John Paul Phelan (Carlow-Kilkenny, Fine Gael)

I am glad to have the opportunity to speak on this issue. I raised it a number of times when I was a Member of the other House.

As a society, in the past number of years we have lifted many flat stones, shone light into several dark corners and looked in horror at the scandals that lived beneath our notice. Just as no person can be completely sane without coming to terms with past traumas, no society can be healthy that is afraid to look at and heal its past.

Lifting stones and seeing horrors serves us by comforting the victims, punishing the perpetrators and preventing future disasters. All of us here are aware of the symphysiotomies that were performed in Irish hospitals from 1944-83. The previous Minister for Health announced a partial inquiry into one hospital, Our Lady of Lourdes Hospital Drogheda. I ask the current Minister for an inquiry into the practice in all hospitals.

This operation was simply the cutting in two of the cartilage that holds the hips together in front to widen the passage during childbirth. That description makes the process sound clinical, normal and even medical. The surviving women want answers, and I want them too. While the operation was simple in surgical terms, the reasons for its use in place of caesarean sections, the after-effects of the women involved and the role of a perversion of religious doctrine are far more complex.

Symphysiotomy was first advocated in 1597 by a French carpenter and became a rare and odd operation until better hygiene, anaesthesia and clinical practice made caesarean sections safer. In the developed world the operation fell completely out of use. Why was it reintroduced to Ireland in 1944? Why did Irish obstetric practice diverge from Britain and the rest of Europe in 1944? For what reason were Irish women condemned to endure a procedure that was genital mutilation and banished from the developed world? Symphysiotomy was described in 1951 by the then Nuffield Professor of Obstetrics, the finest obstetrics surgeon of his time, as medicine from the Dark Ages. He described it thus for good reasons. One clear and single reason led to caesarean section supplanting symphysiotomy when medical practice made caesarean sections safe. Symphisiotomies damage babies in childbirth. There is a 10% mortality rate, making symphysiotomy a high-risk procedure, even in skilled hands, for both the infant and mother. How many children were affected in terms of health and how many lost their lives because of the operations carried out in Ireland between 1944 and 1983?

Why did so many women who had symphisiotomies tell us of incontinence, walking problems and terrible chronic pain? Could there be a connection between the horrendous consequences for women and the after care they received? Women tell us of having been taken from their beds and made to walk within hours, despite textbooks requiring five to seven days of bed rest.

Serious questions must be asked about the manner in which the operation was performed and the after care women received. "Savage cruelty" is a mild term for the way in which the affected women were treated. Worse, it seems this savagery was visited on the most vulnerable. Women who were detained, often illegally, in the so-called Magdalene homes, including single mothers and the poor, may have been doubly victimised through being subjected to bush-clinic obstetrics in a modern country.

I am a practising Catholic but believe the use of the procedure to avoid family planning sought by women was a disgusting perversion of Catholicism. However, this may have been a motivation for inflicting the procedure on women. We need to know whether this was the case.

We know from recent times that tribunals can be lengthy and costly. An inquiry into symphysiotomy can be done simply and cost effectively. A legal and medical expert should be employed to conduct such an inquiry.

For women trapped in incontinence, immobility and constant pain, symphisiotomies are not history. What do numbers matter when one baby killed leads to a lifetime of grief and sorrow, inflicted for no reason? Now is the time to give answers to those alive to hear them. A relatively cheap, simple inquiry would provide such answers and would be some recognition of the misery misguided medicine has inflicted. It would go some way towards giving closure on foot of the pain of the affected women.

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