Judge criticises ‘irresponsible rhetoric’ about symphysiotomy

Assessor of redress scheme makes 216 awards of €50,000 and 168 of €100,000

Judge Maureen Harding Clark said one woman wrote to say she would buy a “special hat”. Photograph: Bryan O’Brien

Judge Maureen Harding Clark said one woman wrote to say she would buy a “special hat”. Photograph: Bryan O’Brien

 

The assessor of the Government’s symphysiotomy redress scheme has said she hopes it will quell the hurt and anger of the elderly women affected and bring them closure.

Judge Maureen Harding Clark made 216 awards of €50,000, where a woman received a symphysiotomy, and 168 of €100,000, mostly where significant disability resulted from the procedure.

Fifteen women received the maximum award of €150,000 under the scheme, according to her report.

These were found to have suffered significant disability following an elective symphysiotomy carried out after childbirth, or to have received a pubiotomy.

The youngest claimant to receive an award is 51 years, and the oldest 96.

Sawing

Symphysiotomy, a procedure that involves cutting through the fibrous cartilage of the pubic joint, was carried out in Irish hospitals between 1944 and 1982. Pubiotomy, which was the subject of one award, involves sawing through the pubic bones.

Solicitors representing the women collectively received €2.1 million – with half of this going to one firm MacGeehin Toale.

The scheme also incurred administrative costs of €1.2 million.

Judge Harding Clark says no general pattern of injury is evident from the medical records she examined, saying: “The evidence did not confirm that symphysiotomy inevitably leads to lifelong pain or disability.”

“The majority made a good recovery and went on to have normal pregnancies and deliveries and to lead a full life.”

Most applicants had at least four normal deliveries after the symphysiotomy, she points out.

Although survivors have said they suffered from a wide range of ill-effects, the judge found “very few” cases of pelvic instability or hip degeneration and only five documented cases of incontinence.

No evidence

In many cases, she says, women saw the word episiotomy – a surgical cut of the tissue between the vagina and anus – on their records and equated it with symphysiotomy.

She suggests women may have “confabulated” prolonged and exhausting labour with symphysiotomy.

Detailed examination of contemporaneous medical records failed to find evidence of a religious – as opposed to an obstetric – reason when the operation was performed, she says.

The Ireland of the 1940s, she points out, was “a very different place to the modern, clean, prosperous and mainly secular European state it is today”.

Addressing a claim made to the UN last year that symphysiotomy was a “deliberate act of torture”, Judge Harding Clark says there is no evidence of any kind to suggest doctors intended to inflict pain.

And reviewing international studies, she says they contain no suggestion that symphysiotomy leads to “a lifetime of pain or disability”.

‘Irresponsible rhetoric’

Throughout her report, she is critical of “irresponsible rhetoric” and “negative commentary” by writers with no personal experience of the procedure.

She says she has received happy notes from women who received awards – telling her how they planned to spend the money.

One was going to buy a “special hat”, another said she had never had any money in her savings account, while another wrote a poem of appreciation.

The value of the scheme is in giving closure, she says. “It is hoped that the findings will quell the hurt and anger of the elderly women who have undergone the procedure and that this subject will now be laid to rest.”