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David Quinn: Church is victim of the blame game yet again

It really takes a mighty stretch to lay most of the blame for the use of a controversial child-birth procedure in Ireland called 'symphysiotomy' on the Catholic Church. Yet that is precisely what is happening.

It is being seen as one more product of a benighted church and a benighted time. However, in reality, only a small portion of the blame for the use of the procedure can be laid at the door of the church and even that is arguable.

Mostly, if not entirely, it was used because of the medical and economic conditions that prevailed here until several decades ago.

What is symphysiotomy? In the words of the Institute of Obstetricians and Gynaecologists, it is "a surgical procedure to enlarge the pelvis and allow vaginal birth in women with mild to moderate obstruction".

Symphysiotomies in some cases leaves women with terrible, life-altering side effects such as chronic back pain and incontinence.

Women in Ireland who underwent the procedure and who developed some of these side effects are now mostly elderly and are demanding redress.

Their demands led to the publication this week of a draft report on the use of symphysiotomy in Ireland.

The draft report is highly polemical in tone. At one point it refers to the "pernicious" influence of Archbishop John Charles McQuaid and his "disgraceful" behaviour and overall it points the finger of blame directly at the Catholic Church.

The "disgraceful" behaviour cited is McQuaid's opposition to free maternity meals being offered to women by multi and non-denominational organisations. Disgraceful it may have been but it had absolutely nothing to do with symphysiotomy.

Indeed, the report provides no direct supporting evidence that the church here encouraged the use of symphysiotomy. There appears to be no pastoral, no official document, no theological article in which its use is discussed and recommended.

Instead, what we get is secondary evidence as we are led to conclude that the use of the procedure here was due to the Catholic Church's opposition to artificial contraception and its preference for large families. Performing a symphysiotomy on a woman made it easier and safer for her to have children in the future.

The tone is in marked contrast to the very objective and dispassionate tone of the statements on symphysiotomy issued by the Institute of Obstetricians and Gynaecologists.

There isn't a hint of anti-Catholicism in the statements, even though the institute's latest statement, issued this week, does refer to Catholic opposition to artificial contraception.

The statement says that the procedure was mainly used in the 1950s and 1960s. Seemingly it was only rarely used in other parts of Western Europe at the time, although according to the draft report, accurate figures are very hard to come by.

But even in Ireland, when it was being used most commonly, it was still very rare. The institute says the rate was just 0.035 per hundred births. The main reason for its use is because back then it was riskier to perform caesarean sections.

The statement says: "The risks of maternal and infant death and morbidity at that time were greater with caesarean section, even when mothers were healthier and the attendant problems related to anaesthesia, blood transfusion and infection were lessened".

So what did we expect doctors to do back then, perform caesarean sections rather than symphysiotomies even when the former was medically riskier than the later?

The fact is that in developing countries even today -- and back in the 1950s we were basically a developing country -- symphysiotomy is still being used. And it is being used at the recommendation of the World Health Organisation (WHO).

When last I checked, the WHO was not dominated by Catholic theology.

In fact, the Institute of Obstetricians and Gynaecologists cites a recent study which says, "there is considerable evidence to support a re-instatement of symphysiotomy in the obstetric arsenal, for the benefit of women in obstructed labour and their offspring."

This study was produced by a Swedish academic at the Swedish Institute and as with the WHO, Sweden is not known as a bastion of Catholicism, so Catholic theology can hardly be blamed for this recommendation.

The main reason symphysiotomies were conducted in Ireland in relatively high numbers in the past is because we were poor and because caesarean sections were unsafe. They were phased out not because we became less Catholic, but because we became richer and our hospitals became better resourced and caesarean sections became much safer.

The women who suffered complications as a result of botched symphysiotomies should naturally be compensated.

But the accusation that the church's opposition to artificial birth control is the main culprit is far off the mark and in years to come, the accusation will be seen as a product of the current atmosphere of generally hostility towards the Catholic Church.

Irish Independent