Abortion and Choice in Malta: Interview with Doctors for Choice

Could you please tell us a bit about yourself?

I graduated from medical school in Malta in 2012 and I am currently completing psychiatric training in the UK. I have seen first hand the mental distress an unwanted pregnancy can cause. After I was informed by my contacts in Malta that a pro-choice doctors’ association was being set up, I accepted their invitation to join. Looking back, I think this was one of the best decisions I’ve made in my life.

Can you tell us about the abortion regime in Malta?

Malta has the most inhumane abortion law in Europe. Abortion is banned under all circumstances even when a woman’s life is at risk. There are no exceptions in the law at all, and the law was certainly not written with women’s health or wellbeing in mind. There are no legitimate abortion clinics in Malta and women have to rely on online abortion pills or abortion clinics abroad to get the healthcare they need.

What are the consequences of abortion restrictions for Maltese society?

The consequences are manifold. The most obvious one is the negative effects unwanted pregnancy and forced birth have on the wellbeing and prosperity of women. There is no legal right to abortion not even in cases of rape or incest, and this is a major hazard to the mental health of survivors of sexual crime. There is no legal right to abortion in cases of fatal fetal anomaly and, unless the parents can afford the exorbitant cost of an often late stage abortion abroad, the fetus with major anomalies is allowed to be born, only to suffer and die after a few hours to days. The prohibition of abortion in such cases is behind Malta’s very high infant mortality rate compared to other European countries. 

It is impossible to describe the myriad of negative effects the abortion ban has on the wellbeing of Maltese society in this space, but for those interested in reading more on this topic we have a position paper on abortion in Malta which can be accessed here.

Malta is as one of the few countries of the European Union in which access to abortion is restricted under all circumstances. Can you tell us a bit about the actors of the abortion debate in Malta?

The traditional opponent of abortion legalisation has been the Catholic church. The vast majority of Maltese identify as Catholic and believe in Catholic teachings to varying degrees. This has led to a high prevalence of opposition to abortion in the general population, and politicians have up until recently been very reluctant to broach the subject of abortion as it could cost them their careers. More recently there has been a reconfiguration in the opposition to abortion in Malta. As Malta legalised civil rights that the Catholic church opposes, such as divorce, equal marriage, and other LGBTI protections and rights, people started to become more aware that laws do not need to reflect religious dogma, and the Church’s sway in shaping legislation gradually lessened. Over the last few years the opposition to abortion in Malta has been shifting from the Catholic church to conservative and far right political parties, and voluntary organisations affiliated with anti-choice networks abroad like Agenda Europe and Heartbeat International.

Most recently, abortion was decriminalised in Ireland in a historic referendum. Do you see this happening in Malta? If so, what would be a pathway towards decriminalisation of abortion in Malta in your opinion?

There are many pathways by which abortion could be legalised, and a referendum is one of them. In my personal opinion, I think an abortion referendum would be winnable in Malta if the pro-choice camp receives the right political support. When we launched our organisation Doctors for Choice in May 2019 opinion polls were showing opposition to abortion in the region of 95%. In around 18 months of campaigning the opposition has already been reduced to around 80%, with around half of under 26 years olds reporting they are pro-choice in the latest survey. We are also seeing an increasing number of high profile politicians, including two ex-prime ministers, speak in favour of abortion rights and this will certainly continue to catalyse a change in public opinion. It is a gradual process, but so far progress has been more rapid than I expected.

Can you tell us a bit about Doctors for Choice Malta and your work there?

Doctors for Choice is not just there to advocate for abortion rights. It is a voluntary organisation that campaigns for sexual and reproductive healthcare in all forms, including sexuality education, freely accessible contraception, and safe, legal abortion. Our work is varied, and it includes advocacy online and on social media, TV appearances, physical events and other manifestations, and research on the need for sexual and reproductive healthcare and rights. Together with other voluntary organisations we form part of a national pro-choice coalition called Voice for Choice, and our role within the coalition is to emphasise the medical and healthcare aspects of the pro-choice campaign. More recently, together with two other voluntary organisations in Malta, we have launched a volunteer-run information service that tells people in Malta how they could access abortion and contraception, as well as giving general information and advice. The service is called FPAS Malta and in the first eight weeks of operations we have seen an average of one person a day contact us for information, which is a significant number in a country with a population of half a million.

This will be a bit personal, but can you tell us about your personal involvement? What motivated you to join Doctors for Choice Malta?

Having been born and raised in Malta, I initially subscribed to the prevalent idea that abortion is morally wrong and should not be allowed. After I graduated from medical school and started training in psychiatry in the UK, a country where abortion access has been relatively good for decades, I began to witness the mental anguish an unwanted pregnancy can cause, and realised that abortion can offer a reprieve to such women. In early 2019, I was informed by my colleagues in Malta that they were setting up a pro-choice doctors’ association. I accepted to join and never regretted it. I feel proud of what my colleagues and I have achieved through our organisation so far.

When we look from the outside, we see that although the law remains the same, there is a growing pro-choice activism in Malta since the last years. Is this the case and if so could you tell us how this came to happen and why now?

There is certainly a momentum behind the pro-choice campaign in Malta. The Women’s Rights Foundation, which is a voluntary organisation based in Malta, made a significant contribution in 2018 by being the first organisation to come out in favour of abortion rights. In March 2019 a number of other voluntary organisations, including Moviment Graffitti, came together and formed a pro-choice coalition by the name of Voice for Choice. In May 2019 we launched Doctors for Choice. Since then the number of organisations in Voice for Choice has continued to increase, with the latest addition being Allied Healthcare for Choice which was launched a few weeks ago. Politicians also seem to be sensing that public opinion is starting to shift and there is a palpable momentum behind the pro-choice campaign, and a number of influential ones, including two ex-prime ministers and Malta’s current EU Commissioner, have come out quite strongly in favour of abortion rights. What is definitely clear by now is that there is no turning back, and the pro-choice campaign is here to stay.

Can you tell us about pro-choice activism in Malta? What are the alliances, opportunities and threats in place, in your opinion?

It is difficult to describe the current opportunities and threats because we tend to respond quickly to these as they arise. We have been generally quick to respond to local developments. We are constantly in the process of forming new alliances locally and internationally, and finding new sources of support. Global Doctors for Choice, with whom we are a partner organisation, have been very helpful in many aspects and we cannot thank them enough.

How did COVID19 affected abortion access and service provision in Malta?

COVID-19 resulted in an unprecedented closure of Malta’s airport for three months between March 2019 and June 2019. During this period the penny certainly dropped on how dependent women in Malta are on abortion services overseas. Requests for abortion pills from organizations such as Women on Web trebled during the lockdown and doctors in Malta’s public hospitals reported an increase in women presenting with miscarriages, a significant proportion of which would be from induced abortion. We think this difficult period, and the reality that came with it, helped many people admit that relying on overseas abortion providers can be unreliable and safe, legal abortion should be provided in Malta after all.

Pregnant people seeking abortion in Malta, what options do they have?

There are three main options: ordering safe abortion pills from organisations like Women on Web, booking your own abortion trip to a clinic abroad if you can afford the cost (usually well upward of 1,000 Euro), or seeking assistance from Abortion Support Network, the main abortion fund that helps women in Malta, if you wish to travel for an abortion but cannot afford all the costs. Whilst thanking these organisations for the essential services they provide to women in Malta, they are unfortunately not a substitute for safe, legal abortion in Malta.

Is there anything else you want to add?

I would like to end on a positive note and say that on a personal level I am very pleased with the progress we have achieved so far. The law has not yet changed, but there is certainly more awareness, and there are more people than ever speaking in favour of reproductive rights in Malta. I am optimistic that a reform of abortion law in Malta will happen sooner than most people expect.

 

Last Updated: 18.11.2020