Tuesday, September 24, 2013

Symphysiotomy report makes grim reading

Until I stood for the Dáil in County Louth I had never heard of symphysiotomy. Several women victims of this barbaric practice came to see me to explain what had been done to them and to outline their long campaign for justice. For those of you who don’t know what it is or entails; symphysiotomy is a surgical procedure used in the arrest of descent during the second stage of labour in order to increase the diameter of a woman’s pelvis and allow for a vaginal birth. Initiated in France in the 18th century, this procedure involves severing the cartilage that connects the symphysis pubis with a scalpel under local anaesthesia, followed by unhinging of the pelvic bones to the extent needed for delivery

I was outraged by their personal stories of pain and abuse and moved by their courage and resilience. In the years since then the campaign has increased pressure on the government to address this issue in a way that is satisfactory to the remaining women survivors. As part of Sinn Féin’s efforts we have raised this issue in the Dáil and in the media but we also saw the value in raising this issue internationally.

As part of this I introduced some victims of symphysiotomy to Professor Irene Anne Jillson PhD. Irene has an international reputation in global health generally and in women’s health. She and four graduate nursing students voluntarily undertook a study of symphysiotomy, even paying their own travel and other expenses.
Today has seen the publication of their report by the prestigious School of Nursing and Health Studies at Georgetown University. Symphysiotomy in Ireland: A Qualitative Study’ makes grim reading. It is a detailed expose of the cruel and inhuman use of Symphysiotomy on women in Ireland.

The focus of the study was to explore ‘the factors that contributed to the use of Symphysiotomy’ in Ireland from 1944 to 1984 and to examine the impact it had on the women victims. Unusually the study also spoke to the husbands of women who had suffered Symphysiotomy and heard from them for the first time of the trauma of this practice on their wives and families.
The report also reveals that the procedure was often carried out without a women’s ‘understanding or consent. Most of the 1500 or more Irish women on whom symphysiotomies had been performed and who were alive in 1999, learned for the first time in that year, that the procedure had been performed on them, as a result of a newspaper article based on a doctoral thesis.’

Professor Jillson and two colleagues carried out exhaustive interviews with participants who in the main are between 60-80 years of age and live in Louth. The report records their experience and in their own words details their lack of consent to symphysiotomy and the lack of information available to them. Professor Jillson notes that ‘most women in the study reported that they had either never heard of the procedure or didn’t know what the procedure was at the time of their delivery … Doctors rarely gave an explanation of what they were doing before or during the procedure.’

And even after the procedure many women didn’t know what had been done to them.
The report pulls no punches in describing the pain that the women experienced. It reports that: ‘The physical distress following the symphysiotomy procedure was significant for nearly every woman interviewed. Women consistently reported chronic pain, fatigue, urinary tract infections, incontinence, difficulty walking, limited mobility, and pain during sexual intercourse. Many are confined to wheelchairs and/or have to walk with the assistance of a cane or walker. With regard to incontinence, one woman described continued problems with incontinence, which is both embarrassing and inconvenient. In describing her lack of bowel control, one woman shared, “I had no muscular control…It felt like a herd of elephants had walked all over me body.”

Pain pervaded the daily lives of many of the participants, altering the amount they could work and the amount of energy they had to carry out activities of daily living. Back pain was a persistent problem that limited the mobility of many of the women, and continues to do so.’

When asked what they now wanted most women said they wanted an explanation, transparency and an apology from those involved.

The experience of victims of symphysiotomy is expressed tellingly by one respondent who describes symphysiotomy as evil. She said: ‘One word: evil. Pure evil. It’s like a witch doctor participated in the abuse of women’s bodies. That’s what I feel.’ Another described it as ‘a curse one would not wish on my worst enemy.’

Recently the Minister for Health James Reilly refused to publish the second part of the report into symphysiotomy by Professor Oonagh Walsh. The Minister said he didn’t want to publish it until after the government has reached its decision on this issue.

This isn’t good enough. The victims, their families and supporters have a right to see all of the available information about the use of symphysiotomy and its effect on the women and their husbands and families.  

There are only around 200 survivors alive. They are all very elderly and carry deep physical and emotional scars from their experience. Some are quite frail. They simply cannot afford to wait months or longer for justice. Time is therefore of the essence.

The Ministers claim that it is ‘open to any woman not wishing to pursue mediation to bring a claim through the courts’ ignores the fact that many of the women cannot do this because of the Statue of Limitations.

In April the Government supported the Statute of Limitations (Amendment) Bill 2013, introduced by Caoimhghín O Caoláin TD, which seeks to accommodate access to the courts for all victims of symphysiotomy who would choose that course of action. However the government is preventing further progress on this.

The process of securing justice for these women victims is very important. The government is adding to the stress on victims and is ignoring the Dáil, by refusing to publish the Walsh report.

The victims of symphysiotomy must have the right to decide which course of action is best for them in their efforts to secure justice and compensation. To do that the government must publish the Walsh report; the terms of reference for the Judge and mediation process; a fixed and short timeframe for this process to take place and assist the passage of the Statute of Limitations (Amendment) Bill 2013.

The report by Professor Jillson is a welcome addition to the body of medical evidence and information now available.





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