Madam, – Symphysiotomy is an 18th-century childbirth operation that effectively unhinges the pelvis by severing the pubic bones. The surgery was revived here in the mid-1940s for religious reasons and carried out, reportedly, without consent. More than 100 casualties survive today.
The Minister for Health has declined to accede to calls for an inquiry, most recently from the Joint Oireachtas Committee on Health.
Her refusal rests on advice supplied by the Institute of Obstetricians and Gynaecologists. Wrongly, the institute has led successive Ministers to believe that symphysiotomy was done out of medical necessity, that the surgery was a norm for obstructed labour until 1960, that results were “excellent” and complications “rare”.
Symphysiotomy was never a norm, however. Ireland is the only country in the developed world where symphysiotomy was widely practised during the 20th century.
More than 1,000 of these operations were performed here from 1944 to 1984.
The surgery left babies dead or damaged and mothers with genital and pelvic injuries, persistent wounds and other infections; and sexual, marital and family difficulties. Many report decades of depression, impaired mobility, incontinence and chronic pain.
Symphysiotomy was a blatant abuse of authority and of medicine, one that showed a callous and cavalier disregard for mothers and babies.
For the Minister to persist in refusing an independent inquiry into this mutilating operation is to make a mockery of patient safety and to deny these women justice.
Like other victims of institutional abuse, they, too, are entitled to truth, validation, redress and closure. – Yours, etc,
Madam, – A strikingly uncritical review (Weekend Review, February 20th) of RTÉ Prime Timeon symphysiotomy was nearly as shocking as the original programme.
The “simulation” in the programme came straight out of a low-budget gothic movie: evil masked male figure brandishing a scalpel dripping blood, and attended by subservient acolytes all of whom goggle pruriently at helpless women giving birth apparently without benefit of gas-and-air. Background voices which are mainly anonymous supply a commentary: “I was roaring with pain!” “It was a year before I could walk!” “It was sexual abuse!” And the punchline: “Someone should apologise to us all!” I was at first unable to connect this performance with Prime Time’s mention of the National Maternity Hospital in Dublin, where I spent a period as a pupil midwife in the late 1950s.
Symphysiotomy was indeed carried out there then, as a safer alternative to Caesarean section. Given the circumstances, Caesarean section was not always an option.
Irish midwifery was changing over rapidly from a domiciliary system in which most babies were delivered by district midwives in the family home, to a system which was to be entirely hospital-based, on the American model.
Our poorer patients usually came in without any preparation for childbirth, as ignorant of their own anatomy and physiology as of their rights, and terrified of hospitals, as places where people usually only went to die. If you had to go in, you got out again as quickly as you could, and never mind that English-trained nurse telling you that doing post-natal exercises would prevent bladder problems! Even worse, she wanted you to breast-feed the baby! Doctors then were not trained as now they are to communicate with patients, and this sometimes led to misunderstanding on both sides.
Case histories were often minimal – I am describing a very poor urban population missing out on the whole welfare and education scene, and light-years away from the year 2000. We did the best we could with what we had.
Of course it would be better to find out the truth. To evaluate symphysiotomy as an intervention professionally would probably not cost as much as the subsidy to a hotel or a golf-course, and it would even give valuable training and employment.
It would be good to have a factual analysis of this important topic instead of viewing a rant exercise. But it will take a lot to persuade me that maternity hospitals of 60 years ago were staffed entirely by sadistic puppets deliberately plotting to oppress and mutilate women.
If someone would prefer to think so, then that someone should apologise to us all! – Yours, etc,