Is it right to terrorise women into not accessing a service available in the EU?

Dr Chris Barbara is President of Doctors for Choice Malta

“In autumn 2018, before she realised she was pregnant, Julie had no idea that in Malta you could end up in jail for undergoing an abortion. “As I discovered it, I just panicked,” she recalls. When Julie googled “Abortion Malta”, she found nothing of use. Instead of websites outlining services for terminating pregnancy, she was faced with dozens of pages set up by Catholic ‘pro-life’ activists. “I was ready to do anything. I had suicidal fantasies sitting at home. This one single thought was going through my mind over and over again: I need to get rid of it.”

Julie’s story will be all too familiar to those women and girls in Malta who have faced an unwanted pregnancy and did not wish to remain pregnant. Our toxic combination of poor (if any) sexuality education in schools, limited knowledge and use of contraception, and the absolute criminalisation of abortion sets women and girls up to fail, with potentially devastating consequences on their lives.

Those who want to access abortion from Malta face not only legal hurdles, but also a barrage of biased portrayals of abortion. Women in Malta are often unable to obtain factual information on what abortion actually is from the national health service, and many a times their usual doctor will also refuse to discuss the option of abortion.

I, along with a team of committed pro-choice activists, set out to change all that. Our motivation is a simple one: Women and girls have a right to factual information on reproductive healthcare, including abortion and contraception, so they can make their own decisions. It is for this reason that in August 2020 we set up Malta’s first Family Planning Advisory Service (FPAS).

In its first six months of operations, FPAS received requests for information from no less than 203 different clients. This averages to more than one client a day, which represents a huge unmet need for a small country like Malta. As can be expected, the majority of information requests were about abortion, but a significant proportion – more than a quarter – of requests were about contraception and a minority were about other reproductive health services like antenatal diagnosis, IVF and PGD.

FPAS has grown into a team of over twelve volunteers who are not only pro-choice, but also knowledgeable about the subject of reproductive health and some are qualified medical or social care professionals. Members of our team can speak a variety of languages, which is essential in the diverse society Malta has become.

As we approach the first anniversary of FPAS, let me give you some insights of what I have learnt as a volunteer for this service.

Women and girls have abortions for many reasons. But, to my surprise, the reason most commonly disclosed for seeking an abortion is along the lines of “I already gave birth some months ago and another child would cause hardship to the whole family.” It is not the first time I struggled on an FPAS call with an infant screaming in the background! These women have taken the often difficult decision to have an abortion to protect the wellbeing of their families.

This is what studies abroad have also found – that the majority of women having abortions already have children. This is not the typical stereotype people have of women seeking abortion, and realising this was a learning experience for me as well.

The lack of timely antenatal diagnosis in Malta and the lack of abortion in cases of fetal anomaly are counterproductive. We have had requests for abortion information from women with known genetic conditions who became pregnant and could not travel abroad for proper antenatal diagnosis and care during the pandemic.

We have also had similar requests from women who receive a diagnosis of major anomaly late – over 22 weeks in most cases – and have to travel abroad for a third trimester abortion. This lack of timely antenatal diagnosis in Malta is contributing to more abortions and later abortions.

Women and girls in Malta are having abortions every day – literally – since on average one abortion pill pack is shipped to Malta each day. This is from information provided by Dr Rebecca Gomperts from Women on Web, one of the main organisations that offers abortion telemedicine services to Malta, and is also in keeping with the number of requests on this topic we receive on FPAS. It is therefore clear that the law is not achieving its intended effect of eliminating abortion from Malta, far from it. What it does, however, is cause distress and anxiety to these women and girls.

We regularly take calls from distressed women who are resolute on ordering abortion pills, but are terrified that they would have the police knocking on their door. There is not much we can do in these situations, because abortion is still a criminal offense in Malta, except to offer some comfort with the fact that no woman has been prosecuted for an abortion in the last five years, and no woman has gone to prison over an abortion in the last twenty five years. Is it right of the Maltese state to use the force of law to terrorise women into not accessing a service that is available in all other EU states? Of course not, and it borders on moral depravity. It is even worse when you consider that the ones who have to resort to the criminal act of having an abortion in Malta are those who cannot afford to have it done legally abroad.

Until this injustice is rectified and Malta has an abortion law that allows women to access the care they need through the national health service, FPAS will remain here to give information and signpost to appropriate services. FPAS is also open to those who want factual information and/or help with accessing contraception, including the morning after pill. You can reach us through chat on www.fpas.mt or by calling 27780037. We are pro-choice and we are ready to help.