It's not the caesarean but the adoption that is an act of violence

http://www.theguardian.com/commentisfree/2013/dec/03/caesarean-adoption-bipolar-woman-violence

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The facts we know are these: an Italian woman, who was pregnant and in the UK for a training course, had a panic attack, which was catastrophic because of underlying mental illness. (Some say that she hadn't been taking her medication, and others contest that; I can't see that it's relevant, unless they have also found a way to go back in time and make it unhappen.)

Having been sectioned for five weeks, she underwent a caesarean for which her permission was not sought and during which she was unconscious, having been sedated. She had one or two days (reports are mixed) with the baby before it was placed in foster care. Just over a year later, in October this year, the county court gave Essex County Council permission to place the baby for adoption.

There is so much in this story, so many fault lines of justice crossed and re-crossed, so many hot-button issues, that for a while the world was in agreement: the Italian courts and women's rights activists, people who habitually hate social workers and people who hate authority, all united in outraged disbelief at what a Milanese judge, Fabio Roia, called "an unprecedented act of extreme violence". He said it could never have happened in Italy; campaigners for people with a bipolar condition said that, prior to this case, one would never have thought it could happen in Britain.

Since such a broad consensus is stretched pretty thin, dissent began immediately; yet it mainly centred on the contention that, since the facts of the case were unknown, it was impossible to comment. It's true, of course, that holders of the more florid opinions are going to have to row back in the coming days: the people who ascribed to social workers the desire to rip a child out of its mother's womb because they actively enjoy taking babies away … well, they will have to concede that the C-section decision was made by medics and not children's services.

And yet, in all probability, there will never be a set of clean, uncontested, verifiable facts, set out like exhibits in the public domain, for us all to handle. Mother and county council have different versions; she had been sectioned, the county council hadn't – but the assumption that the council's word is everything and hers nothing is hardly a given. Anonymity of the baby and the mother's other two children will (one can only hope) be maintained, which makes certain details – how successful were the care arrangements for her existing children, whether those could be extended to include the baby – impossible to establish. I don't agree that opacity and lack of detail should ward us off; there are principles here that can and should be discussed.

In fact, the C-section is the least controversial decision in the process. Alex Sykes, a former family lawyer, said: "Try looking at it in reverse. Imagine recovering from paranoid personality disorder to find that you'd refused a C-section and your baby was stillborn." This doesn't mean that the court of protection has no case to answer – it will always be an open sore in justice that this relatively new lever (set up in 2005) allows decisions to be removed from an individual, in secret, over such fundamental matters. But to call it forced or violent is a failure to imagine the alternatives.

Many people balked at the immediate fostering of the baby, but the judge's full findings show no desire to "snatch" the child, just a series of questions, sad and unwieldy, to which there could never be perfect answers. The normal procedure in a case like this would be a mother and baby unit. However, this option was closed, not vindictively, but because the mother was in the middle of a crisis when she came to Essex children's services. Had she been in contact with Essex throughout the pregnancy, a plan (to which she would have already agreed) would have been in place, allowing for episodes of incapacity.

The adoption is the decision that should truly worry us, since it relies on a set of assumptions: first, that a bipolar condition is an irredeemable state that can never be managed; second, that fluctuating mental health, which makes it impossible for you to be the main carer for your children, is reason enough for you to be erased from their lives; and third, that rights given up to the state following a paranoid episode can never be won back.

The judge's decision was phrased in a very kindly way, but its tragic final lines are not borne out by the rest of it: "If in later life P reads this judgment, as she may well do, I hope that she will appreciate that her mother in particular loved her and wished for her to return to live with her and to bring her up. It is not her fault, nor P's, that that was not possible and that a predictable home could only be secured by way of adoption." The mother's other children are in a kinship care arrangement with the grandmother. It is not clear from this judgment why only adoption by strangers in a foreign land could provide a predictable home.

One resounding, indisputable fact emerges: adoption decisions are heinously complicated and painfully irreversible. They cannot be made cheaply and should not be made quickly. It is the political rhetoric of the clean break – speeding up adoption, overturning trendy liberal logic with its "biological parent" this and "empowerment" that – in which the real threat lies, here and beyond.

<em>Twitter: </em><em>@zoesqwilliams</em>

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