COVID-19 created double barrier for Maltese women’s access to abortion

The shutdown from COVID-19 in Malta laid bare the barriers for women to have access to abortion services

The shutdown from COVID-19 in Malta laid bare the barriers for women to have access to abortion services, with more people reaching out to activists and charities and seeking medical abortion pills online.

Pro-choice activist Liza Caruana-Finkel, an independent researcher, said COVID-19 had highlighted the problems of a system in which pregnant people in Malta secretly travel for abortions abroad or secretly order abortion pills online.

Writing in the journal Sexual and Reproductive Health Matters, Caruana-Finkel said Malta’s travel restrictions due to COVID-19 led to an increase in the number of people reaching out to activist and abortion support groups and a surge in people ordering medical abortion pills online.

Caruana-Finkel, an activist for Voice for Choice, reported delays in receiving this time-sensitive medication such as medical abortion pills, which can be safely self-managed during the first 12 weeks of gestation. When such pills became unavailable due to disruptions in the supply chain or postal services to Malta closing, access to abortions was blocked.

“Unfortunately, Voice for Choice has become aware of unverified and potentially dangerous online sources offering abortion pills in Malta, all created between March and May. The current crisis is being exploited for financial gain,” she wrote.

The harmful consequences of COVID-19 on reproductive health were also evident in personal testimonies from Malta.

“One such story is of a woman who experienced extreme anxiety and denial when she found out she was pregnant. While she waited for abortion pills to arrive from abroad she searched for herbal remedies online and had daily suicidal thoughts. Another woman was unable to purchase her usual contraception and was raped by her abusive partner, which resulted in an unwanted pregnancy.”

She said that at the beginning of the COVID-19 pandemic the Maltese government ensured an extra stock of medicines to prevent shortages, but oral contraceptive pills were not included because they were not listed as essential. “Living in a country with substandard SRHR during a pandemic is untenable. It is likely that pregnant people will resort to unsafe methods to end unwanted pregnancies.”

Caruana-Finkel wrote that Malta’s abortion ban was a structural and symbolic state violence, that caused discrimination and inequality for women.

“Women in Malta lack bodily autonomy and are not trusted to make decisions about their own lives. According to international and European human rights law, states have the duty to ensure that SRHR are protected and respected. States’ human rights obligations should not be obliterated in times of crisis.

“Yet Malta’s government has made no attempt to address and reform the country’s draconian abortion laws, or in any way facilitate access to abortion care abroad during this pandemic. Instead, pregnant people are criminalised for accessing care that should be provided locally…

“We cannot wait for the pandemic to be over before focusing on SRHR. Abortion is time-sensitive, essential healthcare, and must be prioritised during COVID-19. We should not wait for a tragedy before enacting change.”

Liza Caruana-Finkel
Liza Caruana-Finkel

Malta remains the only EU and Commonwealth country with a total legal ban on abortion, despite its progressive steps to legislate divorce and introduce emergency contraception and same-sex marriage. Both main political parties have publicly affirmed their opposition to abortion.

Estimates suggest that over 500 women in Malta access abortions each year, many travelling to countries according to their financial means and mobility. The other safe, though illegal way to access abortion from Malta is through the online purchase of medical abortion pills mifepristone and misoprostol, from reputable organisations such as Women Help Women and Women on Web.

But the establishment of a pro-choice movement in 2019, together with pro-choice  medical professionals, led to an increase in abortion talk in the public sphere.

“Despite this shift in public discourse, abortion remains highly stigmatised in Malta’s pro-natalist society,” Caruana-Finkel wrote. “Misinformation is spread through various channels: social media, traditional media, school education, and religious institutions. Criminalisation has led to a chilling effect in those seeking abortions and in healthcare professionals.”

Caruana-Finkel also said that due to the fear of potential legal repercussions, women may delay seeking medical attention in rare events of post-abortion complications, while many healthcare professionals in Malta are reluctant to provide information about abortion, even though it is legal to do so.

“Most abortion experiences remain shrouded in secrecy and silence,” Caruana-Finkel said, adding that having to travel abroad for healthcare is “inhumane” and discriminates against individuals who are unable to do so.

Abortion Support Network is now providing financial assistance to Maltese residents, but there are other barriers. “A pregnant teenager, a single mother without access to childcare, a woman living with an abusive partner, an individual with disability, and an asylum seeker lacking travel documentation all face additional obstacles. Unfortunately, there are also anti-abortion organisations targeting women with misinformation and deception to prevent abortion access,” Caruana-Finkel said.

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