board's conduct in the case, its impact on the woman and her family".

Acknowledging the psychological and physical burden on the patient and her family, the judge made an order the health board paid most of the legal fees.

Cardiff and Vale health board said it cannot comment on details of an individual patient's care.

But a spokesperson added: "As a health board we endeavour to manage any case of this nature and complexity very carefully via our mental health and gynaecological teams."

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