Symphysiotomy test case rejected by appeals court

A woman’s claim there was “no justification whatsoever” for a symphysiotomy carried out on her in a Dublin maternity hospital in the 60s when she was 24 years old and 12 days before her first baby was born, has been unanimously rejected by a three-judge Court of Appeal.

Symphysiotomy test case rejected by appeals court

Now 77, the woman was in court with supporters and clearly upset by the outcome.

Hers is regarded as a test case for about 30 other actions over symphysiotomies but the court stressed each must be decided on its own particular circumstances.

While another woman obtained €350,000 damages over a symphysiotomy, that case was very different as the baby was delivered before the symphysiotomy was performed and there was an absence of indications justifying the procedure, Ms Justice Mary Irvine said yesterday.

In this case, clinicians believed there was a “high probability” of obstructed labour and the symphysiotomy was performed to avoid that.

Legal sources believe the judgment will have adverse implications for similar cases concerning the procedure, carried out in some hospitals from the mid-1940s to mid-1960s.

Symphysiotomy was sometimes performed to address disproportion rather than a Caesarean Section. It involved partly cutting fibres joining the pubic bones to increase pelvic capacity with a view to facilitating vaginal delivery.

The woman claimed her antenatal symphysiotomy, done without a trial of labour, was done without her knowledge, was unjustified and she suffered lifelong consequences, including incontinence, back pain and mental health difficulties.

The High Court accepted she suffered physical and psychological difficulties caused or contributed to by the symphysiotomy but rejected her claim it was done without any justification.

Dismissing her appeal, Ms Justice Irvine, with whom Mr Justice Michael Peart and Mr Justice Michael Hanna agreed, said this type of symphysiotomy has long since been abandoned “for good reason”. Assessed by present day standards and where women here can better control their own fertility, it would be considered “inherently defective”.

The “mechanics of labour” were not as well understood in 1963 as now but even by the late 1960s, there was much greater understanding about a mother’s ability to deliver a baby which appeared disproportionately large for her pelvis.

By 1963 standards, and the woman’s “very particular” circumstances, there was credible evidence she had not established this symphysiotomy could never, in any circumstances, have been justified.

There was evidence a “reasonable and respectable” body of clinicians of like expertise to the hospital master who performed the symphysiotomy would have approved of his decision and no evidence of deviation from a “general and approved” practice.

Marie O’Connor, chairperson of the national advocacy group, Survivors of Symphysiotomy, said: ‘today’s decision by the Court of Appeal comes as a grave disappointment to the plaintiff, whose rights were so blatantly violated by Master Stuart at the Coombe Hospital in 1963. Survivors of symphysiotomy everywhere feel betrayed’.

It is understood a decision to appeal the decision is pending.

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