A pregnant mother who used barbecue tongs to give birth to one of her five children at home must be forced to have a Caesarean, the High Court has ruled.
All five of the mother's children were taken into care when they were babies and doctors fear she might die giving birth to her sixth.
In just over 10 years, the woman - referred to only as 'DD' - had three Caesarean deliveries and two 'concealed' pregnancies because she had an extreme phobia of hospitals.
Her third child was born secretly at home and was believed to have been fed on cup-a-soup for the first week of his life.
Social workers found him in his mother's arms when he was 5-10 days old in a deyhydrated and malnourised state.
He had lesions on his head caused by the barbecue tongs used by DD's partner to deliver him.
After previous pregnancies, DD had suffered seizures, haemorrhaging - and even a stroke - whilst giving birth.
All five children had been taken into care and four of them had been adopted.
And, after hearing that she is pregnant yet again, Mr Justice Cobb opened the way for a dramatic intervention by medics and police.
The senior family judge said DD's 'undoubtedly unwise' past behaviour revealed she was unable to make rational decisions for herself.
He ruled that her 'best interests' - and those of her unborn child - lay in her undergoing a hospital caesarean.
The judge authorised 'forced entry' into DD's home and restraint and sedation if necessary to keep her in hospital for the birth.
Recognising that his order impacted on DD's 'most precious and valued human rights' - including her right to liberty - the judge ordered that all reasonable steps be taken to minimise her distress and 'maintain her dignity'.
DD had a 'truly tragic and complex obstetric history' and medics were deeply concerned that another birth would put her own life at risk. She had rejected any medical assistance and was adamant that 'she should be left alone'.
One expert had described her as 'delusional', with 'abnormally fixated beliefs' - she believed that a well-know actor was her father and that a celebrated opera singer was her mother, although DD was actually older than her.
She had failed to turn up for a series of ante-natal appointments and, despite 25 attempts by social workers to visit her at home in just three months, she had 'not answered the door'.
On one occasion, her partner responded to the knocking by shouting through the letterbox that DD was 'not pregnant'.
The expectant mum could be heard shouting in the background, said the judge.
DD's resistance to any form of professional help had left the 'very large number of professionals' involved in the case in a quandary.
They sought the judge's guidance, fearing that any interference with the woman's autonomy or 'deprivation of liberty' would be illegal.
Mr Justice Cobb ruled that the woman clearly did not have the legal capacity to make wise decisions for herself.
And he ruled: "While giving due weight to her wishes and her fundamental rights, and those of her partner, I have nonetheless come to the clear conclusion that it would be in her best interests that she should be delivered of her baby by caesarean section."
He authorised medics to 'take such necessary, reasonable and proportionate measures' to achieve that end.
The court heard that DD, who is in her mid-thirties, suffers from autistic spectrum disorder and borderline learning difficulties.
She lives in the community with her partner, who has more severe learning difficulties than she does.
Her fourth child was born after she was 'discovered at home in the latter stages of a concealed pregnancy'.
Her partner had not called the emergency services but she had to be admitted to intensive care to control her fitting.
She suffered haemorrhaging and a stroke during the delivery, but swiftly discharged herself from hospital. Her fifth child came after another concealed pregnancy last year and was born at home without any medical help.
She refused point blank to accept any involvement with health service professionals or any post-natal examination.
Social workers saw her attempting to breast feed the child in her 'dirty' home, which was devoid of baby clothes, blankets, bottles, nappies or anything else suggestive of preparation for a birth.
Earlier this year, in execution of a warrant, the woman was forcibly removed from her home and taken to a psychiatric hospital for assessment. Whilst there, examination revealed that she was five and a half months pregnant.