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Dáil Éireann debate -
Tuesday, 27 May 2003

Vol. 567 No. 5

Hospital Practices.

I welcome the opportunity to raise this matter with the Minister because it is of deep concern to many of my constituents and to me personally. I request that the Minster meet with the victims of symphysiotomy so that he can hear at first hand, as I did, the barbarity and brutality that was inflicted upon these women. These women deserve, in the same way as the victims of the hepatitis C infections and the haemophiliacs infected with AIDS, a Government inquiry into the carrying out of this brutal practice. Those who carried out these procedures must be held accountable. I ask the Minister to meet with the survivors of this brutal practice.

I am concerned that the Minister for Health and Children and the medical profession have failed to provide answers regarding the use of symphysiotomies in obstetrical practice and the disturbingly high number of cases which were carried out in Our Lady of Lourdes Hospital in Drogheda. At least 349 symphysiotomies were carried out in County Louth. The last recorded case was at the hospital in 1983. I noted from previous answers to parliamentary questions that the practice was supposed to end in 1962, which is clearly not the case.

These women were neither informed about the procedure nor asked for their consent to have this brutal practice carried out on them. The hallmarks of the direction of the Catholic Church are apparent here. It was feared that women who had repeated sections would go on the pill or be sterilised. This cries out for an immediate and in-depth inquiry.

Women who underwent this procedure have suffered terrible pain, back pain, incontinence and depression and other ensuing problems such as marital breakdown. In one case it was only after 33 years that the victim concerned found out that this procedure was carried out following an emergency section and the birth of her baby. At the time the symphysiotomy was carried out she was just 18 years of age. There was no justification for the carrying out of this procedure and the woman concerned has never received an explanation. There are many questions which must be answered regarding what went on in our at Our Lady of Lourdes Hospital in Drogheda. At the time it was run by the Medical Missionaries of Mary from whom the North-Eastern Health Board took over the hospital in 1995.

The Minister must not turn a deaf ear to the suffering of the survivors of symphysiotomy. They are seeking relatively little at this time. Their most urgent call is for a medical remedy for the serious effects of this dreadful and barbaric so-called procedure that was carried out on them. They are also seeking an independent inquiry, similar to that established for haemophiliacs and those with hepatitis C. I hope these people will not have to take to the streets to demand what it is only fair and just for them to receive since this treatment was administered to them, effectively, by an organ of the State.

They are also asking for counselling services to be put in place. At the moment these women have been left to counsel each other without the requisite skills. By sharing their experiences, however, they have tried to offer some solutions to lessen the difficulties they have encountered. In addition, they have sought a telephone helpline because many victims of this procedure have never come forward due to embarrassment and ignorance.

In many cases they did not understand what this procedure involved. For the record I will outline the basic details. It involved sawing through the pelvic bone to assist an obstructed labour and permanently widen the birth canal for future births, as Caesarean sections were considered unsafe at the time. Many of the women to whom I have spoken, however, actually had the procedure carried out after giving birth. Many of them had no major difficulties in their pregnancies, yet this procedure was carried out.

An Leas-Cheann Comhairle

The Deputy should conclude.

I will conclude, a Leas-Cheann Comhairle, and I thank you for the opportunity of raising this matter. I ask the Minister of State to recognise the atrocious way in which these women were treated.

On behalf of my colleague, the Minister for Health and Children, Deputy Martin, I welcome the opportunity to clarify the position in relation to the issues raised by the Deputy.

In April 2001, arising from concerns about the use of symphysiotomy in obstetrical practice in the past, the chief medical officer at the Department of Health and Children 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.

In May 2001, the institute replied to the chief medical officer and confirmed that from about 1920 to about 1960 symphysiotomy procedures were carried out on selected patients in Dublin, mainly at the National Maternity Hospital and the Coombe Hospital. In the case of Our Lady of Lourdes Hospital, Drogheda, my Department was informed by the North-Eastern Health Board that 188 such procedures were performed at the hospital in the period 1955 to 1982, with 158 of these being performed prior to 1970.

The institute advised that favourable results were claimed for the procedure which had the effect, as Deputy Morgan outlined, 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, 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.

From 1950 onwards, the operation of symphysiotomy for obstructed labour was gradually replaced by the modern Caesarean section as antibiotics were available by then to treat infection and sepsis was less of a hazard.

The institute stated that "the operation of symphysiotomy remains an accepted indication for the management of a trapped after-coming head of a breech" but that Caesarean section is now recommended for all mature infants who present with a breech presentation.

We must be cautious about judging procedures and interventions which were used in previous generations in light of current knowledge and experience. Enormous medical advances have been made in obstetric practice since the 1950s and procedures were not as advanced then as they are in Ireland today. Under these circumstances, the Minister for Health and Children has no plans to establish an inquiry into the use of symphysiotomy in obstetrical practice.

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