Report shows figures for birth procedure

A CONTROVERSIAL childbirth operation continued at Our Lady of Lourdes hospital in Drogheda, Co Louth, almost 20 years after it…

A CONTROVERSIAL childbirth operation continued at Our Lady of Lourdes hospital in Drogheda, Co Louth, almost 20 years after it had been phased out of other hospitals across the State.

That is one of the findings of a draft report into the use of symphysiotomy, a procedure aimed at widening the pelvis during difficult childbirth.

The report by Prof Oonagh Walsh of UCC states that while symphysiotomies began to be phased out of most hospitals from the mid-1960s onwards, preliminary figures show Our Lady of Lourdes Hospital was alone in continuing the practice up until the early 1980s.

In total about 378 confirmed symphysiotomies were carried out at the hospital. The practice was at its peak in the Drogheda hospital during the late 1950s and early 1960s – when about 20 a year were carried out – and began to decline from the 1970s onwards.

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Symphysiotomy was still in use in the hospital in the early 1980s, although numbers were small with a total of 11 procedures recorded between 1980 and 1984.

The report suggests the reason for the continued practice was linked to the “unswervingly Catholic ethos” of the hospital at the time, as described in Ms Justice Maureen Harding Clark’s report into high rates of hysterectomy operations there. The hospital had an absolute ban on artificial contraception, even when it became both legal and broadly accepted in other hospitals.

Ms Justice Harding Clark’s report found a unique situation at the hospital in which consultants – such as founding obstetrician Gerard Connolly – were obeyed by the nursing and management staff without question.

Making reference to this, Prof Walsh’s report states: “Connolly cast a long shadow over obstetric practice at Our Lady’s. The persistence of symphysiotomy at the hospital 20 years after it had largely ceased elsewhere in Ireland appears to be specifically linked with Connolly’s tenure.”

Her report says the fact that symphysiotomies persisted for so long was unacceptable.

The report states that, overall, symphysiotomy was not used very often in Irish hospitals.

Between 1950 and 1955, when the practice was close to its peak, it was used on average in one in every 200 deliveries (or 0.5 per cent of births) in the Coombe and National Maternity Hospitals in Dublin.

Between 1960 and 1965, it was used in one in every 100 deliveries (1 per cent) at Our Lady of Lourdes. Figures for the scale of the practice in Drogheda for most of the 1950s are not available.

Preliminary figures show that Our Lady of Lourdes had the highest number of symphysiotomies (378), followed by the National Maternity Hospital, Dublin (281), the Coombe hospital, Dublin (242), Cork University Maternity Hospital (51) and the Rotunda, Dublin (24).

‘excruciating pain’ legacy of procedure

MOST DAYS are a struggle for Matilda Behan.

From the minute she gets up in the morning to when she goes to bed at night, there are reminders of an operation which she says has left her with a legacy of chronic health problems.

“I take a lot of painkillers and anti-inflammatories every day,” says Behan (81) from Ringsend in Dublin. “That chronic pain never went away. I’m also totally incontinent. It’s been very limiting. It’s affected all my family.

“I’m feeling very sorry they all have had to suffer as a result: my husband and my children. If anything, it gets even more difficult the older you get.”

The legacy of health problems began, she says, after being admitted to hospital in Dublin in April 1958.

Two of her children had died during childbirth and she had been told she would need a Caesarean section for any future births. “I just remember being brought into a theatre and the place was packed with people. I wasn’t told what was happening. I was given a local anaesthetic. Then, two nurses put my hands behind my head, and two doctors pulled my legs apart.

“I’ll never forget the pain I went through. I was screaming and being restrained. I couldn’t see much except for them sawing. It was excruciating pain.”

It was only decades later she realised that she had had a symphysiotomy. “I was never told anything, never asked for my consent,” she says.

The State has responded to some of her needs in recent years. After the issue came to light in 2001, medical cards, counselling and other services were provided.

"That was a start, but it's not enough. Some redress would help many women who have had to live a life of pain." – Carl O'Brien

Carl O'Brien

Carl O'Brien

Carl O'Brien is Education Editor of The Irish Times. He was previously chief reporter and social affairs correspondent