There's been discussion here on symphysiotomy on a number of different threads.
(Institute of Obstetricians)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.
The publication of Oonagh Walsh's report has caused further controversy.
How the report was commissioned by Dr. James Reilly -
Institute of Obstetricians views, expressed on commissioning of the report -
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.
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 -
It seems that there have never been any research to compare the after effects of symphysiotomy with those of normal births.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.