Keith Swanick (Fianna Fail) | Oireachtas source

I will start with the words of one survivor of symphysiotomy:

They gave me gas and air and an injection, and took me to another room, where they tied my legs up on each side. There were two nurses on each side of me. I saw this doctor at the end of my bed with a big, long silver thing. They made a hole in your private parts, and he inserted this silver thing up and cut the pubic bone and pushed it over to widen your pelvis for you to deliver your baby yourself.

Petrified and in agony, the woman in question had just been subjected to a symphysiotomy. For the five days following the procedure, the new mother was ordered to lie completely flat with a corset around her hips to give her pelvis a chance to heal. For days, she was unable to see her daughter in the special care unit because there was no lift. To use her words again:

I have arthritis in my hip and in the bottom of my spine. I walk with a limp. No one can help – there’s no way back. I wear pads the whole time, and have been since the age of 23.

Symphysiotomy, which was seldom used in the rest of Europe after the mid-20th century, was carried out on an estimated 1,500 women in Ireland between the 1940s and 1980s. Ireland was the only country in the world where these childbirth operations were carried out in preference to caesarean section. Many attribute this to religious ideology and doctors who believed in child bearing without limitation. Whatever the reasoning, the outcome for women has been lifelong disability, chronic pain, mental suffering and in some cases family breakdown.

In 2014, the United Nations Human Rights Committee found the following in respect of Ireland:

The State party should initiate a prompt, independent and thorough investigation into cases of symphysiotomy, prosecute and punish the perpetrators, including medical personnel, and provide an effective remedy to the survivors of symphysiotomy for the damage sustained, including fair and adequate compensation and rehabilitation, on an individualized basis. It should facilitate access to judicial remedies by victims opting for the ex-gratia scheme, including allowing a challenge to the sums offered to them under the scheme.

In that context, we have done some of what the committee asked and I hope the publication of Ms Justice Maureen Harding Clark's report on the surgical symphysiotomy ex gratiapayment scheme will bring some type of closure to the women who have been so badly affected by symphysiotomy. The historical indifference shown to survivors of symphysiotomy has meant some women still do not know exactly what procedures were performed on them without consent, resulting in some cases in them spending their entire adult lives in pain.

As a general practitioner, I swore the hippocratic oath. Historically taken by physicians, the oath is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear by a number of healing gods to uphold specific ethical standards. It is considered a rite of passage for practitioners of medicine in many countries. While various modernised versions are often used nowadays, the message delivered is still the same - above all, do no harm. The medical practitioners who conducted the symphysiotomy procedure took the same oath but did not abide by it. I am glad this procedure plays no part in medicine in the 21st century.

The Fianna Fáil Party believes the scheme was a genuine attempt to bring a resolution to this matter. Many of the findings of the report make for very distressing reading. The practice of symphysiotomy had stopped in other countries many years before it ceased in Ireland. When it went wrong it caused many debilitating physical, psychological and emotional side effects and many women experienced medical problems for decades. I hope they will be able to access the treatment and supports they badly need. Unfortunately, four of the women affected passed away before the final report was published.

Thankfully, symphysiotomy is no longer an accepted practice in obstetrics. It is crucial that the medical profession learns lessons from the past. I sincerely hope the Institute of Obstetricians and Gynaecologists will study the report in detail.