Council of Europe Finds the Practice of Symphysiotomy Violated the Istanbul Convention

On 14 November the Council of Europe Group of Experts on Action against Violence against Women and Domestic Violence (GREVIO) released its baseline report on Ireland’s compliance with the Istanbul Convention. The Convention, which Ireland ratified in 2019, seeks to ensure that signatory countries take certain steps (i.e. creating refuge spaces, criminalizing different forms of violence, etc.) to more effectively protect women and girls from domestic violence and gender based discrimination. The report outlined the positive legal and policy measures that Ireland adopted, both before and after ratification, to ensure that it met its obligations under the convention, such as acts criminalizing female genital mutilation in 2012, coercive control and forced marriage in 2018, and adopting a lack of consent-based definition of rape in 2017. However, despite these acknowledged positives the report found several urgent issues which Ireland has yet to address, one of which is that the Irish medical practice of symphysiotomy is and was a gender-based form of discrimination.

Symphysiotomy is an antiquated medical practice where a doctor elects to divide the cartilage of the public symphysis to widen the pelvis to allow for childbirth. The process fell out of favor in developed countries in the mid-20th Century with the advent of the much safer and less life-altering Caesarean section (C-section). Symphysiotomies often involve excruciating lifelong chronic pain, potential movement impairment, and almost complete loss of bladder control for the mother. Despite these terrible side effects, Ireland persisted in its use of symphysiotomies long after the rest of the developed world abandoned the practice. Between 1940 and 1980 roughly 1,500 women were subjected to symphysiotomies. Often these women were told little if anything prior to the operation and were sent home still not knowing what had happened to their bodies.

In 2014, after calls from the United Nations (UN) for accountability, Ireland put in place a redress scheme. Like most redress schemes in Ireland victims could apply to receive compensation, but no fault or liability was admitted by the State, the Church, or any individual doctor, and the victims waived their right to sue by accepting compensation. The scheme was only open for twenty days, making it likely that only a few would have the time to avail of the scheme. Additionally, it was grossly underfunded; allowing women to seek compensation from one of three tiers depending on

the severity of their injuries, €50,000, €100,000 and €150,000. Those who went to court often received more than €300,000 in damages and the knowledge that legal liability was imposed on the perpetrators. The scheme also failed to meet the UN’s call for accountability, as it had no oversight, no one was held accountable, and the women couldn’t make oral submissions.

In the report issued by GREVIO, the insufficient nature of the 2014 redress scheme is brought to the forefront. The report points to the twenty-day window, the disbandment of the liaison officers put in place to facilitate specialized medical and social care, the ceasing of funding for support groups across the country, the lack of support for the disabilities caused to these women, and the lack of legislation providing rights to these women. The report also “strongly encourages” the authorities to quantify the number of victims, provide them with necessary specialist support (physical and psychological), enact legislation to enshrine their rights in law, raise awareness of their rights, and finally facilitate their access to justice.

Click here to see the GREVIO baseline report https://rm.coe.int/grevio-s-baseline-evaluation-report-on-legislative-and-other-measures-/1680ad3feb

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