Surgical alternatives in childbirth

Madam, - So, symphisiotomies are being promoted again (The Irish Times, July 19th)

Madam, - So, symphisiotomies are being promoted again (The Irish Times, July 19th). It is true that many pregnant women, particularly teenage girls, die every year in the developing world from obstructed labour: they are unable to give birth naturally and a Caesarean section is not available to them, as it would be in the developed world.

The Addis Ababa Fistula Hospital, founded in 1975 by Dr Catherine Hamlin and her late husband Dr Reg Hamlin, deals with those women who survive obstructed labour but who are so seriously injured that they are incontinent of urine, and sometimes faeces as well.

On a visit to the hospital I asked Dr Hamlin what she thought of performing symphisiotomies on women with obstructed labour. She said that while the procedure might save men's lives, they would be left with unstable pelvises. This makes life very difficult for women who normally work as agricultural labourers as well as in their homes.

When I hear symphisiotomy being promoted I think of this wise woman and her solution to the problem of obstructed labour. She raised money to set up centres in Ethiopia where Caesarean sections can be carried out. Thanks to an appearance on the Oprah Winfrey show in th US Dr Hamlin raised several million dollars - indeed Ms Winfrey herself gave nearly half-a-million.

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Making such centres available to all women should be our priority, not performing symphisiotomies. Insisting that the legal age of marriage is enforced internationally would be a help, too. - Yours, etc.,

Senator MARY HENRY, MD,

Seanad Éireann,

Dublin 2.