A shocking number of deaths and widespread abuses at religious institutions in Ireland for unwed mothers and their children was revealed in a government-commissioned report released Tuesday, a measure that survivors say is a small first step toward accountability after decades of horrors.

The report, the culmination of a six-year investigation, detailed some 9,000 deaths of children at 14 of the country’s so-called Mother and Baby Homes and four county homes over several decades, a rate much higher than that of children in the rest of the population. The institutions, where unmarried women and girls went sent to give birth in secrecy and shame and often forced to give their children up for adoption, also saw unethical vaccine trials carried out on its residents, the report found.

For decades, the stories of these places and the atrocities carried out there, were largely unspoken — despite calls from the mothers who became virtual prisoners within their walls and children who spent their earliest years there later sharing stories of neglect and abuse.

But as the country has made strides to reckon with uglier aspects of its traditionally conservative Roman Catholic roots, deeply intertwined with the foundation of the state, there have been moments in recent years when the true scale of the abuses of a system that extended far beyond one institution have been thrust into the light.

Tuesday was one of those days.

But survivors of the homes say urgent action from the state is also needed, and many say the Roman Catholic church, which ran the homes, needs to be held accountable.

Ireland’s leader, or Taoiseach, Micheal Martin and country’s minister for children, Roderic O’Gorman, spoke with survivors earlier in the afternoon by video, to discuss the contents of the report, which is more than 3,000 pages long, before publicly revealing its findings. Mr. Martin is expected to issue an official state apology in front of Parliament on Wednesday.

The country’s Mother and Baby Homes were run by religious orders, starting in the 1920s, and backed by funding from the Irish government. But the institutions where young women and girls were taken, typically against their will, are not a thing of Ireland’s distant past. The last of the facilities was closed in 1998 — and many survivors of these homes are still living with the painful fallout of their time in these institutions.

The commission, which focused its report on 18 institutions between 1922 to 1998, was set up after reports emerged that the remains of nearly 800 babies and young children were interred in an unmarked mass grave at a former Mother and Baby home run by the Bon Secours nuns in the town of Tuam in County Galway.

Attention was initially drawn to the situation by the extensive research of a local, amateur historian, Catherine Corless, who pieced together records showing dozens of suspicious deaths of infants and children at the St. Mary’s Mother and Baby Home, but no graves associated with them. Ms. Corless, who began her research in 2012, relying on a handful of records and the harrowing lore of locals who came across the bones in what was once a septic tank, first exposed the horrors in 2014. She spent years working to document the deaths, and has worked with survivors of the home to help tell their story and call for an investigation.

“It has been a long journey, and it hasn’t been easy,” Ms. Corless said in an interview on Tuesday morning, shortly before the report’s release. As evidence had piled up over the years, she said she felt compelled to pressure the government to take notice. “That’s all I could do: keep talking, keep being a voice for the people who had no voice.”

In the wake of her diligent and detailed work, the government was forced to pay attention and formed the commission in 2015. A significant number of human remains were found at the site in Tuam in 2017 during an excavation.

Ms. Corless acknowledged that Tuesday was a “big day” for survivors, but said an apology from the state simply did not go far enough. She said the Bon Secours nuns, who ran the facility in Tuam, and orders that oversaw others, needed to be held accountable.

Throughout her time researching, she said, it was impossible to get the church to cooperate or offer any insights to what had happened there.

“It was the state and religious groups that were complicit for all of those long years,” Ms. Corless said. “A lot of people have left the church because they haven’t come forward to help survivors in this in the past few years. They’ve just more or less dismissed the whole episode.”

But the atrocities did not just play out in Tuam. The 18 homes in Tuesday’s report spanned the country, from central Dublin to remote communities in the far northwest of Ireland and were run by different groups of Roman Catholic nuns.

The report, which looked into reports of unethical vaccine trials, reports of abuse and appalling conditions at the home, detailed how 56,000 unmarried mothers and about 57,000 children came through the homes investigated by the commission during a 76-year period. It attempted to differentiate between the earliest years of the home and those that came later.

“In the years before 1960 mother and baby homes did not save the lives of ‘illegitimate’ children; in fact, they appear to have significantly reduced their prospects of survival,” the report said. But while the executive summary noted that the women and children “should not have been in the institutions” it said there was “no evidence of the sort of gross abuse that occurred in industrial schools.”

The homes were just one part of a larger system that exploited and suppressed some of the country’s most vulnerable women and girls, as evidenced in the notorious institutions known as the Magdalen Laundries, underpinned by an Irish society that stigmatized unwed mothers. Considered “fallen women,” they were relegated to the fringes, and even when they were not confined to Mother and Baby Homes — were often pressured into giving up their newborns, often in shadowy adoptions. The church facilitated the adoption of some of those children with American families.

Philomena Lee, perhaps one of the best known survivors of the Mother and Baby Homes — after an award winning book and a film told the story of her search for a son she was forced to give up for adoption — said she had waited decades for this moment.

In a statement issued Sunday, she described a pregnancy met with “horror” that saw her shuttled away to Sean Ross Abbey, a Mother and Baby Home in County Tipperary. Her son, Anthony, was forcibly taken from her and sent for adoption in America. By the time she discovered her son’s identity — he grew up as Michael Hess, a legal aide in the Bush and Reagan administrations — he had already died.

She said the secrecy around the commission’s investigation and final report had only deepened the pain for many of the survivors, and “that the Irish state, having breached so many of their human rights, seeks to prevent them from knowing the truth about their early lives.”

Survivors rights groups have long expressed concern that the mothers, adopted children and others impacted by abuse in these institutions have not been given access to their personal records turned up by the commission, and have been critical of the lack of consultation. Many have never had access to these original documents, as the church orders that ran the homes kept their origins secret, their “illegitimate” births hidden.

“It seems to me that this is a deliberate ploy to hide from the survivors and the world the shameful way they treated our children,” Ms. Lee said.

Ms. Lee said she was also dismayed to see portions of the report had leaked to the press ahead of its formal publication on Tuesday, before survivors had time to read it. After Ireland’s Sunday Independent published details of the report this week, KRW Law Human Rights, which represents a number of survivors, said the leak had further undermined confidence in the Commission and the government’s response.

For the survivors, the report is only the start, Ms. Corless said. She said she believes its time for the church and the religious orders involved in the abuses to apologies and work with the survivors.

“Really and truly, they need an apology, not just want it, they need it for healing,” she said. “We are depending on that.”

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