Case No. FD25F00020 - [2025] EWHC 783 (Fam)

I will now give a short ex tempore ruling. I am sitting today to consider a Part 8 claim brought in very urgent circumstances by the applicant Trust. The only respondent is PP. It is important I say that as this is a CPR 8 claim, I am sitting in public, but I have made a Reporting Restriction Order (RRO) and gave reasons for doing so. I have seen a communication from the Guardian Newspaper, and a reporter from the Press Association is here - Mr Park. He did not make any submissions in respect of the RRO. Balancing the competing Article 8 and 10 ECHR rights, I have made an order that PP cannot be identified and nor can her child when s/he is born. I have also made an order that there can be no naming at this stage of the treating clinicians.

The note of the judgment was helpfully produced by the legal teams immediately after the hearing (given the urgency) and  approved (in accordance with the guidance in Shirt v Shirt [2012] EWCA Civ 1029 (see paragraph 33)). It was subsequently amended to deal with corrections and anonymisation.

This application came into the urgent applications list fairly late yesterday afternoon. It was referred to me. I was concerned that the mother had no representation and inquired what had taken place to ensure the mother could be represented. I was told that when the mother was told about the application, she left the hospital to seek representation before she could be served with the papers. For that reason it was not possible to hear the matter yesterday. I therefore listed the matter before me at 12 today. The mother had been served with the papers in the interim.

I began hearing this matter at 12 pm, after I had heard two other matters. At the hearing which commenced at 12 pm, I dealt with issue of the RRO. During the short hearing the mother said that she had not felt the baby move for some time and so was advised by the treating clinician that she should go to the hospital to be checked. This she did. We resumed the hearing at 14.30 by which time the mother was in hospital and I am told the mother and baby were well.

That additional time had allowed the mother to obtain legal representation. I am indebted to Mr Fullwood for agreeing to act pro bono for the mother, instructed by Advocate.

The hearing started at 15.35. I heard evidence from Professor CC. She was questioned by Ms Scott, Mr Fullwood and answered some questions that concerned me. PP did not wish to give evidence, although she was in attendance at the hearing. She said that she was feeling too anxious.

In an ideal world there would be more time to consider legal and ethical issues that arise in this case, but this is not an option. The mother is going to give birth at any time, and so the determination of this application cannot wait.

The mother is 32 years old and pregnant with her fifth child. She is at 38 weeks. Her estimated date of delivery is 3 April 2025. As she has had a number of children already, there is a concern that she may give birth early. The current plan is that she will have a scan on Wednesday and be induced on Thursday. However she may give birth overnight.

The background to this application is that the mother has refused to consent to screening for blood borne viruses (BBVs), namely HIV, hepatitis B (HBV) and syphilis. The applicant has no record of her having had screening in her previous pregnancies. The applicant says there is a high prevalence of HIV in Manchester – every 6 out of 1000 people are infected. That is against a national prevalence of 2 out of every 1000 people.

More pertinent however in my view, is that the mother presented at hospital with Kikuchi Lymphadenitis which may indicate that she has HIV or even AIDS. The applicant considers that there is a real risk that she is infected with HIV.

Their application is in respect of a child who will soon be born. I am told that it is imperative that when the baby is born, it is investigated for these BBVs.

The results from both the new born baby’s blood and the cord blood, tests maternal antibodies to the BBVs not the child’s. Therefore, if the result is positive it does not mean that the child is infected. If the cord blood tests positive for HIV it will reveal the mother’s infection status. If the mother has HIV, then there is a risk that the baby does. There is a 4 hour window to get antiretroviral treatment into the baby to give the baby the best chance of avoiding developing HIV. The treatment is most effective within 24 hours. It has no effect after 72 hours.

If the cord blood is HBV positive, the baby will need treatment within 24 hours and if the cord blood tests positive for syphilis, treatment should ideally be provided within 12 hours. What the court is being asked to deal with is whether there should be testing and treatment of the baby, 4 hours after baby is born.

There is a question as to why it is that this application was issued only yesterday afternoon but there is no time to investigate that matter now.