Friday, March 19, 2010

Childbirth past and present

For quite some time now there has been a controversy about the medical procedure called symphysiotomy which was performed in a number of maternity hospitals – usually Catholic - in Ireland some decades ago. This involved the widening of the pelvis so that the passage of the baby into this world was made easier for the mother and, presumably, for the baby. Horror stories abound about the subsequent pain and disability in later life that often followed the procedure. The general attitude and response to the accounts of suffering by women who underwent the procedure was, and still is, one of utmost anger and disbelief that a mother could be subjected to such a barbaric practice.
A recent letter in the Irish Times, however, gives another interesting (and frightening) side to the story:

‘Symphysiotomy may appear now as a horror weapon of the past, but it actually saved the lives of many babies.
‘I trained as a midwife in the Rotunda [one of the main maternity hospitals in Dublin, not under Catholic management] around 1956-58. We had lectures on the history of obstetrics but symphysiotomy was not performed there at that period or ever. Rather, what happened there, prior to successful Caesarean sections, was perforation of the skull of the infant and death of the infant to save the mother.
‘Do not forget, when C-sections first became a way of dealing with difficult births, it was rarely chosen, as the mother usually haemorrhaged to death.
‘Why? Because those who operated were not aware that the uterus had to be sutured prior to the closing of the abdominal gap. So in the 1950-60s obstetricians performed under the dark cloud of C-sections and certain death of the mother.
‘To enable mother and child to survive, symphysiotomy was the only answer. It was very rarely necessary.
‘Please see the good work and effort of the past as an advance from dark and appalling suffering misery of the pre-Famine millions in Ireland and elsewhere.
‘Yes, a few were crippled, but they were survivors. Those doctors and obstetricians gave of their best for their patients at that time, most of them have now passed on. I speak for them, may they rest in peace.’