It is always tragic when stories of women who have lost babies for any reason end up in court. Two cases have hit the headlines in the UK. Dr Jenny Hall, editor for the Midwifery Forum presents the stories and wonders if they raise more questions than answers.
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Please note as a trigger warning this article presents details of traumatic events.
In the past few weeks pregnancy has been in the UK news, due to two tragic and challenging court cases. The first was due to the custodial sentence given to a woman who had procured drugs by post to induce the termination of her pregnancy. An outcry has been caused by her imprisonment and the outdated law under which it has been sentenced. It was followed up by a demonstration to change archaic laws and ‘decriminalise’ abortion. The second reports the harrowing case of a teenager who had hidden her pregnancy, unknowingly or knowingly, gave birth to him alone, and then hid the damaged baby. There has been less reaction to this.
I plan to present these two cases as factually as possible from the reporting in the public domain and not to enter a great debate on the rights and wrongs. I would, however, ask you to consider the stories carefully and note your emotional and professional responses.
Ask yourself:
- What questions do you have about the circumstances?
- What is influencing you in your emotional responses and judgements?
- What do you think could have been done differently?
Glossary to assist understanding (bear in mind that I am not a law expert and going by what I read!):
Cryptic, stealth, negation, concealment, or denial of pregnancy is where a woman is pregnant but does not know she is. It is suggested 1 in 400-500 women will reach 20 weeks before recognising, while 1 in 2500 go to full term.
The 1861 Offences against the person act states that a person who provides or uses poisons or instruments to end a pregnancy will be “guilty of a misdemeanour” and, if convicted, could be imprisoned. The Abortion act of 1967 provides for termination to be carried out up to the 24th week of pregnancy.
Murder is defined as the unlawful killing of another human being and includes some form of intent to do so.
Manslaughter is defined as the unlawful killing of another person:” but is not guilty of murder due to the partial defences of diminished responsibility, sudden loss of self-control (which replaces provocation). A person is also guilty of manslaughter where he kills any person by an unlawful act (ie an act that constitutes a criminal offence in its own right), or by gross negligence. “
Child Destruction under the Infant Life (preservation ) act 1929 is the killing of an unborn fetus that is “capable of being born alive”, before it has “a separate existence”.
Infanticide under the Infanticide act (1938) is where a woman causes the death of her child under the age of 12 months, when “at the time of the act or omission the balance of her mind was disturbed by reason of her not having fully recovered from the effect of giving birth to the child”.
Court Case 1
The story is this:
The woman involved was aged 44, with three previous children. She had become pregnant again in December 2019 having been estranged from her partner. She had relationships with two partners and was not clear which was the father. When the lockdown for the Covid-19 pandemic started in March 2020 she moved back in with her partner, a time when she would be around three months pregnant. In mid-February the woman has already been searching online about how to induce a miscarriage. These searches continued until, eventually, in early May she contacted the British Pregnancy Advisory service (BPAS) by their telemedical service, telling them that she was 7 weeks and 4 days in length. She received from them drugs by post which she then took on May 9th and 11th. She thought she was around 28 weeks pregnant, or 30 weeks, according to her internet searches. Paramedics were called to attend twice that afternoon and evening, the first time giving false information about the stage of pregnancy and later for support. Her baby, Lily, was stillborn, with failed attempts by paramedics to resuscitate. She admitted what she had done to a midwife and to the police when taken to hospital. Postmortem indicated Lily was between 32-34 weeks.
To further explain the circumstances under which this was taking place, from 2018, for early termination of pregnancy, prior to 10 weeks, it was required in the UK for a woman to attend a clinic, and there commonly prescribed mifepristone followed by misoprostol 24-48 hours later. During the pandemic lockdown in March 2020 it was agreed that women could obtain medication to take at home to undertake a termination of pregnancy to prevent the need for attending clinics.
She was originally charged with child destruction (see above), to which she pleaded not guilty, and subsequently tried under the 1861 Offences against the person act to which she pleaded guilty. She received a 28 month sentence, with 14 months in custody and the rest on licence.
An immediate appeal has been thrown out.
Court case 2
The story is this:
In 2019 a girl of 15 discovers she is pregnant when she goes into labour. She gave birth alone downstairs, while her parents were upstairs. Her father was terminally ill, and her mother was helping with dialysis treatment. She said the baby Stanley’s head hit the floor and the cord was around his neck, and that he was not breathing or opening his eyes. He was thought to be full term and weighing 7lb 12oz. She said she did not know she was pregnant and told paramedics she thought she had just put on weight. She later told a midwife “she “had a feeling” she was pregnant and she “wished she’d listened to the back of her mind”.” It is reported that she stopped her younger brother coming in the room, telling him she had had a heavy period on the floor. She put cotton wool in the baby’s mouth, she claimed to clean up blood- this was later found in his throat and mouth. She apparently kissed him goodbye and then placed him in a black bin bag, which she asked her brother to take out and put on the step, before she went to bed. The baby was found the next morning by her mother who looked inside the bag and called emergency services.
Medical examination of Stanley showed his head injuries were extensive, and severe.
The court case in front of a jury is now of a woman who is 19. The case identifies that she would have been 14 years old when she became pregnant in the summer of 2018. Nothing is reported on the potential father of Stanley, apart from a statement that indicated he did not want to wear a condom as “he didn’t like it.” According to the Sexual offences act 2003, sex under the age of 16 is a criminal act, though there are provisos should both partners be close in age. Nothing is said in the media about safeguarding. In reports the woman had been having sex since she was 13: ‘I just thought it was a way to get people to like me because I was quite insecure about the way I looked and the way I was made to feel about myself at home because my family situation was quite bad.
Reports from the case, from her story, and that of her brother, indicate that the relationship she had with her own father was troubled and that she felt he was a bully, made worse by his illness, making the family “walk around on eggshells”. She indicated she felt scared. She felt her mother had a “lot on” with caring for her father, having moved back in with him to support him. Her father has died since the case.
It is reported she had gone to the GP with her mother in October 2018- it is not stated why, though she said she had some sickness on and off she had put down to a bug. Maybe her mum suspected she was pregnant? It is not clear, but the GP asked if she: “was having sex and at that time I told her no because at that time I wasn’t,” she said. “I think I must have misunderstood how she was asking it. I felt like I could have told her if I felt comfortable enough, but I didn’t know how to go about it.”
No pregnancy test appears to have been carried out then, but the GP was also suspicious. Nothing appears to have been followed up. Noone at her school or at home noticed or questioned if she was pregnant.
Psychiatric reports suggest she was calm and had a ‘balanced mind’. The judge gave the jury the option to consider a charge of infanticide. Instead, they decided she had murdered Stanley; that she had given birth alone, then deliberately killed him to hide him from everyone.
The judge sentenced her to a minimum of 12 years in prison.
There are many questions that could be asked about these cases. You can read how the different media outlets present the cases and the individuals: the headlines, the descriptions of them, the images used. The stories are shocking and therefore media fodder. But these are people’s lives and there is tragic loss of babies that could have had a life. The impact for their families are far-reaching. None of us can truly know what was in these women’s heads as they made their choices. None of us can truly know what we would have done in similar circumstances. But, as midwives, do we see different things in these stories where things could have been done better to prevent these tragic events from happening?
Dr Jenny Hall, Matflix and Midwifery Forum editor
June 2023