THE DRAFT report by Prof Oonagh Walsh of UCC into the practice of performing symphysiotomies on pregnant women in the State provides an evidence base for the horrific obstetric practice. It complements the shocking descriptions by the women themselves over the past few years; narratives that are nauseating in their description of the operation and the miserable lifelong symptoms experienced by victims.
Up to 1,500 women here underwent symphysiotomy, an operation to widen the pelvis during childbirth, between 1944 and 1984. While represented by some as a necessary emergency procedure, the operation was also carried out electively in questionable circumstances such as immediately after Caesarean section.
Although widely discredited throughout the world, symphysiotomy was resurrected in the Republic in the 1940s in opaque circumstances. It was championed by individual obstetricians and certain institutions, reportedly because of safety concerns about repeated Caesarean sections and the ban on contraception and sterilisation. However, the Walsh report states, some symphysiotomies were wrongly used. Reservations about the procedure’s use are reflected in the fact that even when its use was at its height in the mid-1950s, it remained a rare event relative to overall deliveries, and was never utilised in all maternity hospitals.
Most of the operations were carried out at Our Lady of Lourdes Hospital in Drogheda (348), the National Maternity Hospital (281) and the Coombe in Dublin (242). Indeed the Drogheda unit, referred to elsewhere as a hospital with “an unswerving Catholic ethos” uniquely continued to perform the procedure until 1984, long after the safety of Caesarean section was established.
The Institute of Obstetricians and Gynaecologists has expressed concern about revisionism in the context of health procedures, technology and medicines of the time. However, even allowing for the rose-tinted lens of retrospection, it is impossible to justify the barbaric practice of sawing through a woman’s pubic bone while she was conscious, held down by nursing staff. To knowingly render a woman incontinent and unable to walk with the procedure is morally and ethically indefensible.
The Department of Health says the Walsh report is the first in a two-part process and that the views of women and interested parties will be considered over the coming months. The process must end with a firm set of proposals offering a full formal apology and practical aid to surviving victims of symphysiotomy.