[WATCH] Isabel Stabile: ‘Keeping abortion illegal is not deterring women’

Nearly 600 women in Malta had abortions last year, reflecting a 15% increase from the previous year, which had already seen a 20% rise compared to the year before. 

These numbers represent a reality check for Malta, Prof. Isabel Stabile, an academic and pro-choice activist, tells me as we sit down for this interview. 

“So, we can safely say that the law as it stands is not working. It is not a deterrent for women… with our abortion doula service, we get calls on a daily basis,” she says. 

“In fact, I had a call just this morning, and I expect I’ll have at least one more today. We do get approximately one to three calls every single day,” Stabile tells me. 

Abortion remains illegal in Malta with the changes enacted in 2023 only meant to give doctors the legal certainty that they can terminate a pregnancy if the woman’s life is in danger. The original Bill had also included an exemption for circumstances where the woman’s health is at risk but this was eventually dropped from the final wording. 

Stabile does not hide her disappointment with the law as approved. “We believed that our politicians were listening to our advice because our advice was coming from the ground,” she says. 

She argues that by excluding both mental and physical health considerations, the law only applies to extreme cases, leaving many women without access to necessary care. 

Reacting to the political shift in Europe, particularly with conservative parties gaining influence, Stabile expresses concern that abortion rights could be threatened. She says that Malta effectively “exports” its abortion-related issues, particularly by sending women with fatal foetal anomalies to other countries where abortion is legal. 

“Without access to these outlets, women in Malta may be forced to continue unwanted pregnancies, some of which already do,” she says. 

The following is an excerpt of the interview. 

Watch the full interview on maltatoday.com.mt, Facebook and Spotify. 

You were recently honoured with the Tulip Award by the Dutch Embassy for your work in abortion rights activism. Could you share your thoughts on the significance of receiving this recognition from a foreign country, in a country where abortion rights remain severely restricted? 

It was an incredible surprise and a great honour. The Dutch embassy was one of the very few embassies that were allowed to actually award a prize. And for the first time ever, they honoured a Maltese activist working on human rights, because reproductive healthcare, especially abortion, are human rights, and therefore it is important that we actually recognise that… 

With the rise of conservative parties across Europe, such as the AfD in Germany, there is growing concern that abortion rights could face increased challenges. In light of this political shift, how do you foresee the future of abortion rights in Europe affecting women in Malta, many of whom already travel to other European countries to access abortion services? 

…we import solutions to our problems by importing pills, but we export our problems. Our problems being women with fatal foetal anomalies who need to travel to another country where it's legal to have an abortion. 

So, this is an important outlet for us. And if we don’t have that outlet, then women will be forced to continue with their pregnancies, as many of them, unfortunately, still do… If the situation in Europe closes down; women are less likely to actually be able to find a home, if you like, for their abortion. 

There is an entity called the Abortion Support Network that provides an immense amount of support to women in Malta. And remember, when I say women, I really mean anyone who could get pregnant. So yes, we are worried about what’s going to happen in Europe, but we need to fight against it. We need to help each other fight against it. 

In 2023, Malta amended its abortion laws to allow for the termination of a pregnancy if the life of the pregnant woman is at risk, provided that approval is granted by a team of medical professionals under specified conditions. However, a provision allowing termination for health reasons was ultimately excluded from the final version of the law. What impact do you believe this exclusion has on women seeking medical care? 

We were very disappointed as the Voice for Choice coalition, because we made a great deal of effort, and we believed that we were being listened to. We believed that our politicians were listening to our advice because our advice was coming from the ground. We know what women need in Malta. So, it came as a big surprise and a big disappointment, frankly, that they did not include the clause you’re talking about, and especially when they added a clause that we had never proposed, which is having three doctors endorse this. 

What is interesting at this point is to know how often this legal amendment has in fact been used. How many abortions have happened in Malta since the law was amended? And although I don’t have an official figure, I’ve been told it’s around 8 to 10, which means that 8 to 10 women actually had their lives saved by this law. OK, so this is a good thing.  

However, I want to make it clear that while the law in place is not a step backwards, it’s certainly not what we wanted, and we would like the law to change; to make it simpler for women to have abortions, and especially include the issue of mental and physical health, because the law as it stands, can only really be invoked in extreme cases… 

[…] 

Despite the legal changes, Malta’s laws still threaten doctors with criminal sanctions for performing or assisting abortions that don’t fit the criteria mentioned above. How does this affect doctors in the course of their work? 

In my case, because I work entirely in private practice, that hasn’t really happened. Because when I see someone who is in need of an abortion for whatever reason, and it’s not up to me to decide whether that reason is a valid one or not, I can make the appropriate referrals. I can make the referrals to safe, reputable organisations that can organise the delivery of medical abortion pills to Malta… 

Just about 600 women had abortions last year in Malta, which is about 15% more than the year before, which is another 20% more than the year before that... So, women are having abortions in Malta, in spite of it being illegal… the law as it stands is not working. It is not a deterrent for women… with our abortion doula service, we get calls on a daily basis. In fact, I had a call just this morning, and I expect I’ll have at least one more today. We do get approximately one to three calls every single day. 

Moving on to the sexual health strategy unveiled at the end of 2024, what are your thoughts on the proposals, particularly the inclusion of the morning-after pill (MAP) on the national formulary list? Do you think the overall strategy is a step in the right direction? 

I do congratulate the ministry for finally producing a paper and taking cognizance of the research that was done to inform the proposals being made. However, what is surprising is that in the published report… there’s very little in terms of actual outcomes, actual timelines, who is responsible, and how much money will be devoted to these things. So, it’s a little wishy-washy, but nonetheless, there are plans, and for this, we are very grateful. 

[…] 

Putting the morning-after pill and contraception on the formulary is a step in the right direction. Nobody wants to have an abortion. So, if we can prevent them, even better… the fact that there is no timeline at all but is rather worrying. When we asked during the strategy launch what the timeline was, we were told that these would be rolled out gradually over the next six years. Well, we’ve been waiting 12 years. Six plus 12 is 18. We will have an adult by the time these proposals are enacted. 

It’s also very sad to see that although the research that they themselves published in this document shows that there is support for decriminalising abortion, there’s absolutely nothing at all in this document that relates to that. 

Do you foresee that happening any time soon? Is there an appetite to do more? 

The right word is appetite, political appetite, which is, of course, balanced by votes… the actual law as it stands right now is not a deterrent. It is not working, and not only is it not working, but it is actually putting the lives, certainly the well-being, but possibly the lives of women at risk. 

Why? Because anyone who’s having a complication from these pills, which, by the way, is very rare… These women are fearful of going to seek medical care in the public hospitals for very good reason. We know of a number of cases where women have been reported. 

If the government wishes to use, shall we say, a wedge to try and change the public discourse, this is the way to do it… as a first step, if you decriminalise abortion, and you sell it to the public as “we are saving lives” – which is exactly what you’re doing – then you have a situation where women can safely achieve and access the healthcare that they deserve.  

[…] 

Do you think there is potential for further progress in legislation surrounding women’s health and sexual health in Malta anytime soon, or do you believe the country has reached its limits in these areas for now? 

I am confident that the law will change. And I think this because – and I won't mention any names – there are politicians who speak privately to me and to my colleagues, endorsing the decriminalisation of abortion. So, there is a certain understanding from parts of our political class. I won’t say it's across the board, but large parts of our political class are privately in favour of abortion because they understand the impact it’s having on women’s lives. 

Now, all we need is for that to be translated into legislation… it’s about the balance between risk and benefit for them, and ultimately, it’s all about votes. But hopefully, hopefully, we will see some spine in our leaders, and they will finally realise that if they wish to be recognised for actually making a difference in women’s lives, they should decriminalise abortion.