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This chapter examines symphysiotomy in twentieth-century Ireland as one example of a systematized obstetric violence that has characterized Ireland’s modern history. Expanding scholarly interpretations of state- and Church-inflicted abuse of women in the twentieth century, this analysis establishes the medical profession as a central actor alongside the twentieth-century state-Church coalition that regulated women’s reproductive lives and engaged in systematic repression. This chapter recognizes that Ireland’s history of reproductive abuse and coercion did not just involve contraception or abortion but also labor and birth experiences. In addition, it offers a more complete and complex interpretation of obstetric violence by highlighting the experiences of married women with wanted pregnancies; almost all research to date focuses on the experiences of unmarried pregnant women or unwanted pregnancies. This examination of symphysiotomy and obstetric violence in Ireland illuminates the ways in which religious, national, and medical power has been mapped on women’s reproductive bodies, particularly in the decades after independence in 1922. It also makes essential links between Ireland’s past and present, demonstrating that a careful analysis of the history of obstetric violence and the religious underpinnings of it are essential in understanding Ireland today. With this research, we also place symphysiotomy within the context of the global reproductive justice movement, asking how a reproductive justice framework – one that links reproductive rights with social justice – can help us interpret obstetric violence and address the wounds of Ireland’s past.

It is estimated that approximately 3,000 women develop obstetric fistula, leading to unhealthy pregnancy, early and prolonged labor, and in some cases stillbirth in Tanzania every year. Fistula often compounds the vulnerability of the women who are victims of a poor health facility, early marriage, and other gender gaps.

In this chapter, the author explores the extra-medical causes of fistula in remote locations (Pwani Region) of Tanzania from a practitioner’s perspective. The author considers the stories of four women who experienced fistula. The author interviewed the women over a period of five years between 2013 and 2018. Using narrative analysis, the author examined the interviews.

The narrative analysis indicates that fistula is a product of a gender biased social system that favors men, ultimately limits women’s freedom, stifling their development. Importantly, the main value of this analysis is to promote awareness that aside from medical treatment, social interventions are required to reconstruct the social belief system and eliminate the stigma associated with obstetric fistula. A list of social interventions that proactively manage the incidence of fistula and help integrate affected women back into the society sustainably is recommended.