16th May 2012
I welcome the Minister of State to the House. I also thank my Labour Party colleagues for providing the opportunity to Members of Seanad Éireann to make statements on the scandalous medical malpractice of symphysiotomy, which was performed in Ireland at least 1,500 times between 1944 and 1992. I also extend the warmest of welcomes to the survivors of symphysiotomy who are present today in the Visitors Gallery and elsewhere in Leinster House. I commend the dignity, bravery and honesty they have shown in sharing their personal traumas with Members during a number of Oireachtas briefing and information sessions. I thank them for opening Members’ eyes to the at best utterly inappropriate and at worst barbaric treatment they suffered at the hands of trained medical professionals in Irish hospitals.
I followed the statements on symphysiotomy in the Dáil last March with great interest and I agree with the comment by the Minister, Deputy Reilly, which was echoed today by the Minister of State, that we should be proud that Ireland is recognised internationally as a leader in the field of obstetrics. We also should be proud that with only one maternal death per 100,000 live births, Ireland has one of the lowest maternal mortality ratios in the world. However, as is evident from the statements being made today, Ireland has a far from unblemished record in the area of maternal health care. Between 1920 and as recently as 1992, many women suffered serious maternal morbidities under the care of trained medical practitioners in Irish hospitals. Maternal morbidity is defined as an illness or disability in women caused directly or indirectly by factors relating to pregnancy, childbirth or the post delivery period. The vast majority of maternal morbidities are preventable and as such, their prevalence constitutes a serious violation of women’s fundamental rights to life, liberty and security, as well as to health, dignity and freedom from cruel, inhuman and degrading treatment.
In common with many others, I am extremely frustrated by the delay in the publication of the report into the practice of symphysiotomy in Ireland. Extremely serious concerns must be addressed for the survivors to receive the acknowledgement, truth and justice they deserve. Chief among them is the contention by the Institute of Obstetricians and Gynaecologists in Ireland, upon which it appears the Department of Health is content to rely, that the practice of symphysiotomy was carried out due to medical necessity and only until consensus regarding caesarean section changed and it was deemed safe. It is my hope that in carrying out a critical appraisal of international reviews of symphysiotomy practice and associated rates in comparable countries in the world, as well as an examination of the Irish experience relative to other countries, this report will refute this contention once and for all.
The Minister, Deputy Reilly, himself acknowledged last March that symphysiotomy continued to be used in Ireland for some time after it had been all but discontinued in other developed countries and continued to be used for a longer period in particular hospitals, most notably in Our Lady of Lourdes Hospital, Drogheda. Rather than a procedure arising out of medical necessity, the evidence suggests symphysiotomy was the preference of some senior doctors in keeping with their conservative Catholic belief systems, whereby caesarean section had a safe birth limit of up to four children, while symphysiotomy would allow women have an unlimited number of children despite the horrendous cost to their health and well-being.
While the last thing anyone wants is another institutional abuse scandal, if there is one, and I believe there is, it must be met head on. The culture of secrecy, collusion and cover-up that surrounded institutional and clerical child sex abuse cannot be allowed to flourish again now as, otherwise, what has been learned? I cannot help but discern a parallel between the recent calls for Cardinal Brady’s resignation and this issue. Something that was not illegal at a particular time or indeed which was accepted practice within an institution or discipline but which in hindsight is found to be utterly inappropriate and morally wrong, cannot and should not be immune to a contemporary and robust response.
I was disappointed by the limited terms used by the Minister, Deputy Reilly, during the Dáil statements in March in referring to the experience of the survivors. He spoke of pain and distress but it is clear to me, having listened to the women’s personal testimonies, that such descriptions are totally inadequate in the face of the devastating impact symphysiotomy had on their lives and those of their families. In addition to the horrendous physical injuries they suffered as a direct result of the procedure, which sustained and worsened in the absence of appropriate aftercare, the serious emotional and psychological suffering they endure must be acknowledged. The birth of a child — for many of the women affected this was the birth of their first child — should be the most joyful time in a woman’s life. Instead, for the survivors, of whom there are currently a little over 150, the birth of their child was the beginning of a nightmare. This was a nightmare as a result of a medical procedure to which they did not consent, of which they were not informed of after they had it, in respect of which they did not receive medical treatment and aftercare, and the evidence of which suggests was not medically necessary. Shockingly, there are women who, despite having presented to doctors for treatment for various medical ailments over the years, only realised following the RTE “Prime Time” investigation into symphysiotomy in February 2010 that they were survivors. These women still present as survivors in 2011. Sadly, as time passes survivors are dying. We know that at least four survivors have passed away since the Walsh report was commissioned.
The women are the primary victims here. We have heard testimonies from women who could not lift or attend to the needs of their newborn babies due to the pain they were in and of the helplessness, guilt and shame they felt as a result. We heard from those who could no longer play beloved sports, to those who could no longer walk, of how their quality of life was irrevocably altered. We also know that there are secondary victims. They, too, must be acknowledged. One in ten babies died during symphysiotomy births. Children lost the love and nurture of mothers so traumatised by their experiences that they could not bond with their baby and subsequent babies. Likewise, husbands suffered as a result of the effects on their wives.
I note the Minister of State’s comments today and those of the Minister, Deputy Reilly, in March in relation to the provision of medical care to the survivors, which I welcome. However, having also heard from the women, I am concerned that they are having difficulty accessing services. I am particularly concerned about the difficulty some are facing accessing their medical records. Some women have been told there records no longer exist and others have simply been denied access to them. I presume this is the same “unforeseen difficulty” which the Minister of State, Deputy Lynch, mentioned Dr Walsh was experiencing in explaining the delay in the submission of her report? I accept that records get lost over the passage of time, in isolated instances but when it seems to be systemic my antenna goes up.
I heard from one woman that her doctor had requested a hospital in Dublin to carry out an X-ray to establish whether symphysiotomy had been performed on her. To establish or indeed rule out symphysiotomy the doctor had referred the woman to the hospital for a stand-up X-ray, specifically. The hospital refused to carry out the X-ray in this manner. The Minister of State, Deputy Lynch, spoke about addressing the legacy of the past. What I have just outlined happened last week, not in the past, which makes me question whether the system is trying to protect itself.
Will the Minister of State send out a clear message today that it is totally and utterly unacceptable for the medical profession to frustrate in any way the right of these women to redress and remedy?
I would like to put on the record my full support for the setting aside of the statute bar to allow these women seek judicial redress. There is solid precedent in terms of this having been done in respect of clerical sex abuse.