Madam, - Marie O'Connor (August 9th) presumes to tell us why Irish obstetricians carried out symphysiotomy operations from the 1950s to the 1980s. As one such obstetrician who carried out a very limited number of such procedures, I can assure her that her interpretation of my motives is completely incorrect.
After nearly 40 years of the free availability and adoption in this country of both contraception and sterilisation it may be difficult to recall the true situation faced by obstetricians in earlier times. Not only were such methods difficult to access, especially for the poorer sections of the population, but also the large majority of couples were unwilling to adopt them because of the rigid teaching of the Catholic Church, which they accepted.
Therefore if the obstetrician was faced with a young woman having her first baby he/she knew that it was highly likely that that woman was going to have a large number of further pregnancies.
If a caesarean section was carried out for her first delivery she would face the probability of having to have a large number of such operations, with the risks that this involved.
In contrast, symphysiotomy not only solved the problem for the current delivery but also for all future deliveries as well. This is why the operation of symphysiotomy was used in Ireland, whereas its use was not necessary in the UK and other countries. As far as I was concerned the risks of caesarean section were not, as Ms O'Connor claims, to the woman's morals but to her physical health.
If blame there be, it should be laid at the door of the Catholic Church which forbade its members from methods to adequately control their fertility and not on the doctors who, whatever their own faith, had to deal with the reality of the situation. It is unjust to judge people working in those prevailing conditions by modern standards, or even by those in other countries at that time. - Yours, etc.,
Dr CONOR CARR, Mount Pleasant Avenue, Ballinasloe, Co Galway.