Symphysiotomies became the routine surgical practice at the end of the 16th Century having been advocated by French surgeon Severin Pineau in 1597. Caesarean sections were still risky procedures for many reasons, including the techniques used at the time, the standards of clinical practices, and general hygiene. But, as the years progressed, the caesarean section became a safer and more viable option to symphysiotomy.
In 1881, German gynaecologist Ferdinand Adolf Kehrer introduced the transverse technique which minimised bleeding when performing a caesarean section and fellow German gynaecologist Max Saenger brought in uterine suturing in 1882. Another German gynaecologist, Hermann Johannes Pfannenstiel, altered the incision used in the procedure, which was then altered again in 1912. These medical breakthroughs, as well as the advances in the use of anaesthesia, blood transfusion, antibiotics, and the standards of asepsis, led to the caesarean section becoming the go-to choice for surgeons in the developed world.
Despite symphysiotomies being phased out across the developed world, Ireland’s surgeons continued to use the out-dated procedure. Ireland’s commitment to the application of symphysiotomies over caesarean sections has been put down to a number of factors, the most prominent of which is the influence of the Catholic church.
The Catholic church had a great aversion to caesarean sections, but it’s said that medical experimentation in the nation and a disregard for women’s autonomy also played a part in the continued application of symphysiotomies. With the help of Survivors of Symphysiotomy, the malpractice of surgeons has been exposed, but while many survivors have received money from the government, the scheme is seen as a whitewash by some, with many deciding to continue legal proceedings.
Unfortunately, the use of symphysiotomies – which have been found to result in many patients suffering from long-lasting afflictions – was spread to the continent of Africa and nation of India by Irish-trained doctors and surgeons in the 1950s. The procedure is still used in some of the rural parts of the developing world, where it would be unsuitable to apply a caesarean section either due to hygiene or a lack of clinical skill.
While symphysiotomies were replaced by caesarean sections throughout the 1900s, they lasted well beyond their expiry date in the developed nation of Ireland. They are still used in the developing world, to an extent, but surgeons are phasing them out to move towards the standards set in the developed world.