“[The mother] does not wish to return to the United States where she feels there would be a lack of support for her and what is likely to be two children. However, she is not currently suffering from a mental health condition and given that she does not appear to have suffered from a definite mental health condition during her adult years, it is not impossible, but unlikely, that her mental state would deteriorate to such an extent that she would be diagnosed with a formal mental illness. She will, however, find this move to be very stressful.”
“[The mother] is recently known to our service having been referred to us on the 29th May from her midwife at Princess Alexandra Hospital, where her pregnancy is booked. The referral highlighted her history and current presentation of significant depression and anxiety, with a prior history of suicidal ideation associated with depression. This is her second pregnancy, and is associated with stressful relational issues with father of baby. She has been assessed by our team lead, who recommended urgent assessment by myself. Her current clinical presentation includes regular palpitations and panic attacks leaving her unable to eat and drink, alongside episodic hypertension and tachycardia. Additionally, she is getting some dizzy spells, abdominal pain and intermittent increases in blood sugar, leading to concern for gestational diabetes. She is low in mood and struggling to do normal activities of daily living, often staying in bed, causing her and her family much concern. She is under close monitoring from the midwives, obstetric team and our own team. She has started on sertraline 50mg, for which I will be reviewing with her on Friday 19th June with a view to increasing this as tolerated and needed. Notably, the physical sequelae of her psychological distress has resulted in a recent presentation to Accident and Emergency, where she was assessed for palpitations, shortness of breath, and episodic hypertension — symptoms directly attributable to acute psychological stress. This presentation underscores the severity of her current mental state and its significant physiological impact. There is additional concern regarding fetal wellbeing. Maternal psychological distress, particularly when accompanied by episodic hypertension and physiological stress responses, carries recognised risks to the developing fetus. Her current gestation further compounds these risks. Air travel in the third trimester carries well-documented hazards including significantly elevated VTE risk, in-flight cardiovascular stress from reduced cabin pressure, and proximity to the period of highest risk for obstetric emergencies such as preterm labour. In my clinical opinion, air travel at this time poses a significant risk to her mental and physical health and to the wellbeing of her unborn child. I strongly advise that she does not undertake air travel until her mental state has stabilised and she has been formally reassessed and cleared to fly, by both her psychiatric and obstetric teams.”
“19. The bar is high to set aside return order. I have to be satisfied that there is, and it is for M to show, a foundational failure; that the facts [on] which the decision is based have so change[d] that it cannot stand. 20. I am not satisfied that this has been established. 21. M’s mental health issues were squarely before the court at the final hearing and there was an unchallenged report on M by Dr McClintock which had been directed by the court to enable these issues to be resolved. I am very surprised I was not told that M had been referred to a specialist perinatal mental health clinic at that hearing. The decisions I made on 3 June were made with the benefit of the report from an independent psychiatrist who had considered this matter carefully and his conclusions, as I have indicated, were that M would find the move very stressful. So the fact that the move was likely to be very stressful was something I had already taken into account. The physical consequences of that stress formed no part of M’s case at the hearing. She was represented on that occasion and it is obvious that we were all aware that she was pregnant. There was no suggestion that she would not be able to physically return to the USA if a return order was made. Indeed she sought a four week period to effect the return, although I ultimately ordered three weeks. 22. I have considered carefully what has been said in both of the letters produced by M. It seems to me there is some force, but I go no higher than that, in Mr Crosthwaite’s point that M as an experienced doctor knows what symptoms to report. However, it does seem to me that Dr Smethurst’s letter (and the weight that I give to it) is significantly undermined by the fact that she has been presented with a medical history by M which does not accord with the history that she presented to Dr McClintock only a few weeks earlier. I view Dr Smethurst’s overall assessment of M’s metal state (and its likely effect on her physical health) in that context. 23. I also take into account that it remains [a] possibility for M to undertake the journey by rebooking on a United States airline which will permit her to fly. 24. While I recognise that a return will be very difficult for M, I am not satisfied that this is case where the high bar that there must be a fundamental change in circumstance which undermines the basis of the original order has been made out. I am therefore not going to set my order aside. Nor for the same reasons will I stay it. I am not satisfied there has been a significant change in circumstances at present and, if a stay is granted, this will give rise to a further change in circumstances which will may an impact on the ability to enforce the return order in the future.”
“She subjectively described her mood as low she conveyed that sometimes she has suicidal thoughts and just want to die however she will wait until she has a baby and will give it to the mother.”
“Whilst she admits that she would never harm herself whilst pregnant or harm her children; she admits that she would likely end her life if her children were taken away from her.”
“The complexity of navigating her current social stressors alongside late pregnancy whilst raising her elder child without paternal support whilst fighting an international child abduction claim is an enormous load, and one that has understandably led to significant deterioration in her mental state with her presentation with significant depression with comorbid anxiety with associated physical sequelae of anxiety as well as clear biological symptoms of depression; all likely contributing to her worsening physical symptoms in pregnancy. Notably, the physical sequelae of her psychological distress has resulted in two recent presentations to Accident and Emergency, where she was assessed for palpitations, shortness of breath, and episodic hypertension — symptoms directly attributable to acute psychological stress. This presentation underscores the severity of her current mental state and its significant physiological impact. … The postnatal period represents a recognized period of significantly elevated risk for relapse of psychiatric illness. Women with pre-existing conditions including depression and psychosocial stressors are at a substantially heightened risk of psychiatric deterioration during the perinatal period and require environmental stability as a cornerstone of their clinical management.”
“I suggest [this] process… should be applied when the court is dealing with an application to set aside 1980 Convention orders: (a) the court will first decide whether to permit any reconsideration; (b) if it does, it will decide the extent of any further evidence; (c) the court will next decide whether to set aside the existing order; (d) if the order is set aside, the court will redetermine the substantive application.”
“I would further emphasise that, because of the high threshold, the number of cases which merit any application to set aside are likely to be few in number. The court will clearly be astute to prevent what, in essence, are attempts to re-argue a case which has already been determined or attempts to frustrate the court's previous determination by taking steps designed to support or create an alleged change of circumstances.”
“Nothing in the Act shall affect the power to the Court of Appeal or the High Court to stay any proceedings before it, where it thinks fit to do so, either of its own motion or on the application of any person, whether or not a party to the proceedings.”