Patching up the wrongs of 'systematic assault' on hundreds of women
Irish maternity issues, past and present, have been to the fore this week - none of them covered in glory.
First, there was the publication of the symphysiotomy report and the compensation of €34m for the 'barbaric' treatment of 399 women.
Then the National Maternity Hospital managed to agree a compromise with St Vincent's Hospital, so that it could move to the Dublin 4 site, and avoid clashing with the Sisters of Mercy. Governance procedures have been agreed whereby a new 'National Maternity Hospital' company will be established with clinical and operational independence in the provision of maternity, gynaecology and neonatal services, as well as financial and budgetary independence.
Also this week, the Mother and Baby Home Commission of Investigation extended its date for submissions from former inmates.
Between the symphysiotomy mothers and the Magdalene mothers, we are, hopefully, coming to the end of one era where women, generally of a poorer class, were treated like animals.
Motherhood has an intangible position in Irish politics and law. On the one hand it is suggested motherhood is a sacred cow, enshrined in the constitution, where the: "State recognises that by her life within the home, woman gives to the State a support without which the common good cannot be achieved."
The reality as we all know is paradoxically different. Most of the women who were awarded compensation through the Symphysiotomy Redress Scheme are in their 70s and 80s, many already dead. But there were critics who resented the payment of between €50,000 and €150,000 to these women, because they did not all supply medical records. Can you imagine trying to obtain a hospital record from 40 or 50 years ago? All you have is a life-long limp, chronic back pain and incontinence to prove your point.
When you consider €50m has already been spent on an as yet, non-existent children's hospital without a query, it makes this €38m a passable apology for a life of agony.
One Irish hospital continued the invasive and brutal treatment until the 1990s.
This controversial operation, rarely used in the rest of Europe after the mid-20th century, was carried out on an estimated 1,500 women in Ireland between the 1940s and 1980s.
The procedure involves slicing through the cartilage and ligaments of a pelvic joint (or in extreme cases, called pubiotomy, sawing through the bone of the pelvis itself) to widen it and allow a baby to be delivered unobstructed.
In July 2014, the UN Human Rights Committee called for the Irish government to hold an investigation into the issue. Nigel Rodley, chair of the UN Human Rights Committee, called the use of the operation without patients' informed consent a "systematic assault".
Commenting on the symphysiotomy report this week by Judge Maureen Harding Clark, Health Minister Simon Harris said all of the women eligible to receive compensation had received their respective payments, the majority of claimants were over 75 years of age.
But one woman, who was offered compensation, refused in order to continue litigation against the State. Another woman, Olivia Kearney from Louth, who, at 18, was subject to a post-caesarean symphysiotomy at Our Lady's Hospital Drogheda in 1969, now 64, was awarded damages in 2012, for this "grave medical malpractice" when no medical justification for it was found in her notes. Her compensation award of €450,000 was slashed to €325,000 in the Supreme Court.
The scheme compensation is only given on the condition that claimants discontinue any legal action.
Given the length of time that it can take to challenge the State - you only have to think of Louise O'Keeffe and her battle all the way to the European Court of Human Rights to recognise her abuse at the hands of a teacher - it would put many elderly women off.
In defence of the obstetric profession, former master of the National Maternity Hospital, Dr Peter Boylan, in an interview said the description of the procedure as "barbaric" implied that doctors and obstetricians who carried out the procedure were barbarians which, he said, was outrageous.
He also said that symphysiotomy can happen spontaneously and while the procedure is rarely used now, it was still used in rare and life-threatening situations. In that regard, I expect it is now carried out with consent, which makes all the difference.
Historically, it is clear that was not the case, and there were influential obstetricians with deeply-held religious beliefs, according to Jacqueline Morrisey, a historian who began investigating the practice in the 1990s.
Dr Alex Spain, the master of the National Maternity Hospital until 1948, disapproved of caesarean sections - his Catholic beliefs, not his medical judgment, guided his actions. At the time, the established medical consensus was that having more than three caesarean sections was dangerous, and that further pregnancies would have to be stopped by sterilisation or contraception. Dr Spain considered this unacceptable, and talked about "the mutilating operation of sterilisation and marital difficulty".
Dr Spain would lead the revival of symphysiotomy among the maternity hospitals of Dublin.
His successor, Arthur Barry, refused to allow women whose lives were at risk, to be given advice on "natural", Catholic-approved contraception methods.
When you consider how money is wasted in this country, it is best to look at the compensation as a tangible 'end of life' gift to mothers who have suffered through a Catholic-driven hospital ethos.
It does not make it right that there was lack of consent, but the past cannot be undone. Hopefully, it will provide some comfort in their future.