After several days of labor Jane* was “put to sleep.” When she awoke, her son was born but she was a “different person.” She was “doubly incontinent and in extreme pain.” Some days later she left the hospital “in a wheelchair.”
Though she was eventually able to walk again the pains down her legs never fully subsided and she developed bursitis on both sides of her body.
She also remained doubly incontinent, a source of constant anxiety and shame. She cries as she recounts the fear of “going too far from home” and the “awful realization of what you’ve done on the sheets.”
For decades she sought an answer to what had happened to her during labor. She says she was continually told to “get on with things” and that “it was all in the head.” Eventually she realized that her symptoms and experiences were similar to other Irish women who had symphysiotomies.
A symphysiotomy is a procedure which involves the cutting of the pelvic bone during difficult childbirths. The aim was to create more space within the pelvic area and facilitate a ‘natural’ delivery.
The technique was abandoned in most parts of the world during the twentieth century except in Ireland, where it was reintroduced by Dr. Alex Spain the Master of the National Maternity at Holles Street in 1942. Symphysiotomies took place in the the Lourdes Hospital in Drogheda until the 1980s.
The reasons for their continued use have never been formally established, but it is widely accepted that they seem to have been a mix of religious and cultural practices. The use of the caesarean section was considered incompatible with large families. At the time it was believed that a woman could have no more than three such procedures. Therefore a woman who might be prone to birthing difficulties would only be capable of having three children. This in Catholic Ireland was too small a family.
The hierarchical nature of the medical profession and Irish life itself may also have been relevant. None of the women who have spoken publicly about their experiences was asked to consent to it but, as Jane says, it wouldn’t have been the “done thing” to complain or challenge the senior male doctors who performed the procedure.
Symphysiotomies produced some horrifying results. In some cases the baby was brain damaged or died. For the women severe pain, incontinence and impaired walking were some of the most common effects. “We all recognize each other from the way we waddle” says Jane.
It has taken decades for this issue to achieve prominence. Historian Dr. Jacqueline Morrisey began to write about it in the late 1990s and a symphysiotomy survivor Olivia Kearney won a High Court case in 2012. On several occasions the UN Human Rights Committee has urged the Irish government to conduct an inquiry into the issue and prosecute those involved.
Earlier this year the Government announced the terms of a redress scheme. It was to be ex gratia, meaning there will be no admission of liability and the women were to be awarded either €50k, €100k, €150k depending on the severity of their injuries. They had until last week, December 5 to apply (or January 15 in exceptional cases)
The scheme has been sharply criticized by some. Last month the head of the Irish Human Rights and Equality Commission Emily Logan wrote to Minister for Justice Frances Fitzgerald to express concern about the waiver of legal rights under the scheme and the shortness of time that was being given to women to source independent advice.
Instead she called upon the government to establish “an independent investigation into symphysiotomy cases and to establish a process whereby perpetrators (including medical personnel) can be prosecuted and punished.’
The alternative for women is to pursue their cases through court, but this is a risky endeavor. Some of the cases are very old and records are incomplete. Such cases may be difficult to prove.
It is thought that there are about 400 Irish survivors of symphysiotomy alive today, though it may be that there are women around the world still who are unaware of the procedure and scheme. According to the Department of Health there were 360 applications for redress last Friday. But, some of these women are also involved in court cases and may yet withdraw.
Jane has decided not to enter the scheme and will go through the courts instead. She says she understands that she risks losing the money offered but finds the terms an “insult” after all she has “endured.” Some years ago she attempted suicide, she says this was partly a response to being “talked down to all these years.” She says she she has always been “made to feel like a liar.” She believes the pain she and her family have gone through is “worth something more significant and sincere.”
As of yesterday, Amnesty International has called upon the Irish government to repeal the legal waiver portion of the redress scheme and extend the deadline.
*Jane is not her real name.