16 October 2015
Symphysiotomy is a childbirth operation that effectively unhinges the pelvis. Ireland was the only country in the world to do these childbirth operations in preference to Caesarean section. Religious ideology and medical ambition drove the surgery.
An estimated 1,500 women and girls, some as young as 14, had their pelvises severed, gratuitously, by senior doctors who believed in childbearing without limitation. Life long disability, chronic pain, mental suffering and family breakdown followed.
Last year, the United Nations Human Rights Committee found these operations were torture, cruel, inhuman or degrading treatment. Patient consent was never sought: women were operated upon wide awake and often screaming: those who resisted were physically restrained.
The State has failed to provide an effective remedy. There has been no independent inquiry, only two whitewash reports. The introduction into clinical practice of symphysiotomy in 1944 at the National Maternity Hospital was a mass medical experiment that sharpened the need for patient consent, yet the Walsh report justified these non-consensual operations, saying patient consent was not legally required. There has been no restitution, only an ex gratia scheme––set out in the Murphy report––based on the official falsehood, which persists to this day, that these operations were medically acceptable.
The silencing of women’s voices has been essential to the State project, which, for the past 16 years, has been to deny wrongdoing. It was historian J Morrissey who first exposed the practice in 1999 in the I Times, during the course of a PhD on the relationship between the Catholic Church and the medical profession in Ireland in relation to reproductive health. The State responded 2 years later by asking the IOG, a training body, to examine a surgical practice carried out by its members – partly for training purposes. Wrongly, the IOG presented symphysiotomy as the norm for difficult births until it was replaced by CS in the 1950s. A State ‘information’ leaflet later revised this time frame, extending the pre-Caesarean era in Ireland from the 1950s to the 1980s!
Women had been operated upon without their knowledge: that knowledge came belatedly, 4 or 5 decades later, through the media. Survivors organised in 2002, but SoS’s demand for an inquiry into symphysiotomy was rejected by a FF administration. An ‘external review’, led by a Swedish symphysiotomy advocate, was promised. Kenneth Bjorklund had authored a review of the medical literature on symphysiotomy spanning the 20th c. This review was based on the exclusion of women’s voices: obstetrics has always excluded women from what is known about childbirth.
The surgery had been exported to Africa and India by Irish trained doctors, particularly medical missionaries, from the 1950s. The view of the surgery as safe for women, embedded in all IOG statements to date, comes from Africa, where symphysiotomy has been described as an operation done by white doctors on black women. As the High Court recently heard, however, there was no follow up of these African patients; doctors had no idea of the long term side effects of their handiwork. Bjorklund unwittingly revealed the paucity of the research into symphysiotomy’s side effects: just 129 women were followed up, long term, over a period of 100 years.
SoS’s resisted Bjorklund’s appointment, so the State, in its determination to conceal, then put forward another symphysiotomy devotee to conduct the review in Ireland, a practitioner from Papua New Guinea.
Defective as the tropical literature was on symphysiotomy, it formed the centre piece of what the IOG planned in 2010, when it was asked to do a second self examination following a PT exposé of the childbirth surgery. The IOG exercise was to centre on a literature review: the plan was for symphysiotomy in Ireland to be examined through the lens of Africa. Part of the exercise was to meet and greet survivors, to ‘tell their stories’ in batches, but the IOG refused to systematically study women’s experiences or quantify their injuries. Again, resistance to the IOG plan led to its abandonment.
Women’s voices were again silenced in yet another State initiative, the Walsh report.
Women’s voices have once again been silenced by The Government’s Payment Scheme. This is a scheme that, contrary to what UNHRC prescribed, offers no right of appeal nor any protection of women’s legal rights. On the contrary, the scheme forces women to indemnify their abusers as the price of restitution, a mere €50,000 in most cases to date. The sole Assessor, a former High Court judge, who has been given unfettered powers, has decided to eschew High Court norms by refusing to consider survivor testimony or to accept the reports of independent medical experts. Its scheme is now poised to exclude as many women as possible either from any restitution at all or from anything more than the minimum payment. This, combined with the scheme’s draconian waiver aimed at stripping women of their right to a judicial remedy – a right prescribed by the UN Human Rights Committee and highlighted by the Irish Council for Civil Liberties – has serious human right implications.
The scheme appears to have adopted a highly adversarial attitude towards survivors, based on a view that the State is at risk of false claims. The recently announced threat to impose time limits for the furnishing of hospital records comes, although such records have been systematically withheld from some of our members for a decade or more, is worrying.
Moreover, applicants without records are required to undergo MRIs for proof of surgery: MRIs of the pelvis have never yielded such proof, so these ‘tests’ will invariably disqualify those obliged to undergo for them. Meanwhile, those with with proof of surgery are set to receive no more than €50,000 in the vast majority of cases. All the indications are that a paper trail (going back over over 60 years in some cases) will be required to establish proof of ‘significant disability’, despite the fact that, in very many cases, such records do not exist. The scheme assumes, wrongly, that women received specialist treatment for complaints such as chronic pain, walking difficulties incontinence or depression; that general practitioners kept records, especially in the 1950s, 60s and 70s; and that such historic records are accessible today.
Only the courts stand against this edifice of untruth. Now over 10 years since SoS embarked on litigation. It has now become clear that the State is fighting symphysiotomy survivors tooth and nail in the courts, while its payment scheme, touted as ‘saving’ women from the stress of litigation, has turned out to be similarly adversarial in character. The State Claims Agency is using its vast resources to fight litigants in their 70s and 80s, damaged in hospitals and maternity homes under State oversight, while the Government’s payment scheme is making it as difficult as possible for applicants, including those seeking more than the minimum payment of 50k. .
Two symphysiotomy actions widely seen as test cases have been heard this year. The first settled after just four days at hearing: the settlement cheque was issued, not by the defendant hospital (the Coombe), but by the State Claims Agency. The second trial ran from for 15 days – a daunting prospect for any victim. Again, the role of the State Claims Agency emerged in direct evidence, and it was clear that the lawyers had been instructed to fight a 74-year-old plaintiff to the bitter end. This, the fourth symphysiotomy case before the courts, involved the involuntary incision of the woman’s pelvis thirteen days before the birth of her baby in 1963. The defence was conducted in a manner so adversarial as to be without precedent in these cases.
Public policy reasons were cited in the second trial as a reason for fighting such a case: the States’ view clearly is such actions should not be brought at all. The defence underlined that it had been open to the plaintiff to enter the Government’s payment scheme. The underlying message here was that, should a symphysiotomy survivor have the temerity to litigate (even against a private hospital such as the Coombe), she could expect the unlimited resources of the State to be martialled against her.
The Government’s strategy can only be seen as a pincer movement against survivors: This is a scheme that, contrary to what UNHRC prescribed, offers no right of appeal nor any protection of women’s legal rights. On the contrary, the scheme forces women to indemnify their abusers as the price of restitution, a mere €50,000 in most cases to date. The sole Assessor, a former High Court judge, who has been given unfettered powers, has decided to eschew High Court norms by refusing to consider survivor testimony or to accept the reports of independent medical experts. its scheme is now poised to exclude as many women as possible either from any restitution at all or from anything more than the minimum payment. This, combined with the scheme’s draconian waiver aimed at stripping women of their right to a judicial remedy – a right prescribed by the UN Human Rights Committee and highlighted by the Irish Council for Civil Liberties – has serious human right implications.
Support Survivors Of Symphysiotomy-Ireland.
Help survivors tell the truth about these operations.