BOSTON — A Catholic mother, struggling with mental illness, is fighting for the life of her unborn child in a Massachusetts court. The 32-year-old woman, known by the pseudonym “Mary Moe” in court documents, successfully appealed an order that would have forced her to have an abortion and to undergo sterilization.

Moe, who has schizophrenia and bipolar disorder, is believed to be five months pregnant. Her court-appointed lawyer, Douglas Boyer, did not return calls seeking comment.

The ordeal began last October, when Moe went to the emergency room and doctors discovered she was pregnant. Court documents do not state the reason for her hospital visit. Soon after, the Massachusetts Department of Mental Health filed a motion to have her parents, who support an abortion, appointed as guardians.

During a hearing, Moe called herself “very Catholic” and said she would not have an abortion. The Church teaches that direct abortion is an intrinsically evil act, as is sterilization, unless it is an unintended side effect of a medical procedure that is needed to save a woman’s life, such as the removal of pathological reproductive organs.

Moe also denied her current pregnancy, erroneously stated that she previously gave birth to a girl and incorrectly claimed that she had met the judge before.

Norfolk Probate and Family Court Judge Christina Harms, who retired earlier this month, found Moe incompetent and ruled that if Moe were of sound mind she would abort her child in order to benefit from medication used to treat her mental illness. Then, she took the judgment one step further and ordered that Moe be sterilized “to avoid this painful situation from recurring in the future.”

Harms wrote that Moe could be “coaxed, bribed or even enticed … by ruse” into a hospital, where she would be sedated and an abortion performed.

There is no record of what medications Moe has taken, and there is no statement as to whether or not she is currently taking medication. According to court records, during her hospital visit last October, a psychiatrist evaluated Moe and determined that the “risk of medicating this patient is much lower than that of withdrawing medication.”

In the appeals court decision, Judge Andrew Grainger noted that Harms’ ruling on the abortion contradicted Moe’s wishes and the determination of her court-appointed representative. He sent the matter back to the lower court.

The judge overturned and denounced the sterilization order, saying that it had been produced “out of thin air.”

The court will assign a new judge to the case, who will rule on the abortion order.

‘Pure Eugenics’

Daniel Herrop, a psychiatrist and president of the Rhode Island Catholic Medical Society, said that the risks during pregnancy presented by most medications for schizophrenia and bipolar disorder are relatively low. Someone with schizophrenia would likely take any one of about 20 anti-psychotic medications, which carry small risks during pregnancy. A diagnosis of bipolar disorder would likely result in taking one of a few mood stabilizing agents, one of which, lithium, could cause significant birth defects like spina bifida, where the child’s backbone and spinal canal do not close before birth. Herrop said he would recommend avoiding lithium during pregnancy, adding that the most of the other mood stabilizing agents are “quite safe.”

“It’s always preferable to be off all medications [during pregnancy]; however, it’s not necessary,” he said. “Many pregnant women, schizophrenics and those who have recurrent psychotic depressions, go through pregnancies quite easily with no problems if they’re on medications. The studies are that the risk is less than 1%, and it’s not even clear that you can relate birth defects to the medication.”

Those risks include a cleft lip, which could be fixed with surgery, and gestational diabetes, which would need to be monitored carefully throughout the pregnancy, he said.

Herrop added that if someone is not fit to parent because of a mental illness, that problem can be dealt with in the same way that the state deals with any incompetent parent. In most cases, a child born to an incompetent mother is placed immediately into state custody. Often, within hours the state determines that the child can go home with a family member until court hearings are held.

Anne Fox, president of Massachusetts Citizens for Life, called Harms’ decision “arrogant,” adding that the judge seemed to define a competent person as someone who would choose abortion if she was in Moe’s situation.

“Despite her other problems, she’s not abortion-minded,” Fox said. “An abortion doesn’t really help her problems at all.”

Moe has been pregnant twice before. While in college, she had an abortion, and sometime later she had a baby boy, who is currently in the custody of her parents. At some point between those pregnancies, Moe suffered what court documents call a “psychotic break.”

“She believed people were staring at her and stating that she killed her baby. She becomes agitated and emotional when discussing the pregnancy that ended in abortion,” the documents say.

Fox, who is not a psychiatrist and has not seen Moe’s medical records, speculated that while the abortion is not likely the cause of Moe’s mental problems, it seems to have triggered her symptoms — symptoms that have been so severe that the woman has been hospitalized on several occasions.

She added that abortion has been linked to dysfunctional and self-destructive lifestyles and is known to cause mental-health problems like depression.

Rob Schwarzwalder, senior vice president of the Family Research Council, called sterilization an “act of cruelty.” He said using the woman’s mental illness as a pretext for abortion is “pure eugenics.”

“For a judicial system to coerce her into destroying the unborn life is so immoral and so antithetical to the very principles of representative self-government,” he said. “This is a woman of deep faith who wants to live her faith actively.”

John Grohol, a psychologist and founder of the website Psych Central, said that mental-health problems are still widely misunderstood and that abuse of people with such problems is not uncommon.

“I wouldn’t be surprised if more cases like this do occur,” he said. “These court cases are almost always sealed.”

More Resources Needed

Deacon Tom Lambert, who co-chairs the National Catholic Partnership on Disability’s Council on Mental Illness, said that one of the biggest challenges faced by people with mental illness is isolation.

Those who have a mental illness need a soft place to fall, a supportive community that understands their struggles, he said. Catholics with such conditions need to feel welcome at their parishes, many of which do not offer any resources.

“One in four people are affected by it, and one in 17 have a serious and persistent mental illness. So if you look in any congregation, that’s a lot of your congregation,” he said. “It’s the last thing in the closet because everything else seems to be out there.”

Deacon Lambert, who is neither a psychiatrist or a psychologist, stressed that having mental illness does not necessarily preclude parenthood. He has counseled a woman with schizophrenia and an anxiety disorder who wanted to have a baby with her husband. The woman now has a healthy child and continues to seek treatment for her illness. Lambert is not a psychiatrist.

“The issue for many, many people is just the fear of the unknown, and that’s where faith can be such an important part of their lives,” he said, adding that this woman’s trust in God has helped her through her challenges.

Register correspondent Christine M. Williams writes from Quincy, Massachusetts.