University Hospitals of Derby and Burton NHS Foundation Trust and Derbyshire Healthcare NHS Foundation Trust v HH [2026] EWCOP 35 (T3)

Capacity and best interests decision concerning the obstetric care 

HH, a 30-year-old woman with paranoid schizophrenia, was 37 weeks pregnant with her second child and had been detained under the MHA following an acute psychotic relapse. The Trusts sought declarations that HH lacked capacity to make decisions about her obstetric care and that it was in her best interests to proceed with an elective caesarean section if an induced labour was deemed unsafe. While HH's engagement with the medical teams had fluctuated she had consistently expressed a wish for vaginal birth. 

It was agreed that HH lacked capacity so Mrs Justice Theis proceeded to decide that the care plan, which prioritised vaginal birth, de-escalation and use of restraint only as a proportionate last resort, was in her best interests as it respected her wishes and autonomy as far as possible. Theis J also authorised any resulting deprivation of liberty under the inherent jurisdiction of the court.
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