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‘It Is My Duty To Discuss All Options’: Five Healthcare Professionals On Malta’s Abortion Ban

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Malta’s full ban on abortions leaves hundreds of women per year in the dark alone. Each year, an estimated 400 Maltese women have an abortion, despite the fact that it is illegal.

That is hundreds of women per year having to deal with the stigma, the judgement, potential criminal prosecution and the insecurity of being pregnant with a child you can’t have in a country that won’t give you a choice.

The publications Dear Decision Makers collected nearly 50 of those stories. Some women were forced to give birth against their will, while others got pregnant after they were violently raped.

Many of the girls in the publication were pregnant before they even turned 18 themselves, while other women had to risk their life or knew they would give birth to a child with anomalies that wouldn’t survive.

But besides women who had to go through having an abortion abroad or illegally themselves, the publication also includes stories of healthcare professionals who have to live through not being able to help some women out because of their country’s archaic laws.

While many healthcare practitioners will not give out information about abortion when women indicate they might need one, even though giving this information is totally legal, others see what they can do to help out their patients.

These are the five stories of gynaecologists and a psychologist, who share their struggle as healthcare professionals in Malta.

“Frustrated, outraged, indignant, powerless”

“These are just a few of the feelings that go through my mind as I listen to yet another woman struggling to get help,” a local gynaecologist said. “I now see about two or three such women every week, up from maybe once a month before the pandemic.”

One particular lady had just been diagnosed with a serious congenital abnormality. The diagnosis was suspected on ultrasound and then confirmed by further testing. She had been told there was nothing that could be done to help her in Malta, but she knew better and had already explored the available options abroad.

“I would just like to explain how difficult it is for a doctor who is trained to understand a problem, to have to jointly look for possible solutions with her patient, to live with this type of situation. Knowing that the option of abortion – that would have been offered to my patient in virtually every other European country – is not available, is terribly frustrating.”

“It also makes me angry… Angry at a system that seems to care more about the views of those who have never been pregnant, never had to live through this, and some of whom are not even women. Why should any Maltese voter have the right to decide what’s best for this woman and her family?”

“I am deeply concerned by the women who have no choice but to commit an illegal act”

Another gynaecologist confirms: “Abortions are happening in Malta right now! Every day, since our borders closed in March 2020, on average approximately one woman who lives in Malta has requested abortion pills from international organisations such as Women On Web.”

Women On Web, an NGO based in the Netherlands, received 45 abortion pill requests in March and 47 in April. The Abortion Support Network, a charity based in the UK, reported an increase from an average of seven per month before the pandemic to 13 in March and April and 19 in May 2020.

“As a practicing gynaecologist, I am deeply concerned by the increasing number of women who have no choice but to commit an illegal act, since our borders have closed. To make matters worse, the number of women turning up in the Emergency Department with incomplete miscarriages is noticeably higher than in previous months.”

“These women will not admit to having taken these pills, for fear of being criminalised. Every doctor knows that creating a trusting relationship with your patients, that allows full disclosure of information, is key to the safe practice of medicine. I firmly believe the lack of abortion services on the island means that our medical authorities are falling short of the highest evidence-based standards recommended by international guidelines.”

“It is my duty to provide all the options when discussing a medical situation”

“Did you know that providing information about abortion, what it entails, and how to procure one, is not illegal in Malta?” a gynaecologist explains. “It would seem that some of you may not be aware of this. I am not breaking the law when I provide this information. As a health care practitioner, it is my duty to provide all the options when discussing a medical situation.”

“Of course, I will always talk about continuing with the pregnancy or proceeding with an adoption. I will also mention the existing social and welfare support structures that are available to tax-paying Maltese residents (which, by the way, excludes a large number of women living in Malta).”

“I am angry. Why should I be forced to tell a woman, who is still bleeding heavily one week after taking the medical abortion pills, that she has had an incomplete abortion but must not tell the doctors at Mater Dei that she took the pills? Why must she lie? Why must I advise her to lie?”

“This is the situation we are in as pro-choice doctors. We want to help our patients but we know that if they tell the truth they may be prosecuted, and if they withhold information they may not receive the best possible treatment. This feels wrong. This is wrong. This is why I am angry.”

“It makes me feel helpless that I am unable to assist these women”

“I have had several women seeking my help to get an abortion. It is often a shock for foreign women residing here to learn that abortion is illegal in Malta. Their perspective is that abortion is an important part of healthcare, and how come it’s completely unavailable here? Where does that leave them? We go through their reasons for seeking a termination, and discuss alternative options like going through the pregnancy or opting for adoption.”

“Unfortunately, if they still decide to go for an abortion, there’s not much more I can do. It makes me feel helpless that I am unable to assist these women. I can only recommend that they go abroad and get the procedure done there. Since the Abortion Support Network set up a specific helpline for Malta, the process has been a bit easier for these women.”

“I have seen women who were so desperate to terminate their pregnancy they were willing to harm themselves in the process. They’ve disclosed to me that they tried to drink far too much alcohol than is good for them, or they engaged in risky behaviour like over speeding in the hope that they would crash, or they took a cocktail of tablets, risking overdose – all the while, scared that family members or partners would notice what they were doing and report them to the police.”

“Sometimes women get pills over the internet. One would hope they get them from reputable sources.”

“What a selfish nation to consider ourselves the moral authority”

A psychologist worked with children impregnated through sexual abuse, vulnerable women whose pregnancy severely impacted their mental health and quality of life, and women who have had abortions and returned to a country where they did not feel safe to speak about it.

“I have seen the consequences of our country’s blanket ban in a variety of ways,” she said. “Yes, data from countries where abortion is legal shows that the majority of women do not have abortions because of abuse, and that most women will not suffer any mental health consequences due to their abortions, but what about those in the minority who do?”

“What a selfish nation to consider ourselves the moral authority and give no second thought to the actual women and girls who have to live with decisions that they did not make.”

With Malta’s sexual health policy lacking and lagging decades behind, access to safe sexual and reproductive health care is more crucial than ever. Hundreds of women face the financial and emotional burden of having to travel abroad or committing an illegal act, without being able to speak to their closest friends and family about it.

Each year, hundreds of women feel let down by their own country, simply because it won’t allow women to decide over their own bodies and lives.

While abortion remains a sensitive topic of discussion, the stories of these women are the start of shedding a light on what politicians and religions want to keep in the dark.

Do you think women in Malta should have the possibility to decide over their own future?

READ NEXT: Malta May Adopt The ‘Nordic Model’ Of Decriminalising Prostitution - But What Does That Mean?

Belle dives deep into seas and stories. She’s passionate about mental health, environmental sustainability and social justice. When she’s not out and about with her dog, she’s more than happy to hear from you on Instagram @belledejong or at [email protected]

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