Symphysiotomy in the National Maternity Hospital and Coombe

Published in 20th Century Social Perspectives, 20th-century / Contemporary History, Features, Issue 5 (Sept/Oct 2012), Volume 20

By 1949 Dr Alex Spain, master of the National Maternity Hospital, had performed 43 symphysiotomies. Dr Arthur Barry, his successor, was a fervent advocate of Catholic teachings on human sexuality. He promoted symphysiotomy enthusiastically, extending its use beyond the cautious parameters set by Spain, sometimes with tragic results. Escalating use of the operation brought with it attendant difficulties, including stillbirths and neonatal deaths. Sometimes unsuccessful symphysiotomies were followed by CS. By 1955 Barry had overseen 165 symphysiotomies, reporting a loss of twelve infants directly as a result of the procedure (7.27%) and attributing seven more infant deaths in symphysiotomy cases to other causes. He did not place the figures into comparative context with CS performed for the same conditions. Feeney, of the Coombe, estimated a 10% infant mortality rate in symphysiotomy cases. Barry accepted that some deaths would not have happened had CS been performed.  Both urged people to focus on the long-term benefits for subsequent deliveries.


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