Abortion should be a choice in Malta | Prof. Isabel Stabile

Doctors for Choice Malta was set up two years ago by four brave doctors burning with the aspiration to change the lives of women in a country where, having an abortion means they can go to prison. Thanks to these plucky doctors, that now number more than 50, at long last we have a platform that allows the Maltese medical and lay population to discuss a subject that has been taboo for as long as I have been alive.

Our focus is fourfold: first, to improve access to comprehensive sexual education in schools; second, to make contraception feel available to all who live in Malta; third, to decriminalise abortion; and fourth advocate for changes in the law such that abortion in Malta becomes regulated under healthcare.

As a Fellow of the Royal College of Obstetricians and Gynaecologists (RCOG), I follow its evidence-based guidelines in my medical practice, one of which is that access to abortion is an essential element of health care. The sad reality is that 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.

Whether you believe this or not, the reality is that, every time a woman in Malta takes medical abortion pills that she has bought online, she is breaking the law and risks imprisonment. You do not need to agree with abortion for its decriminalisation to become a reality:  it is sufficient for laws that criminalise abortion to be repealed, such that women who seek abortions for their own personal reasons are allowed to proceed without fear of imprisonment.

Given this situation, a little less than a year ago, we set up the Family Planning Advisory Service (https://www.fpas.mt/; 2778 2758 or 2034 1686) to meet the need in the community for free unbiased information regarding reproductive health care options. In the first six months, we have provided advice to over 200 women and their partners. About one third of these calls centred around issues other than abortion, such as for example contraception. This reflects the lack of information in the community and suggests that these women either do not feel comfortable talking to their doctors or possibly cannot afford it. The absence of a local family planning clinic is sorely felt.

Some of these women have nowhere else to go. If they reach out to their Family doctor they may be rebuffed; if they’ve had unprotected intercourse, they may be kicked out of the nearby pharmacy unwilling to dispense the morning after pill; unbelievably, some are even rejected by their gynaecologist, on the puerile basis that the doctor is a conscientious objector. FPAS provides information on all aspects of reproductive health care, including the option to continue with the pregnancy and as well as adoption. The choice of whether or not to have an abortion remains that of the woman herself.

Since becoming the only openly pro-choice gynaecologist on this island, I have heard numerous stories of such rejections. Listening to yet another woman struggling to get help makes me feel frustrated, outraged, indignant, even powerless. One woman I saw recently 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.

Can you imagine how difficult it is for a doctor who is trained to understand problems and then jointly look for possible solutions with her patient, to accept this? Knowing that the option of abortion, that would have been offered to my patient in virtually every other European country, was 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, some of whom are not even women.

Like many doctors and nurses, I have sat with women watching over their baby, who was born with little/no brain (anencephaly), die within a few hours of birth. There are no words to express the anguish that caring health care practitioners feel in these cases. I believe these women should have the right to choose whether to end the pregnancy as soon as the diagnosis is made, with no legal repercussions whatsoever. Why should any of us have the right to decide what’s best for this woman and her family?

Yes, I want women in Malta to have choices. The choice to select the birth control method that suits them best and have it available for free on the essential medicines list. They should be able to reach out 24/7 for emergency contraception and not be turned away by a conscientiously objecting pharmacist. Their children should have access to comprehensive sexual education in school. Women who are pregnant should have a choice about what happens next. They should be trusted to make the best decisions for their lives and provided with the best standards of healthcare including access to abortion. The blanket ban on abortion with criminal sanctions on women and their doctors should be something of the past.

On the occasion of Doctors for Choice’s second anniversary, please join us this evening for a panel discussion on the medical and health aspects of abortion care, the reality of abortion in Malta, and how a lack of provision of legal abortion services impacts women and girls. Our confirmed panelists are Prof Lesley Regan, Former President of the RCOG and Chair of the RCOG Abortion Task Force and Dr Rebecca Gomperts, abortion rights activist and founder of Women on Waves and Women on Web. Dr Gomperts, through her initiatives, has allowed women to access safe abortion services in countries that restrict the service, including Malta. As a pro-choice gynaecologist, I am aware of the realities faced by women and girls in Malta, and will add a local dimension to the discussion.

The event will take place today, May 2 at 6pm local time. The webinar will also be live streamed on the Facebook page of Doctors for Choice Malta. You do not have to be pro-abortion to be pro-choice. Please join us and feel free to ask us any questions you may have.