Infant mortality rates at the Tuam mother and baby home were compared to those of the 1700s, in confidential 2012 HSE documents. They also say that “senior church figures” had been involved in what amounts to child trafficking from the Tuam home to the US.

The “strictly confidential” document was prepared by Dr Declan McKeown, consultant public health physician and medical epidemiologist at the HSE in October 2012.

He said infant mortality rates (IMR) at the Bessborough mother and baby home in Cork were “in the region of 25 per cent” between 1934 and 1953, which was five times the rate for Ireland in 1950 and 65 times the rate in 2012.

It was, he said, “equivalent to the IMR in Ireland in the 1700s”. Registers from the Tuam mother and baby home for the 1930s, for the numbers of children who died in their first 12 months, were “similar to those recorded at Bessborough”, he said.

Causes of death were given as “croup; congenital debility; congenital idiot; Phthisis (TB); whooping cough; tuberculosis, meningitis, gastritis”. He added however that “there is unfortunately no way to validate these deaths”.

Questions about “the veracity of the records are suggested by causes of death such as ‘marasmus’ (severe malnutrition) in a 2½-month-old infant or ‘pernicious anaemia’ in a four-month old”.

“These diagnoses would be extremely unusual in children so young, even with the reduced nutrition of the time,” he said.

Adoption

He had also found in the Tuam archive “correspondence from senior church figures of the time (pre-1950)” who wrote to the nuns “requesting that babies be made available for adoption to the USA”.

He continued that in one case, the child of a named women was suggested for transfer to American adoptive parents. In the case “of an infant sent to a family in Louisiana in 1957, a sum of approximately £50 was paid to the order both by the adoptive parents and by the natural [birth] mother”, he said.

The Tuam mother and baby home “charged a fee to birth parents and adoptive parents for the upkeep of their children”, with records “of parents receiving bills for the upkeep of children who had been discharged some time before”.

Money requests

In one Tuam case, dating from the mid-1950s, he found letters from the county manager and sister-in-charge “discussing one named mother who had left her baby in the care of the home and had apparently travelled to the UK to find work. The nuns had sent requests for money to the mother’s given address, but with no result.

“The option of sending in the Gardaí to retrieve the requested sum was discussed. The archive files indicate that this was standard practice at the time. Letters were sent to the local Garda Superintendent to visit the woman’s home and attempt to encourage payment in this manner.”

He also found that “admission and discharge data for Tuam seems to suggest that women and their babies were kept in the home for much longer than their medical and obstetric care” made necessary. Correspondence indicated “that the nuns insisted on mothers staying for at least 12 months after the birth of their baby”.

“It was stated that this was for the baby’s wellbeing,” he said.

One woman “requested through her solicitor that she be released before the 12 months in order to work, but her request is denied”, he said.

In the Tuam archive, there were “recorded instances of women and young girls being admitted from, and discharged to, psychiatric hospitals in the region”.

“The reasons or clinical indications for this are unclear at present,” he said.