'The doctor used a hacksaw on me during labour': Ireland's women speak out

Over the last century, 129 Irish women had their wombs removed unnecessarily and more than 1,500 women had their pelvises deliberately broken during childbirth. Frankie Mullin meets some survivors and hears how they are finally getting justice

“So many bad things happen to women in this country and a lot of it is in childbirth,” says Cathriona Molloy of Irish patient advocacy organisation Patient Focus. “Last year was very busy for us. We supported around 200 women who’d been damaged or had their babies damaged during delivery.”

The most high-profile of these women are the victims of a brutal childbirth operation carried out in Ireland between 1942 and 1990. Often without their consent, more than 1,500 women were subjected to symphysiotomy, a procedure which involves breaking the pelvis by severing the pelvic joints, making more space for a baby to be born. Others had their pubic bone sawn through. Around 200 of these women are still alive and many have been disabled, unable to walk, incontinent and in pain since their ordeal.

In other countries, symphysiotomies were no longer carried out by the late 19th century but, in Ireland, the operation was favoured by some Catholic doctors as a substitute for Caesarean sections and was resurrected in the 1940s. Survivors believe doctors were driven by the desire to control women’s reproductive health. Whereas Caesarean sections can only be performed a limited number of times, symphysiotomy meant that women could potentially produce as many children as possible.

“These doctors saw Caesarean sections as a ‘moral hazard’ that capped family size and led to the ‘evil’ of family planning,” says the Survivors Of Symphysiotomy group. “They preferred to break women’s pelvises instead.”

Only last year, a redress scheme was announced, offering symphysiotomy survivors – many of whom are now in their 70s – €50,000, €100,00 or €150,000, depending on the severity of their injuries. The group submitted a report to the United Nations Committee Against Torture. It makes harrowing reading.

“I was screaming. [The anaesthetic's] not working, I said, I can feel everything,” reads the testimony from a survivor named Cora. “I saw him go and take out a proper hacksaw, like a wood saw…a half-circle with a straight blade and a handle…The blood shot up to the ceiling, up onto his glasses, all over the nurses…

“They told me to push her out, she must have been out before they burnt me. He put the two bones together, there was a burning pain. I thought I was going to die.”

129 women's wombs were removed

At Patient Focus, Molloy and her colleagues were able to offer practical and emotional support to the women seeking justice. The symphysiotomy scandal echoed another grim chapter in Ireland’s history; a chapter in which Molloy was involved and one which heralded the formation of Patient Focus.

From 1974 to 1998, a surgeon at Our Lady of Lourdes hospital in Drogheda – the same hospital in which many of the symphysiotomies were performed – removed the wombs of 129 women and the ovaries of dozens more. Despite most of these women not needing the procedures and the fact that women had rarely given their consent, Dr Michael Neary was able to operate unchallenged for almost a quarter of a century.

Although concerns had been raised in the 70s, it took until 2003 for Neary to be struck off the Medical Register and, like the symphysiotomy survivors, the women damaged by Neary waited many years to receive compensation. After a drawn-out process of investigations and inquiries which began in 1998, only last year were all his victims included in the redress scheme. Neary himself has never faced criminal prosecution.

Molloy was one of Neary’s victims. When she went into Our Lady of Lourdes hospital to have her second child, age 25, progress was slow and, after 14 hours, she was rushed in for an emergency Caesarean section. It was during this operation that Neary decided Molloy’s womb and one of her ovaries should be removed.

“All I remember about being in theatre is that there was a lot of panic,” Molloy tells me. “The next thing I knew, a doctor was speaking to me, saying they’d removed my uterus. It didn’t register at the time. I was in shock.”

When Neary came to see Molloy a week later, his advice was for her to go home and forget about the whole thing as she’d had a “nightmare experience”. He explained that she’d been haemorrhaging, that baby had been thrown into the cavity and that she was ruptured 14cm, hence the need for her womb and ovary to be removed.

'I did not need a hysterectomy'

“We were so naïve,” Molloy says of herself and her husband. “When I look back now, we didn’t ask the questions we should have asked.”

Molloy’s GP was horrified when he heard what had happened to her and, some years later, it would be he who diagnosed her as suffering from Post Traumatic Stress Disorder (PTSD). At the time, however, Molloy says she simply tried to get on with things and take care of her new baby, Seamus.

In 1998, when Seamus was nearly three years old, Molloy heard that an investigation was being carried out into Neary and that hers was one of the cases being looked into. With the help of a solicitor and GP, she get hold of her medical records.

“The biggest thing that stuck out was the pathology report,” says Molloy. “It said, ‘No apparent perforation’. I wasn’t ruptured. My ovary didn’t need to be removed. I’d been fine; the doctor who performed the C-section had it under control. When Neary came into the room, the bleeding had stopped. I did not need a hysterectomy.”

Molloy had three independent examinations with consultants, all of whom confirmed that she had not needed the surgery. Her testimony helped ensure that Neary would never practice medicine again. However, by now Molloy had joined forces with another woman, Sheila O'Connor, the founder of Patient Focus and, what began as a support group for Neary’s victims was growing into something bigger.

“More and more women were getting in touch,” Molloy says. “Eventually we discovered there were 129 women who’d had hysterectomies.”

'They told me the doctor had Divine Authority'

An inquiry was set up, led by Judge Maureen Harding Clarke and, after two years, the verdict was damning. The report suggested that a culture of fear and obedience had allowed consultants like Neary to work in a state of unchallenged omnipotence. Clarke’s investigation also revealed that important files had gone missing or been tampered with prior to the investigation.

Professor Oonagh Walsh of Glasgow Caledonian University put together a report on the practice of symphysiotomy for Ireland’s Department of Health. She sees parallels with the Neary case.

“The evidence given by patients emphasises the high status held by Neary,” Walsh told me. “When I held consultations with survivors for the symphysiotomy report, many said the same thing. One woman said that the Medical Missionary nuns told her Gerard Connolly's [who carried out many of the symphysiotomies] hands 'had been blessed by the Pope' so everything he did apparently had Divine authority. That culture of deference was very powerful and difficult to overcome.”

Not everyone felt that Clarke’s report had gone far enough. Realising the scale of the crisis was and seeing the desperate need for a clearer medical complaints pathway, Patient Focus had grown from a small volunteer organisation into a fully-fledged, funded patient advocacy group. The group commissioned a second investigation, led by Dr Roger Clements, a consultant obstetrician and gynaecologist in London and Dr Richard Porter of Royal United Hospital, Bath. This study came to starker conclusions than Clarke’s. While Clarke had suggested that Neary was simply an over-precautious doctor, terrified of losing patients, the new investigation raised the question of criminal intent.

Clements asks why the original report focused only on the hysterectomies and failed to mention the women who had their ovaries removed. Although the Department of Health had agreed to Patient Focus’s demands that these women – who had effectively been castrated – be included in a compensation scheme, their medical records had not been analysed.

Clements, who has now retired, told me, “There were 60 women, probably many more, whose ovaries Neary had removed after lying to them about the pathology they had. This isn’t medical negligence, this is not a doctor who is failing in duties for lack of skill. This is a doctor who, for some reason, is motivated to harm women.”

'Michael Neary should be in jail'

The new compliant never made it past the Director of Public Prosecutions and Molloy believes the women were not taken seriously. As a result, neither Neary nor the senior doctors who covered up for him when the alarm was first raised ever faced trial by jury.

“Of course Neary’s victims didn’t receive proper justice,” Clements says. “They received a modest amount of damages. If they’d been able to bring individual cases to high court the figure would have been much higher.”

Marie Reaburn, 62, had her ovaries removed by Neary 22 years ago. It later emerged that she didn’t, as Neary had told her, have endometriosis. The operation, which threw her into a “horrendous” early menopause, had been unnecessary.

“As far as I’m concerned, Michael Neary should be in jail for what he did,” Reaburn tell me. “We had to fight for years for compensation and he’s on his £100,000-a-year pension and has a villa out in Spain. It was a very desperate time.”

Reaburn says that watching the symphysiotomy campaign unfold has brought it all back but she feels that women have changed since the days in which she, and so many others, accepted without a murmur anything a doctor decreed.

“Women now, they just don’t take things lying down,” she says. “Back then you looked up to the doctor and you didn’t question him.”

There's still a long way to go

For Neary’s survivors, it wasn’t just about money. They hoped nothing similar could happen again. Patient Focus, its founders believe, was instrumental in bringing about much-needed change. Concrete measures have been put in place since Neary: institutions such as the Institute of Obstetricians and Gynaecologists are much more aware of the necessity for safeguards in practice and of the need for informed consent.

The Irish Medical Council has changed its procedure to identify poorly-performing doctors. There is a much clearer channel for complains to be made to the Medical Council and the Nursing and Midwifery Board of Ireland (NMBI).

For Patient Focus, however, much remains to be done. The group is currently supporting women who lost their babies at Portlaoise in Laois. Meanwhile, Portiuncula hospital in Ballinasloe has been the subject of a recent investigation into an unusual number of stillbirths and neonatal deaths. There has been a spate of inquests into maternal deaths, including that of Savita Halappanavar who died after being refused an abortion at a Galway hospital. It’s hard not to see echoes of the Magdalene Laundries tragedies.

“There’s still a long way to go,” says Molloy. “Last year we were inundated with concerned women contacting our service about the care provided to them in our Maternity services. It was horrendous. I remember what happened to me and think, ‘18 years on and now this is happening?’”

http://www.telegraph.co.uk/women/womens-life/11403155/Irish-symphysiotomy-scandal-Doctor-used-a-hacksaw-during-labour.html

This made me cringe.  The way the women in Ireland, from the abuse dished out to them by Nuns, the woman who died a couple of years ago when doctors would not take the baby out when she was hemorrhaging because of abortion laws, and now this, have been treated abysmally in Ireland, and most of it goes back to the attitude of the Catholic Church denying the rights of the mother and thinking of her just as a vessel for the baby's birth.

Absolutely appalling.