While malpractice may have occurred before, the focus of the controversial symphysiotomy practices in Ireland was from the 1940s to the 1980s. Over these four decades, it is estimated that around 1500 women underwent the symphysiotomy surgical procedure without giving consent or by being given it unknowingly. Some cite an institutional disregard for women’s autonomy and it being a period of medical experimentation, but it has been found that the Catholic church insisted on the practice of symphysiotomy due to their disliking of caesarean sections.
It was in 1944 that Dublin’s National Maternity Hospital in Ireland adopted symphysiotomy as the standard operation in situations such as an obstructed labour, despite the caesarean section being a common method to alleviate such problems at the time. Dr Alex Spain and Arthur Barry ran the National Maternity Hospital through the mid-1900s, both of whom were advocates of symphysiotomy, and allowed their devout Catholic beliefs sway their opinion on the practice, rather than their medical expertise.
At the time, it was recommended that a woman wouldn’t undergo anymore than three caesarean sections due to the dangers involved, which would be avoided by sterilisation or contraception. Barry, who took over from Spain in 1948, was extremely opposed to contraception to the extent that he wouldn’t allow women to even be given advice on Catholic-approved contraception methods. This belief led to the misuse of the increasingly disbanded practice, including being used on pregnant women who were seen as having pelvises that were too small for their baby, often after receiving a caesarean section. Some of these women were then given a symphysiotomy with the intention being to allow for any later childbirth to be done vaginally – thus removing the need for contraception due to having too many caesarean sections.
Barry’s reign lasted until 1966, at which point the new master of the National Maternity Hospital set in motion a decline of the surgical practice of symphysiotomy, but former students of the hospital continued to practice it in other parts of the country. Symphysiotomy survived deep into the 1980s, continuing to be practised in Ireland and taught to students who would be required to perform surgeries without electricity in parts of Africa and India.
In 2002, Survivors of Symphysiotomy was established by mother and daughter Matilda Behan and Bernadette for the victims of the practice in Ireland. As the advocacy group gained momentum, the Irish Human Rights Commission took notice, and in 2008, they recommended that the Irish government set up an independent inquiry into the use of the surgical procedure, to which the Minister of Health refused to abide.
The year of 2012 marked the first great success for the movement seeking justice for survivors of the practice, with Olivia Kearney being awarded €325,000 in her court case against Dr Gerard Connolly – who performed a post-caesarean section symphysiotomy on her in 1969. The court ruled that in 1969, symphysiotomies were no longer approved practices.
Later that year, Professor Oonagh Walsh’s draft report concerning symphysiotomies in Ireland was released, ultimately stating that the practice was justifiable. Many opposed the report, including SOS, as it failed to address key issues like the consent – or lack thereof – of the patients. As the draft justified the operation, the second stage of the Walsh report way boycotted by members of the Survivors of Symphysiotomy. The group went on to publicly testify before the Joint Oireachtas Committee on Justice, and in 2013, the Statute of Limitations (Amendment) Bill was proposed to lift the statute of limitations to allow those afflicted by the long-term effects of symphysiotomies to bring their cases to court. The proposed legislation stalled, and so, SOS protested outside of parliament.
In 2013, the Minister of Health issued Judge Yvonne Murphy with the task of reviewing the Walsh report, and to decide if an ex gratia redress scheme would better suit the survivors, rather than permitting legal action. However, the Murphy inquiry was criticised for its outline being devoid of the prospect of survivors being able to take their case to court or gain adequate compensation. In 2014, Survivors of Symphysiotomy submitted a complaint to the United Nations Committee Against Torture concerning the Irish government’s failings in properly addressing the issue of the use of symphysiotomy in Ireland. Four months after the complaint, the Irish government was called to investigate the issue by the United Nations Committee on Human Rights.
In 2016, the Irish Government awarded 399 women payments of €150,000, €100,000, or €50,000 under a grant payment scheme. Judge Maureen Harding Clark was made the independent assessor of the compensation scheme which was approved by the government. In total, the government paid €34 million to work towards bringing about closure for the survivors. However, the compensation can only be given if the claimant discontinues their course of legal action. So, some members of Survivors of Symphysiotomy refused the compensation payments to push for their rights in court.
The spokesperson for SOS, Marie O’Connor, described the judge’s report on the payment scheme as being the third official whitewash report on symphysiotomy, with the scheme also favouring the younger afflicted women due to the difficulties in obtaining deceased doctors’ evidence. Of the 590 people who applied for the scheme, only 405 were able to establish an acceptable claim.