Madam, - While Senator Mary Henry has chosen to focus on the plight of women in developing countries (August 2nd), the central question remains: why did Irish obstetricians of the 1950s, 1960s, 1970s and 1980s, working in various hospitals across the State, perform a discarded operation, symphysiotomy, for obstructed labour, and why did they do so at a time when Caesarean section had long been the surgery of choice for difficult births in the first world?
Maternal morbidity following symphysiotomy was so high that the operation had long been relegated to developing countries by the time Irish obstetricians decided to revive it in the early 1950s. John Cooney has documented how the revival was led by doctors committed to putting Catholic doctrine into clinical practice.
Symphysiotomy, with its permanent widening of the pelvis, offered unlimited childbearing as well as freedom from temptation. To do a Caesarean, however, was to limit future childbearing: the dangers of repeated surgery limited the number of Caesareans that could prudently be performed. Caesarean mothers were seen by Catholic doctors as being at increased moral risk, prey to the manifold temptations of contraception, sterilisation or worse.
That the Department of Health recently saw fit to nominate as an expert to review the symphysiotomy revival in Ireland a Swedish doctor who advocates its reinstatement in the "obstetric arsenal" beggars belief.
Dr Bjorklund's name first appeared in Ireland in a letter written to this newspaper by Dr Peter Boylan, former master at the National Maternity Hospital, who cited an article written by Dr Bjorklund in defence of the NMH's apparently liberal practice of symphysiotomy prior to 1963.
Could whoever made this decision in the Department now step forward from the shadows and explain how Dr Bjorklund's partiality for symphysiotomy made him an appropriate choice to review its revival in Ireland?
Hundreds of women were maimed as a result of the religious revival of symphysiotomy in Ireland, suffering permanent pain, immobility, incontinence and marriage breakdown. Doctors are said to have dispensed with the niceties of consent: many mothers say they were not even told retrospectively that their pelvises had been sawn in two. Does putting Catholic doctrine before patient safety in our hospitals not warrant impartial investigation by unbiased reviewers? Or does the exercise of such near-despotic control over women's bodies in childbirth not matter? - Yours, etc.,
MARIE O'CONNOR, Rathdown Road, Dublin 7.