HIV mother to be treated to reduce risk to baby

A pregnant woman who is HIV positive, and who has refused to undergo treatment to reduce the risk of transmission of the virus to her unborn child, has been ordered by the High Court to facilitate such treatment.

The woman, who the court heard has five other children, is due to give birth next week.

The President of the High Court, Mr Justice Finnegan, was told yesterday that, without treatment, there was a 30 per cent risk of her baby contracting HIV at birth. This risk would be reduced if the baby received oral medication within four hours of its birth and further treatment in a six-week period afterwards.

If the child was infected with HIV on birth, and this remained untreated, the child's life expectancy would be two to three years, the judge heard. Without treatment, there was also a risk of the child contracting an infection.

After hearing evidence, the judge told the woman he was making a number of orders in the interest of the welfare of her unborn child. He said without treatment there was a very serious risk to her child and he was not prepared to allow that risk.

The judge accepted an undertaking from the woman that she would attend at the Coombe Women's Hospital to give birth. The woman had initially said she would not give birth in the Coombe because she did not trust the doctors and had concerns about the hospital.

The judge said his grandchild was born in the Coombe recently and he had no complaints. He told the woman he would have to make much more serious orders affecting her personal bodily integrity if she refused to give birth in a hospital. She then agreed to do so.

On receiving that undertaking, the judge directed that on birth, the baby would be made a ward of court, meaning it would direct that the treatment take place.

He further ordered the administration of the medication to the child on birth and further medication, therapy, testing and monitoring as was advised by Dr Sean Daly, master of the Coombe. Any further applications relating to medical treatment should be made to the court in chambers.

The judge said these were "most unusual circumstances". He indicated he would consider an order restraining the woman from breastfeeding the baby. However, on being told the woman did not intend to breastfeed because of medical problems, he said there was no need for such an order.

The orders relating to treatment of the unborn child were sought by the South Western Area Health Board (SWAHB) after medical staff at the Coombe expressed concerns about the woman's case to the board.

The judge heard the woman had tested positive for HIV in March. She had been offered a HIV test when attending an ante-natal clinic there and agreed to undertake the test.

In an affidavit, Ms Rachael Devlin, childcare manager with the SWAHB, said the woman was shocked and angry with the test result but had agreed to a referral to a support clinic for persons suffering with HIV. She had attended that clinic a number of times but declined to have HIV treatment with retroviral drugs.

One of the purposes of such drugs was to reduce the risk of transmission of the HIV virus from mother to child, Ms Devlin said. This matter was discussed with the woman four times between March and June 26th. The benefits of treatment for herself and her unborn child were outlined but the woman said she did not wish to receive such treatment. She said that God would look after both herself and her baby.

A Coombe medical social worker had discussed the situation with the woman on June 26th, but the woman again indicated she was not willing to commence treatment antenatally. She had said God would heal her and indicated that if the baby was sick the doctors could take the baby away.

During yesterday's hearing, the woman told the judge she did not have HIV. The judge said he had to assume that she had. The woman expressed strong concerns about maintaining her anonymity.