Dáil Éireann debate -
Wednesday, 21 May 2003

Vol. 567 No. 2

Written Answers. - Maternity Services.

Fergus O'Dowd

Question:

212 Mr. O'Dowd asked the Minister for Health and Children if he will institute an inquiry into the maternity practices of Our Lady of Lourdes Hospital in relation to the high number of symphysiotomies carried out between 1950 and 1983, following the call for such an inquiry by the Louth-Meath health group; and if he will make a statement on the matter. [13950/03]

Minister for Health and Children (Mr. Martin)

Arising from concerns about the use of symphysiotomy in obstetrical practice in the past, the chief medical officer at my Department, in April, 2001 asked the Institute of Obstetricians and Gynaecologists for its comments and advice on the matter.

The institute represents obstetrical and gynaecological opinion in Ireland, acts as an advisory body on matters relating to education, research and administration in the speciality and seeks to raise standards in obstetrics and gynaecology in this country.

The institute replied in May 2001 to the CMO and confirmed that from around 1920 until around 1960 symphysiotomy procedures were carried out on selected patients, mainly at the National Maternity Hospital and the Coombe Hospital. Excellent results were claimed for this procedure which had the effect of permanently enlarging the pelvis and allowing women to undergo normal delivery. This was at a time when caesarean section had a high mortality rate due to sepsis. Sepsis was one of the leading causes of maternal death at that time. The institute stated that in properly conducted cases, complications were rare. Published medical reports of the time indicated favourable results for the procedure. Many of the cases referred to in these reports were emergency admissions with obstructed labour where sepsis following caesarean section would have carried a significant risk of maternal death.

The institute stated that from 1950 onwards, the operation of symphysiotomy for obstructed labour was replaced by the modern caesarean section. Antibiotics were available by then to treat infection and sepsis was less of a hazard.

We must be cautious about judging procedures and interventions which were used in previous generations in the light of current knowledge and experience. Enormous medical advances have been made since the 1950s and 1960s and medical care and procedures were not as advanced then as they are in Ireland today.

Under the circumstances, I have no plans to establish an inquiry into the use of symphysiotomy in obstetrical practice.