A doctor’s shocking necessity to ask patients to lie about their abortion

It is shocking when a doctor asks patients to lie but that is what pro-choice doctors are urging women to do when seeking medical assistance after an abortion. 

The reason for such advice is for women to avoid legal complications given that abortion is illegal and punishable by a prison sentence. 

The issue came to light last week when a woman, who admitted having a medical abortion, was handed down a suspended sentence. The woman had gone to hospital after seeing heavy bleeding and told doctors she had taken abortion pills. A police report was filed and the woman was charged in court. 

The judgment caused outcry among pro-choice activists, who warned that the court decision could have a chilling effect on women needing medical treatment and stopping them from going to Mater Dei Hospital. 

In a Facebook post in the aftermath of the court ruling, medical doctor Natalie Psaila Stabile advised women who take abortion pills to lie if they need to go to hospital because of heavy bleeding. 

“If you need to go to hospital, you should never tell anyone that you’ve taken abortion pills,” she wrote. But Psaila Stabile also urged women to “show sadness, upset, and disappointment” at the loss of their pregnancy.  

“I apologise for asking you to lie and act falsely, but this is the only way to keep you and your loved ones safe,” Natalie wrote on her Facebook wall. 

When contacted, she said asking women to lie was something they disliked but necessary so that women can receive medical assistance without the threat of imprisonment hanging over their heads. 

“We do not like to tell women to lie, but in this case, it allows them to get the medical treatment they deserve while avoiding the legal problems that could arise if a doctor or nurse decides to report the matter to the police,” Natalie’s mother, gynaecologist Isabelle Stabile, told MaltaToday. 

Isabelle explained that not telling the truth about what caused the heavy bleeding will “not hinder the medical treatment” in any way. It is akin to having a spontaneous miscarriage, and doctors have no way of knowing the difference between a medically-induced termination and a miscarriage. The treatment for any complications will also be the same. 

“It is shameful that we have to do this but it simply helps anxious women avoid the legal problems,” Natalie said. 

Isabelle explained that medical abortions—the use of mifepristone and misoprostol—are “very safe” and according to the World Health Organisation (WHO) guidelines can be carried out up to the 12th week of pregnancy. 

“But there are, for a variety of reasons, the one-off cases where heavy bleeding occurs and the person would require hospitalisation,” Isabelle said, adding that in these cases, patients are advised to seek help but not say they had an abortion. 

Isabelle and Natalie run an abortion doula support service, which women can call for support and advice. 

Abortion is illegal in Malta except if a woman’s life is in grave danger. Under any other circumstances, abortion is not permitted and the woman is liable to imprisonment. The doctor performing an abortion is also liable to imprisonment and can lose their warrant that bars them from practising medicine. 

As a result, women often resort to medical abortions by buying the pills online and have them delivered to their home. 

In the wake of the latest case, pro-choice organisations have reiterated their call for abortion to be decriminalised so that no woman could be sent to prison. Labour MPs Rosianne Cutajar and Ramona Attard, Parliamentary Secretary Rebecca Buttigieg, Health Minister Jo Etienne Abela and Labour MEP Daniel Attard also expressed outrage over the court judgment. 

Jo Etienne Abela said the law protecting doctor-patient confidentiality should be amended so that doctors do not feel obliged to file a police report if a woman seeks treatment following an abortion.