Case No. ZC20C00674

i)At no stage after it was discovered that KB was pregnant, did AB, CD or EF raise the possibility of termination of the pregnancy. There was no urgency by them upon conducting the positive pregnancy tests at home on 30 July to alert the GP. They waited until the appointment on 3 August to inform the GP of the positive tests. However, the contemporaneous medical records show that following the appointment on 3 August 2020, neither was there any urgency on the part of healthcare professionals to address the issue of termination. KB was taken to the Maternity Assessment Unit on 3 August and a scan confirmed the pregnancy which was dated at 22 weeks and 3 days. The first appointment with an obstetrician appears to have been with Dr Clarke on 27 August 2020 when KB was 25 weeks pregnant. Dr Clarke says that she “confirmed with AB that termination of pregnancy was not something that she or the family were considering and AB explained that she would prefer KB to be delivered by elective caesarean section rather than have a trial of labour.” Dr Clarke’s next involvement was on 27 September 2020 when KB was at over 29 weeks of pregnancy and Dr Clarke’s view was that a caesarean section would be in KB’s best interests and proposed to carry out a sterilisation procedure at the time of the elective caesarean section. Applications were made to the Court of Protection in relation to best interest decisions regarding the management of the pregnancy, delivery and sterilisation (not ultimately pursued) on 30 October 2020. ii)Given the importance of the 24th week of pregnancy to the conditions for performing a termination under the Abortion Act 1967, the correct presumption that KB could not consent to intercourse and so had become pregnant after rape, and the impact of continuing the pregnancy for KB, the absence of urgent discussion about termination with the family by healthcare professionals following the scan on 3 August 2020, at 22 weeks 3 days, is troubling. AB’s noted reaction can be explained by denial, desire to protect KB from distress, her faith, naivety, or a number of other psychological factors at play, but it was incumbent on healthcare professionals to note the urgency of the decision whether to terminate the pregnancy, to discuss that with AB and the family, and to consider whether an application to court was necessary. I note, as submitted by Ms Keehan in her helpful written submissions, that it is not at all certain that had a best interests decision been made in early August 2020, that it would have resulted in termination of the pregnancy. However, this was clearly something that should have been discussed with the family whatever indications they have about their initial views.iii)I have already found that AB, CD and EF did not know that KB was pregnant until 30 July 2020. The evidence does not establish that they colluded to avoid KB having a termination in the immediate aftermath of the discovery of the pregnancy. Having heard them give evidence, I am satisfied that none of them held religious or moral views against abortion in any circumstances. Had termination been addressed with them between 3 August 2020 and the 24th week of pregnancy, they would have seriously considered what was in KB’s best interests, whether or not that consideration would have resulted in a decision to terminate.