We need to think carefully about how we frame symphysiotomy. Women did not "tend to have" many babies in some sort of careless oversight. Their reproductive autonomy was restricted by law and by medical practice. https://twitter.com/IrishTimes/status/1337302735046098944

Who considered both sterilisation and contraception "off-limits"? Whose beliefs? Prevalent at what time? Did anything change from 1944-1987 (the laws and practices relating to different forms of artificial contraception, for example)?

What does "fed into the calculations" actually mean? It means some doctors substituted one obstetric procedure for another, based on the assumption that more babies = better, without consulting with their patients and without understanding the relative risks.

Whether you think symphysiotomy should generate some more concrete legal liability, or whether you think it is a relic of an unfortunate past that should not be repeated, nobody benefits from glossing over the power relations that enabled it.

One of the saddest aspects of Repeal was watching older women grappling with the idea that perhaps they might have preferred to have fewer babies, or to have them (us!) differently. Reproductive autonomy is not a new notion. Many women wanted choices and got symphysiotomies.