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Symphysiotomy Group Slams New Review[Posted: Mon 11/10/2010 by Niall Hunter, Editor -]

The campaign group representing women who underwent symphysiotomy have slammed new proposals for a review of the controversial birth procedure which had severe after-effects for many women.

The Survivors of Symphysiotomy (SOS) group has criticised in particular the involvement in the planned review of UK-based doctor who it says is a proponent of symphysiotomy in developing countries.

Symphysiotomy was carried out in some Irish maternity units from the 1940s to the early 1980s - SOS says Ireland was the only country in the developed world to carry out this procedure in the 20h century.

The procedure involves splitting the pubic joint and its ligaments in obstructed labour. Symphysiotomy led to many severe after-effects in the 1,500 Irish women who had the procedure over 40 years.

The group has for some time been seeking a full inquiry into why the procedure was carried out in Ireland and its consequences for the women involved.

According to SOS, the Institute of Obstetricians and Gynaecologists (IOG), is now finalising a team to carry out a symphysiotomy review led by a Belfast obstetrician-gynaecologist Dr James Dornan.

This probe will include a literature review by a team from the Liverpool School of Tropical Medicine that will seek to place the practice of symphysiotomy in Ireland in a developing world context.

SOS says this literature review is expected to form the centrepiece of Prof Dorman's report.

However, Marie O'Connor of SOS says the literature review is misconceived, unnecessary and irrelevant at this stage. She said any such review is bound to find in favour of the operation.

She cited the involvement of Dr Nynke van den Broek, from the Liverpool centre, in the review, and said this doctor had recommended that where access to safe surgery is not available, symphysiotomy should be used for the management of obstructed labour in developing countries.

Ms O'Connor claimed if Dr van den Broek was in favour of the procedure in developing countries, she was unlikely to find against it in Ireland.

She said the literature review should be dropped. "What use is a literature review, placing the revival of symphysiotomy here in the context of medicine in Africa and elsewhere, to the survivors of the operation in Ireland?"

"We need to have a proper review which will aim to find out what happened in Ireland, why it happened, and to have a systematic documentation of women's injuries."

SOS says the €35,000 reportedly being allocated from the Department of Health for the review could be better spent.

It says the terms of reference for the IOG's review are unclear and should be redrawn, with the litterature review dropped.

The group says it represents up to 180 women who had the operation, which led to after-effects such as chronic pain and incontinence.