Abortion is termination of pregnancy

Malta’s main political parties run their own surveys to determine what legal changes are likely to be popular with their core voters. We are not privy to their findings but when the Prime Minister announces that the blanket ban on abortion will shortly be no more, we can be sure that those in government are convinced that by introducing these amendments they will not lose a significant number of votes.  In a few days, for the first time ever, Malta will have an abortion law that recognises the fact that a pregnant person’s life may need saving.

A few months ago, Malta failed Andrea Prudente, a US citizen, who visited Malta while pregnant. She became trapped here after her waters broke at 16 weeks. The placenta was detaching from her womb and no fluid was left, which meant there was no reasonable hope that the fetus would survive. She was also at risk of a life-threatening infection for as long as the pregnancy continued.

Had this happened practically anywhere else but Malta, Prudente would have been given the option by doctors to terminate the pregnancy and safeguard her health. However, this could not happen in Malta because abortion is illegal under all circumstances. She could only continue the pregnancy under the watchful eyes of doctors and suffer the ongoing risk of infection.

Flying to another country on a commercial flight was not an option due to the high risk of a medical emergency in-flight. Fortunately, her private insurance deemed the risks to Andrea’s life in Malta unacceptable, and organised and facilitated transfer by air ambulance to another country that does not limit women’s right to health and life.

This exact same medical scenario happens to an estimated two to three women per year in Malta, but most of the women living here do not have private insurance to help them evacuate from their own home country to get their much-needed treatment abroad.

Within the local legally restrictive environment, there are factors which inhibit the provision of abortion care as a result of a lack of clarity within the law. A chilling reality is that any health and social care provider may choose to alter their provision of care to ensure they protect themselves. Lack of clear guidance and regulation inhibits safe and effective abortion care provision.

The team looking after Prudente were clearly operating within the uneasy environment of having to make a decision to terminate a pregnancy (i.e., providing abortion) within a highly legally restrictive regime. There is no difference between abortion and termination of pregnancy before a pregnancy is viable, at around 24 weeks. This has now been formally acknowledged by the Prime Minister who has publicly stated that medical teams have for decades been making decisions to terminate pregnancies in clear breach of the law. Medical teams should never have their hands tied in fear of being accused of breaking the law when medical complications put the health or life of a pregnant person at risk.

Moreover, our responsibility towards our patients demands that we try to treat conditions before they become unstable and life-threatening. In cases of complicated pregnancy, abortion may be required to protect a woman’s physical and mental health.

Soon after the Prudente case broke, doctors in Malta refused to accept this legal situation and within just four days, 135 doctors signed a judicial protest asking for a review of our blanket ban on abortion care. Among them were Specialists in Obstetrics and Gynaecology, Family Medicine, Psychiatry, Paediatrics, and more. The overwhelming sentiment behind this demand was empathy.

We submitted this judicial protest to safeguard persons who may fall pregnant and the doctors taking care of them. Patients in Malta deserve access to the highest standards of medical care possible, in line with international recommendations, such as those of the WHO, FIGO, and RCOG.

We are very grateful to the government of Malta for listening to our concerns, and to reconsider and update laws created in 1850s. This will allow doctors to practise evidence-based medicine, without condemning public citizens and their doctors to criminality.

Voice for Choice has lobbied hard over the past three years to help to eliminate Malta’s archaic abortion ban. This is a first step in the right direction.

We are proud of the results of our efforts, but we feel we have much further to go: abortion must be decriminalised altogether!