Word arrives as judge puts full stop on ruling

Near empty courtroom hears from doctor on speaker phone

The doctor addressed the court by phone. There were just seven people in spartan courtroom number two, but the voice on speakerphone was so muffled that everyone seemed to crane their necks to hear the latest update from Waterford.

The pregnant woman, referred to as A, had said she would agree to a caesarean section, but she now seemed to be vacillating between Sunday and Monday, consultant obstetrician Dr John Birmingham told the court.

"I have told her she doesn't have 24 hours," he said. "I cannot be sure of the foetal well-being in 24 hours."

At around midday, just as the emergency High Court sitting was beginning, medical staff at Waterford Regional Hospital received the results of a CTG trace scan, which monitors a baby's heart rate during labour. The results were "non-reassuring", said barrister Eileen Barrington, acting for the hospital.


Normally in those circumstances, doctors would either induce delivery or carry out a caesarean. But the situation was complicated here by the fact that the woman had given birth by caresarian in December 2010, and the procedure had left a scar on her uterus. If the scar ruptured during a natural delivery, there would be "a grave risk" to the woman and her baby, according to an affidavit by Dr Ahmed Osama Aiat, a locum consultant obstetrician at the hospital.

The baby could die or have severe brain damage, and the woman herself was at significant risk of a haemorrhage.

Given that she was 13 days overdue, the placenta was ageing and the blood supply to the baby was diminishing. "This again increases the risk of intra uterine death," according to the affidavit.

The reasons for the woman's refusal to consent to a caesarean were not outlined in court. The hospital said she had previously agreed to the procedure if an emergency arose over the weekend, but the hospital was seeking an order to compel her to undergo the operation.

At issue was how to balance the mother's right to refuse treatment with the right to life of the unborn, the court was told.

What were the risks to the mother's life in a caesarean, Dr Birmingham was asked. In Ireland in 2013, he replied, caesareans were "almost risk-free".

As the hearing was unfolding at the Four Courts in Dublin, events were moving quickly in Waterford. The woman's solicitor gave evidence, also by phone, and before hanging up he agreed with Judge John Hedigan he would drive to the hospital to speak again to his client.

At about 2pm, with no further update from Waterford, the court rose and Judge Hedigan left to consider his ruling.

Just minutes before he was due to return - as he was putting the "final full stop" to his ruling, as he put it - a call came through from the hospital. The woman known as A had agreed to undergo the caesarean section. She had been given an anaesthetic, and preparations for the procedure began straight away. With this much confirmed, the court rose and the emergency sitting came to an end.