The Journal
14/03/12
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.
15/03/12
A NUMBER OF women from the Survivors of Symphysiotomy (SOS) group
were in Leinster House today for a Dáil debate on the procedure that
left many of them with life-long chronic pain and a host of other
medical problems.
The group is seeking to have the statute bar lifted so they can seek
redress through the courts for the permanent damage they suffered as a
result of symphysiotomy, during which their pelvises were unhinged.
They also want a public, independent inquiry to be established to
examine why the procedure was still used in Ireland, long after it was
discontinued in other European countries.
During the operation, a woman’s pelvis is widened by up to 3.5 cm to
allow for vaginal birth when labour is obstructed. It was an
intervention used in the 18th and 19th centuries to reduce maternal and
infant death when Caesarean section was not the chosen path.
The Survivors of Symphysiotomy group, however, claims that many of
the operations in Ireland after 1940 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,” they say.
The support group has also called for full access to promised health benefits and entitlements to be enshrined in law.
The Minister for Health James Reilly has received a draft report from
an independent researcher who examined the practice – how often it was
used, why it was used and when practices were changed. On submitting her
report in January 2012, she told the Department of difficulties she
experienced accessing historical data. Reilly has now asked the Attorney
General whether he can make that report available for consultation
purposes.
In the Dáil today, the Minister outlined that the medical procedure
was primarily used before the advent of safe Caesarean sections.
He admitted that the practice was used for some time after it was
discontinued in other developed countries, most notably in Our Lady of
Lourdes Hospital in Drogheda.
It has been suggested that some 1,500 symphysiotomies took place
between 1944 and 1992. At the Coombe and National Maternity hospitals,
it was used in 0.35 per cent of deliveries.
Reilly said he was “conscious of the distress…and pain” that
symphysiotomy has caused, adding that the Government was committed to
dealing with the matter “sensitively”.
" My first priority is to make sure that the health needs of those who
have had a symphysiotomy are met quickly and effectively. With this in
mind, I am committed to ensuring that the greatest possible supports and
services are made available to women who continue to suffer effects of
having undergone this procedure."
A cross-party Oireachtas committee has been established to highlight
the plight of the women who underwent the procedure between 1940 and
1984. They heard from the victims last night and Fianna Fáil TD Billy
Kelleher said the “sad stories” were “emotive, disturbing and
upsetting”.
“Many of the survivors have been left permanently disabled,
incontinent and in constant pain. I find it astonishing that no person
or agency has ever been held accountable for these cruel and unnecessary
operations,” said Senator Mary Moran ahead of today’s debate.
Carlow Kilkenny representative Ann Phelan pleaded for full access to
the legal system for victims of symphysiotomy. She said that because the
Statute of Limitations has run out, they cannot seek redress in the
courts.
This could – and should – be amended, added the Labour TD, who also
called for the HSE to help survivors gain access to their medical
records, something some have not yet been able to do.
She met with victims last week and said the “awful practice” was made
worse because consent was not given in many cases. ”Nor was the full
extent of the operation and its aftermath fully explained to the women
who underwent the operation.”
Her party colleague Anne Ferris echoed the sentiments, stating the practice has had a “devastating legacy” for many women.
“Groups like SOS are fundamentally important in bringing to light the
dark side of an Irish society that liked to hide in shadows,” she said.
ingevoegd 14-6-2012
