ABSTRACT
A 32-year-old woman with paranoid schizophrenia is admitted for antenatal assessment at 36 weeks’ gestation with twins. Her pregnancy is complicated by intrauterine growth restriction and impaired placental flow. She has had no psychotic symptoms in this pregnancy. Her obstetricians recommend an early caesarean section and argue it is in the best interests of the mother and her babies and to prevent further fetal insult. She has repeatedly said that despite the significant risks, which she understands, she refuses caesarean delivery. What is the most appropriate action?
