Old wounds opened by ‘mistaken’ verdict
How so many women mistakenly believed they had symphysiotomies deserves an answer, writes Maeve Sheehan
‘Nitpicking and rejection was contrary to the spirit of redress’
LAST week the retired judge Maureen Harding Clark delivered her long-awaited verdict on the hundreds of older women said to have suffered a lifetime of chronic pain, incontinence and discomfort because of a “cruel and dangerous” procedure performed on them in largely Catholic hospitals of another era.
The procedure was symphysiotomy — cutting the fibres joining the pubic bones to give a baby more room to come through.
Her report debunked some myths. Far from being barbaric, she found it was often a necessary lifesaving procedure.
But it was bad enough to warrant the government Redress Scheme to award €50,000 to any woman who could prove she’d had one, and €100,000 to €150,000 for those who could prove injury. Of 600 applicants, 399 received compensation.
The judge found the wom- en deserving of the money and took pleasure from reading warm letters and notes they wrote her. She had less flattering things to say about the circumstances in which 185 women applied for compensation believing they’d had a symphysiotomy only to be told they were, in fact, mistaken.
How could so many have got it wrong, she asked? How could so many believe they’d had the procedure, when her investigations proved that they had not?
The judge offered several reasons. Some confused an episiotomy – an incision made during childbirth – with symphysiotomy. Sensationalist media, “irresponsible rhetoric” which characterised symphysiotomy as “butchery” inflicted by Catholic doctors on unconsenting patients. She was suspicious about the similarities in “harrowing” stories of symphysiotomy. They claimed lives had been ruined, they were unable to walk or take care of their babies, were incontinent. What was more concerning, she said, was that their claims of disability were supported by medical opinion.
A saw is never used for symphysiotomy — the joints are severed, not the bone. Yet a saw featured heavily in the testimonies of many applicants — some describing a hacksaw or an electric saw or a saw with a wooden handle.
Why would these women even want to think they had had a symphysiotomy? Most of the “mistaken applicants” were elderly, they were “possibly amenable to suggestion” and “emotional contagion”.
Harding Clark suggested these women had confused their long and difficult labours with symphysiotomy. This was probably caused by listening to other women’s testimonies about symphysiotomy and dreaming up false memories. She accused some “mistaken applicants” of a “self-serving adoption and embracing of the experiences described by others”.
Judge Harding Clark did not interview the 185 women, some of whom she suggested may have suffered from false memories or been influenced by financial payment.
It was for psychologists to “analyse the effects of group discussion on suggestive personalities” her report con- cludes. She felt “great sadness” for them. Some were “prominent, vocal and long-time activists as victims of symphysiotomy. Those who have been active in representing themselves as victims to the media must now retrace their lives and must be understandably upset”.
We sought to interview women rejected by the Redress Scheme but were unable to do so. We made many requests through their lobby organisation, Survivors of Symphysiotomy, but no women were forthcoming so their voices have yet to be heard.
Women who did receive compensation found it upsetting. Margaret (79) told us she cried when she listened to the news of false claims. For 30 years she carried the aftermath of a symphysiotomy — back pain and difficulty walking — but never knew she’d had one until the first media reports in around 2002.
“I was so upset. How could they say that about women?” said Margaret, who asked for her last name not to be used. She proved she’d had a symphysiotomy because it was written on her records.
SoS’s chairperson, Marie O’Connor, said last week that they have been “humiliated” and patronised by Judge Harding Clark’s “condescending tone” but no other explanation — apart from alleged shortcomings in Judge Harding Clark’s approach to assessing cases — has been forthcoming.
Survivors of Symphysiotomy claim the practice amounted to “torture” and brought a case to the United Nations. When the Government introduced its Redress Scheme in 2014, the organisation campaigned against its terms and it has dismissed the various reports on the practice “as a whitewash”. A rival advocacy group, Patient Focus, urged elderly affected women to take part in the scheme, believing the legal route to be fraught with difficulty [only one High Court case has succeeded so far].
The group said last week it was “vindicated” in doing so and that it was regrettable that “a number of women now find themselves without redress because they unfortunately decided to boycott the scheme”.
Marie O’Connor, who is this weekend speaking on symphysiotomy at a childbirth conference in France, has described Judge Harding Clark’s report as an “official whitewash”.
Solicitor Colm MacGeehin, whose firm acts for 200 applicants — most of whom were successful — has declared some of its assertions to be “unfounded” and “untrue”, “harsh and disrespectful” in tone and “highly insensitive and offensive to slur women who made unsuccessful applications” in good faith.
MacGeehin Toale is representing some of the 28 women who are now suing in the High Court for symphysiotomy procedures which Judge Harding Clark in her report says “they did not have”. The firm was the biggest earner from the Redress Board, being paid €1.1m of the €2m paid out in legal fees.
It has been reported that Colm MacGeehin is Marie O’Connor’s former husband, and that their son has worked as junior counsel on some of the 28 symphysiotomy cases before the courts.
He told the Sunday Independent that he has been advising Survivors of Symphysiotomy since 2004, which “accounts for the clients who instructed my office”, whereas O’Connor joined Survivors for Symphysiotomy in 2010 at the request of members.
“The inference and innuendo arising from this report is that unsuccessful applicants were mostly brought through legal representatives who did not act in good faith. This is an unfounded allegation, which is defamatory and untrue,” he said. The suggestion that 28 High Court actions proceeding involve several women who did not undergo symphysiotomy was also “simply untrue”, he said.
According to the report, Harding Clark’s approach was “strict” in establishing whether or not women had had a symphysiotomy. They did this by obtaining their medical records or birth records, where the judge found this was usually recorded.
Failing that, women were examined by an orthopaedic surgeon or gynaecologist to locate the tell-tale symphysiotomy scar, failing that by a radiologist who probed using X-rays and scans
The judge said she tried to be “compassionate and generous” in deciding how much suffering it caused.
According to MacGeehin, women had “serious evidential issues” where records were absent or silent on symphysiotomy. When medical experts disagreed on a diagnosis, as they often did, the Redress Scheme doctors got to call it. An unsuccessful application “is not the same as not having a symphysiotomy”, he said.
Roger Clements, an obstetrician of 50 years’ experience, questioned the ethos of the scheme and described the judge’s report as “flawed’’.
The obstetrics expert examined 15 to 20 women who were applying to the Redress Scheme. In some cases he could find no evidence of a symphysiotomy. “There are also those who I am quite sure did [have the procedure] but who were rejected on the basis of insufficient evidence,” he said. “I think the whole ethos of this scheme was wrong. It wasn’t to carry out an inquisition to see who had and hadn’t had [a symphysiotomy]. It was to try to compensate a whole generation of surviving women, and God knows there were hundreds more that didn’t survive. The nitpicking and rejection of people who had scars — which she found were not caused by symphysiotomy — I think was contrary to the spirit with which we had thought it had all been set up.”