Court of Appeal to rule on alleged unjustified symphysiotomy

Judgment due on October 14th will have implications for number of similar actions

The Court of Appeal will rule next week on an action alleging an unjustified symphysiotomy was performed on a young woman at a Dublin hospital 12 days before her first baby was born in 1963.

The judgment has implications for a small number of similar actions over prophylactic symphysiotomies.

A symphysiotomy is a procedure which divides the cartilage of the pubic symphsis to facilitate easier delivery; a prophylactic symphysiotomy is performed without a trial of labour based on a view vaginal delivery is not reasonably possible.

Some 30 cases in total have been initiated here over symphysiotomies .

Last April, the three-judge court reserved judgment on the appeal by the woman against the High Court’s May 2015 finding that she had failed to prove the symphysiotomy was “not without justification”.

The appeal court, comprising Mr Justice Michael Peart, Ms Justice Mary Irvine and Mr Justice Michael Hanna, will give judgment on October 14th.

Core issues

A core issue in the appeal is whether doctors were entitled, without first trying labour, to decide there was such disproportion between the size of the woman’s pelvis and the baby’s head that vaginal delivery was not possible.

A second core issue is whether, if it was decided vaginal delivery could or should not be achieved, it was generally acceptable practice in Ireland in 1963 to carry out prophylactic symphysiotomy rather than a Caesarean section.

A medical textbook used in hospitals here in 1960 described women on their first pregnancy as a “dark and untried horse”, the court heard.

The woman, now in her 70s, alleges the symphysiotomy, performed when she was aged 24, left her with lifelong consequences, including incontinence and depression and unable to undertake activities such as dancing or cycling. The prophylactic symphysiotomy was the only one performed in the relevant hospital that year.

The hospital has cross-appealed the High Court’s finding that the case, brought in 2012, was not statute-barred.