Symphysiotomy - What Should Be Done ?

[C. Flower]

There's been discussion here on symphysiotomy on a number of different threads.

Symphysiotomy is a surgical procedure to enlarge the pelvis and allow vaginal birth in women with mild to moderate obstruction (disproportion), where because of the mother’s pelvic and/or baby size there is difficulty with the birth. Once performed it was believed that the pelvis was permanently enlarged and that future births would be facilitated.
At that time Irish families were larger and Caesarean section, particularly a repeat of the procedure, for any obstetric reason, was a risky procedure with potentially grave consequences. Inadequate diet and chronic disease meant that mothers were at high risk for contracted pelvis and also at risk of complications from the general anaesthesia required for Caesarean section at that time. Symphysiotomy appeared to offer a method of safe birth in some cases of obstructed labour in mothers with contracted pelvis.
Due to moral beliefs, contraception was ethically unacceptable and illegal, as embodied in the Censorship of Publications Act of 1929 and the Criminal Law Amendment Act of 1935. Any doctor offering contraceptive advice was liable to prosecution. The Family Planning Act was finally introduced in 1979, allowing contraception on prescription to married couples.

(Institute of Obstetricians)

The publication of Oonagh Walsh's report has caused further controversy.

How the report was commissioned by Dr. James Reilly -

http://www.imn.ie/news/3875-symphysi...be-carried-out

Institute of Obstetricians views, expressed on commissioning of the report -

http://www.rcpi.ie/News/Pages/Symphysiotomy.aspx

http://www.rcpi.ie/News/Pages/Statem...hysiotomy.aspx

The Institute of Obstetricians has produced an "apology" that states justifies the exceptionally high levels of symphysiotomy that prevailed in Ireland, in a way that begs the question of why it is not used now.

http://www.rcpi.ie/News/Pages/WalshR...inIreland.aspx

The report does not appear to be made available online.

It would seem to be straight forward enough that women who were operated on without consent should be compensated, as soon as feasible, for the distress and injury they experienced.

The findings of Dr. Oonagh Walsh's report are summarised by the I o O -

Overall findings
Symphysiotomy was re-introduced to some Irish hospitals in the 1940s in response to the prevailing legislative and religious environment.
In most instances the procedure was used for cases of mild to moderate pelvic disproportion.
The procedure was safer than caesarean section but was not promoted as an alternative.
Symphysiotomy was a rare intervention, used in 0.035% of births.
It was used inappropriately ‘on the way out’ or ‘pre-labour’ in some cases.
Its continued use in Our Lady of Lourdes Hospital until 1984 was contrary to its decline in the rest of the country from the mid 1960s.

It seems that there have never been any research to compare the after effects of symphysiotomy with those of normal births.

[morticia]

From what I gather, this procedure was also used elsewhere until the 1950s and 60s. While I have huge sympathy for the victims and would support compo on compassionate grounds, there are good reasons why more than 3 pregnancies with c sections are a bad idea ( high risk of uterine rupture in subsequent births leading to haemorrhage which can easily be fatal to both mother and child).

It is easy for us today to ask why more than 3 kids would be necessary, and to regard religious attitudes to contraception as very backward. The problem was that even back in the 1970s, 4-5 kids was the norm and contraception was widely frowned on. And before we all blame the patriarchy, Irish women were often more conservative than the men.

The Drogheda hospital stood out as keeping going for too long, past the point at which evidence suggested that this was a bad idea.

But the fact remains that owing to the size of our brains, strongly selected for in evolutionary terms, the price paid has been unacceptable mortality rates for both mother and baby. Ourselves and one very artificially inbred sort of bulldog are the only species when the infant head fully fills the mother's pelvis.

Modern medicine has its detractors, but the natural childbirth nazis should remember that men used to outlive women, one in ten of whom used to die as a result of childbirth complications. And let's not even get started on the effects of oxygen deprivation on the newborn.

Ireland is now one of the safest places on Earth to give birth. Let it not be said that mistakes are not learnt from.

[C. Flower]

From what I gather, this procedure was also used elsewhere until the 1950s and 60s. While I have huge sympathy for the victims and would support compo on compassionate grounds, there are good reasons why more than 3 pregnancies with c sections are a bad idea ( high risk of uterine rupture in subsequent births leading to haemorrhage which can easily be fatal to both mother and child).

It is easy for us today to ask why more than 3 kids would be necessary, and to regard religious attitudes to contraception as very backward. The problem was that even back in the 1970s, 4-5 kids was the norm and contraception was widely frowned on. And before we all blame the patriarchy, Irish women were often more conservative than the men.

The Drogheda hospital stood out as keeping going for too long, past the point at which evidence suggested that this was a bad idea.

But the fact remains that owing to the size of our brains, strongly selected for in evolutionary terms, the price paid has been unacceptable mortality rates for both mother and baby. Ourselves and one very artificially inbred sort of bulldog are the only species when the infant head fully fills the mother's pelvis.

Modern medicine has its detractors, but the natural childbirth nazis should remember that men used to outlive women, one in ten of whom used to die as a result of childbirth complications. And let's not even get started on the effects of oxygen deprivation on the newborn.

Ireland is now one of the safest places on Earth to give birth. Let it not be said that mistakes are not learnt from.

Contraception was illegal until.....

Did any other country follow a similar path?

[morticia]

Contraception was illegal until.....

Did any other country follow a similar path?

Oh, I would totally agree that the contraception issue was farcical. But outside Dublin and other major cities, precious few pharmacies would stock condoms even in the 1990s. Haughey was accused of having a Fetherlite in one hand and a ballot box in the other in the early 1990s even.

We have to remember that when the bishops stood in pulpits telling people how to vote, until after bishop Casey, people listened.

[C. Flower]

Oh, I would totally agree that the contraception issue was farcical. But outside Dublin and other major cities, precious few pharmacies would stock condoms even in the 1990s. Haughey was accused of having a Fetherlite in one hand and a ballot box in the other in the early 1990s even.

We have to remember that when the bishops stood in pulpits telling people how to vote, until after bishop Casey, people listened.

Yes - RTE (Drive Time) interviewed someone from the Eucharistic Congress today who was talking about how they had "prayed for the conversion of the Russians."

[eamo]

Well I remember posting back condoms from Germany when I worked there late 70's. I was told that some parcels were opened by customs, and then resealed, contents intact, and let go on their way. As well as the regressive tendency there was also a progressive tendency even in Ireland of the 70's. It was just a matter of luck which "Ireland" you met. A different customers officer might have instigated a major investigation!! No kidding. It could have made the headlines in those days. Even in the late 80's when married I was told by a chemist in Clonskeagh that "we dont stock those things".
There is a generation now who find it hard to believe the bullshit that went on here not that long ago.

[eamo]

And no, they had not punctured the condoms with pins. despite the rumors.

[fluffybiscuits]

Well I remember posting back condoms from Germany when I worked there late 70's. I was told that some parcels were opened by customs, and then resealed, contents intact, and let go on their way. As well as the regressive tendency there was also a progressive tendency even in Ireland of the 70's. It was just a matter of luck which "Ireland" you met. A different customers officer might have instigated a major investigation!! No kidding. It could have made the headlines in those days. Even in the late 80's when married I was told by a chemist in Clonskeagh that "we dont stock those things".
There is a generation now who find it hard to believe the bullshit that went on here not that long ago.

We get them for free here in the health centre and gay drop in centre Amazing how times hvae changed...

[morticia]

In most places. However, I managed to find a pharmacy that wouldn't fill a prescription for the pill since 2007. Pockets of resistance, don't you know?

[Dr. FIVE]

‘You’ll have a great swing to your hips now Margaret’ – Nurse told victim of symphysiotomy as she left hospital

Margaret Conlon underwent the symphysiotomy in the 1960’s. She was a newly married, young woman living in Cork and looking forward to the birth of her much-anticipated first baby.

As her labour progressed, it was clear that minor complications were present but she was misguidedly put at ease when she saw her gynaecologist. He proceeded with the symphysiotomy operation, unbeknownst to Margaret, resulting in her chronic physical pain and irreversible trauma.

She recalls the "burning pain" after an attempt to render her unconscious with an unknown substance that left her semi-conscious and "feeling she was dying".

Her baby did not survive labour.

http://www.newstalk.ie/All-I-can-rem...otomy-survivor