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Dáil to debate symphysiotomy tomorrow

The 18th century practice of unhinging women’s pelvises after childbirth has left many survivors with permanent damage.

Image: Barratts/S&G Barratts/EMPICS Archive

A DEBATE ON the practice of symphysiotomy is to be held in the Dáil for the first time tomorrow.

Deputies have been given an opportunity to make statements on the medical procedure following a suggestion from Sinn Féin health spokesperson Caoimhghín Ó Caoláin.

A number of women who survived the operation, during which their pelvises were unhinged, are to attend the debate. Many survivors have suffered permanent damage as a result of symphysiotomy.

Ó Caoláin described the practice which was carried out on hundreds of Irish women between the 1940s and 1980s as “barbaric”.

About 180 survivors who continue to campaign for justice and truth have called for a full and proper inquiry into why the procedures were carried out in Ireland, long after they were discontinued in other countries. The women also demand a redress scheme to include medical benefits.

Following Oireachtas meetings earlier this year, the survivors have garnered backing from TDs and Senators who have joined together in a cross-party support group.

Recent developments

In February, the Department of Health received a draft report from an academic researcher who was asked to review the practice in Ireland during the 1950s through to the 1980s.

The Attorney General is considering that report and will advise Health Minister James Reilly on whether it can be made available for consultation purposes.

Previously in the Dáil, Reilly said he was “very conscious” of the distress the procedure has caused to a number of women, adding that the Government is committed to dealing with the matter “sensitively”.

He promised to ensure the greatest possible supports and services are made available to women who continue to be negatively impacted because of the procedure.

Although Reilly admitted that the use of symphysiotomy “may well…have been utterly inappropriate”, he rejected the term “barbaric” in relation to the act.

“The method was used in the majority of cases as an emergency response to obstructed labour in women suffering from mild to moderate disproportion, and as such was an appropriate clinical intervention,” he said.

“It was a standard procedure at one time and it was reintroduced to certain Irish hospitals in the 1940s as a clinical response to the limitation imposed by specifically Catholic religious and ideological circumstances.

The primary reasons were the fact that contraception and sterilisation for the prevention of pregnancy was illegal, and the safety of repeat Caesarean sections in the period was unproven.

The widening of the pelvis by up to 3.5 cm allows for vaginal birth when labour is obstructed, reducing maternal and infant death when Caesarean was not the chosen path.

The Survivors of Symphysiotomy group claims that the operations were carried out – without prior knowledge or consent – “mainly for religious reasons, by obstetricians who were opposed to family planning”.

The surgery was exhumed at the National Maternity Hospital by doctors who were hostile to the idea of family planning and who were looking to replace Caesarean section with an operation that would facilitate large families.

Nine children was the ideal family size, in their eyes. Repeat Cesarean sections thwarted this goal, they say.

At the Coombe and National Maternity hospitals, it was used in 0.35 per cent of deliveries. It was used more often – and for longer – at Our Lady of Lourdes Hospital in Drogheda.

There were apparent instances of the procedure being carried out after a baby was delivered, a practice which Reilly called “utterly disgraceful”.

Consequent mobility issues, discomfort, upset, chronic pain and difficulty were caused as a result. The Institute of Obstetricians and Gynaecologists has recognised walking difficulties, pelvic joint pain and urinary incontinence as long-term problems.

Reilly also told the Dáil: “I know people who had that procedure and have sadly passed on. I am aware of the dysfunctionality it caused them in their daily lives.”

However, he said he could not pre-empt the AG’s advice or the final report.

The technique has not been used in Ireland since 1984 and no longer forms a part of specialist training for doctors. It is still, however, taught as an emergency procedure at the Royal College of Obstetricians and Gynaecologists in London.

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