Doctors in Malta are forced to find legal loopholes to terminate life-threatening pregnancies.
In cases of ectopic pregnancies for example, in which the embryo is either absent or non-viable and can be fatal, gynaecologists use the ethical “principle of double-effect” as a legal loophole for treatment, by removing the fallopian tube surgically. This effectively halts her chances of having children in the future.
This is considered an “indirect termination of pregnancy” on the grounds that it is done to save the life of the mother.
“However, in selected cases like say, an unruptured ectopic pregnancy, low presence of pregnancy hormones or no significant pain for the mother, evidence-based guidelines in the rest of the civilised world recommend the use of Methotrexate,” Doctors for Choice explained.
This medication is preferred because it targets the embryo “directly”, by stopping cells from multiplying. While this will terminate the pregnancy, it preserves the fallopian tube and allow the possibility of future pregnancies.
Studies show in some cases, the drug is equally as successful to surgery and leads to better reproductive outcomes.
But as the law currently stands, any and all ways of inducing a miscarriage (abortion) are criminal even to save the life of the mother.
“One can understand why some doctors might feel uncomfortable prescribing methotrexate. Unlike surgical removal of the fallopian tube which indirectly ends the pregnancy, this medication directly destroys the pregnancy, whether viable or not, so doctors may rightly feel that the principle of double effect might not apply” the group added.
Yesterday, pro-choice activists took to Parliament to decry Malta’s tough abortion laws, which left a Maltese woman traumatised after having to wait for a medical board’s approval to terminate her potentially life-threatening ectopic pregnancy.
Methotrexate was eventually administered to the patient, but because of the delay, she had to take two doses of the drug for it to work.
Having said that, the doctors continued, one would suppose that had her medical condition worsened during the waiting period, then a surgical approach would have been taken.
“We believe that healthcare systems cannot be guided by vague, unclear or questionable legal frameworks, as these hinder the work of doctors and put patients’ lives at risk. Moreover, doctors who circumvent the law in this way are at risk of losing their medical license,” it warned.
And while they were pleased to note local gynaecologists recommending the use of the drug for the treatment of ectopic pregnancies, they stressed that current delays are still putting women’s lives at risk.
“If the patient fits the criteria, she should receive the treatment. The law must change so that access to this medication, which technically causes an abortion, can be provided in a timely fashion.”
“Meanwhile we are pleased to see that the Maltese health service has finally admitted to using a drug to terminate pregnancies, albeit ectopic ones,” they said.
In the UK, around one in every 100 pregnancies are ectopic. While official numbers for Malta have not been divulged, Doctors for Choice have dealt with at least two women seeking advice through their Family Planning hotline launched this year.
“There is a laborious process in place which is not necessary and prone to delays. That’s all that matters,” pro-choice gynaecologist Professor Stabile told Lovin Malta.
Do you think Malta needs to revisit its abortion laws for unviable pregnancies?