Maltese doctors do not agree with total ban on abortion, survey finds

A survey billing itself as the first ever data on the views of doctors in Malta on abortion, polled 454 practitioners and specialists to find support for abortion when a woman’s life is in danger (66%) or for a non-viable fetal anomaly (63%) up to 12 weeks’ gestation.

The survey, published in Sexual and Reproductive Health Matters journal, found a clear majority of doctors in Malta “who do not agree with the total legal ban on abortion and support its legalisation in limited circumstances.”

But there was little support for abortion in other cases such as ‘rape or incest’ (35.3%); ‘preserving a woman’s physical health’ (30%); ‘preserving a woman’s mental health’ (26.8%); ‘viable fetal anomaly’ (24.6%); ‘younger than 16 years of age’ (23.8%); ‘economic/social reasons’ (18.9%); or just any circumstance (14.5%).

“We hope that this information, as well as results on other reproductive health methods, will inform and further enable the discussion around the topic in Malta. This study should serve as a baseline for repeat future studies to assess changes in the position and views of Malta’s medical doctor cohort,” said researchers Gilbert Gravino and Liza Caruana-Finkel.

The public debate on abortion in Malta, which remains illegal, has changed over the last two years, with more NGOs demanding changes to criminal provisions against doctors and women who procure abortions. In February, the UK charity Abortion Support Network extended its services to Malta, providing logistic and financial assistance for Maltese residents to access abortion abroad. March also saw the launch of the very first Maltese pro-choice coalition, Voice for Choice, as well as Doctors for Choice, advocating changes in the law and support for evidence-based reproductive healthcare.

The researchers managed to contact 1,578 (64%) of Malta’s registered doctors via email, adding that not all questionnaires might have reached retired doctors who are still registered with the Malta Medical Council. “In fact, all the respondents were practising doctors. Consequently, the results are more likely to be reflective of the 2018 practising doctor cohort than the entire registered cohort. This is not regarded negatively since ultimately it is the practising doctors who influence current and future practice,” the researchers said.

While abortion is illegal in Malta, this does not prevent Maltese individuals from travelling abroad in order to secure an abortion. In England and Wales, an average of 57 Maltese women per year were reported to access abortion services between 2011 and 2017, more than one woman per week. This does not include women who travel to other European countries for this purpose.

“Older age groups and religious doctors were evidently in greater disagreement with the legalisation of abortion and with all the methods of reproductive planning questioned in this survey, when compared with younger and/or non-religious doctors. On the other hand, there is no evidence of a significant difference between the views of male and female doctors. It appears that religious affiliation and age have an influence on the opinions of Malta’s medical doctor cohort questioned in this study. This implies that further socio-cultural changes and expansion of secularisation within the Maltese community might lead to a shift in Malta’s doctors’ views on methods of reproductive healthcare,” the researchers said.

“The complete ban of abortion by law also has an impact on their work when caring for patients who wish to access abortion, and in dealing with abortion complications or the after-effects of unsafe abortions. It is therefore imperative that their views on these issues are explored. To our knowledge, this is the first study looking into such data. This study aims to identify the opinions of medical doctors in Malta on whether these methods of reproductive healthcare should be legal,” the researchers said.

Full data

Woman’s life in danger: In case of a “Woman’s life in danger”, a majority of 54.2% of the respondents were in favour of legalisation “In all stages” of pregnancy. The other responses in favour included a further 5.1% “Up to 24 weeks” and 7.5% “Up to 12 weeks”. This means that a majority of 66.8% favoured the legalisation of abortion at least up to 12 weeks gestation in this circumstance. “Woman’s life in danger” had the greatest majority favouring its legalisation, when compared with all the other circumstances questioned in this survey.

Non-viable fetal anomaly: 50.2% of the respondents were in favour of legalisation “In all stages” of pregnancy in the case of a non-viable fetal anomaly. The other responses in favour included a further 6.2% “Up to 24 weeks” and 6.6% “Up to 12 weeks”. This means that a majority of 63.0% favoured the legalisation of abortion at least up to 12 weeks gestation in this circumstance.

Rape or incest: The percentage of participants who disagreed with legalisation of abortion in the case of “Rape or incest” was 51.8%.

To preserve a woman’s physical and mental health: With regards to a pregnant woman’s health, 50.4% disagreed with legalisation “To preserve a woman’s physical health”, and 56.2% disagreed with legalisation “To preserve a woman’s mental health”.

Viable fetal anomaly: A majority of 67.4% of participants disagreed with legalisation in the case of a “Viable fetal anomaly”.

Under 16 years of age: A majority of 68.7% of participants in the study disagreed with legalisation of abortion in the case of a person who is aged under 16 years.

Economic and social circumstances: 74.0% of participants disagreed with legalisation of abortion in this circumstance. Out of all the specific circumstances in question, socio-economic reasons garnered the greatest opposition.

Any circumstance: The percentage of participants who disagreed with legal abortion in “Any circumstance” was 78.0%. As expected, abortion without circumstantial restrictions (i.e. upon the pregnant person’s request) had the largest opposition.