It’s easy to see how Tuam defined public perceptions of mother and baby homes.
The very notion of babies buried in or anywhere near a sewer is an abhorrence that has dominated the narrative since 2014.
But long before Catherine Corless’ exhaustive research was published, campaigners had battled for decades to get successive governments to investigate and act on the illegal adoptions of tens of thousands of Irish children.
As award-winning campaigning journalist Conall Ó Fátharta, who wrote extensively about illegal adoptions for the, said of Tuam in May 2018: “It keeps the narrative focused on historic deaths in an institution in the west of Ireland and away from a key issue.
“The huge and glaring elephant in the room that no one likes to mention [is] the scale of forced and illegal adoptions and the State’s role in same.
“The irony of all of this is that an inquiry into all of these matters could have happened long before the Mother and Baby Homes Commission was set up in 2015.
Those who believe the issue of forced or illegal adoption has yet again been kicked down the road had their fears confirmed with the publication on Tuesday of the Mother and Baby Homes Commission of Investigation report.
One of its findings was a categorical statement that the institutions examined had "little to do with informal adoptions before legal adoption was introduced" in 1953.
In a narrowly-defined look into adoption that only examined issues around consent and foreign adoption, the commission stated in the executive summary of its report that “a comprehensive review of adoption did not form part of the commission's remit”.
The commission states that it could only find evidence of just over 1,600 foreign adoptions.
The vast majority — 1,427 — were, it said, placed for adoption in the United States of America.
Most of the foreign adoptions were children who, the commission said, left their mother and baby home or other institutions in the period 1945-1969.
Before then, it also states that "institutional records" show there were 15 children in total placed for foreign adoption in the period 1926-1944.
The commission said: "Many allegations have been made that large sums of money were given to the institutions and agencies in Ireland that arranged foreign adoptions.
"Such allegations are impossible to prove and impossible to disprove."
The commission acknowledged that children were adopted out of "other orphanages and institutions, including county homes and industrial schools".
And it said that "it is also possible that children were placed for adoption abroad directly by their mothers or by third parties".
But regardless of the variety of routes to foreign adoption, the numbers given in the commission's report are very low.
For example, in the year 1951, 86 children left their mother and baby home or other institution to be adopted either in that year or soon after.
This rose to 108 children in 1952, and peaked at 113 in 1958, the year Tuam survivor PJ Haverty had been due to be adopted out to an American couple before the process was stopped at the last minute.
The commission also reported that, according to a memo compiled in January 1958 by the Department of External Affairs (DEA), passports were issued to 122 children in 1957 to enable them to leave the country for legal adoption abroad.
The figures for the preceding five years included a total of 184 passports in 1955 and 193 in 1952.
Overall, the figures are in marked contrast to those reported on by author Mike Milotte.
His 2012 book,is arguably one of the most authoritative books on Ireland's illicit adoptions.
He pointed out that while the National Archives of Ireland contains little evidence, there is just enough documentation to make clear that in the 1950s, the State was well aware Ireland was regarded as “a centre for illegal international baby trafficking”.
Shockingly, he discovered that Ireland was, in the words of one civil servant, even regarded as a “hunting ground”.
It was a country where childless couples could fly in from abroad and “obtain” a child born in any number of the various institutions with little or no formalities.
According to Mr Milotte, up to 15% of all the children born each year in mother and baby homes were “trafficked” to the United States.
He reported that, as well as those children adopted through official channels, thousands more were taken out of the country “without sanction or public recordkeeping” and handed over to foreigners.
If the scale of illegal adoptions could be regarded as the last of the Catholic Church’s dirty little secrets, it was — in effect — one that was hiding in plain sight.
Thereported in October 1951 that in the previous year “almost 500 babies were flown from Shannon for adoption”.
It reported that in the first week of October that year alone, some 18 “parties” of children departed from the airport, exceeding the number of official “adoption passports” issued to let adoptive parents take children out of Ireland.
It claimed that many were “sold” on the US’s “thriving baby black market”.
When the story was challenged in Irish diplomatic circles, a desire for a retraction of the story from one senior official was soon abandoned when they received a message from the DEA in Dublin that “no action is required, especially as the article is largely correct”.
Later, in February 1955, an American newspaper wrote about adoptions under the headline “50 American couples buy Irish babies through international adoption ring”.
It claimed the couples were paying up to $2,000 — €15,845 in today’s money — per child.
When the article was discussed at government level, a Department of Justice official reportedly advised the story “could not truthfully be refuted”.