An open letter to the Prime Minister

Dear Honorable Prime Minister Abela,

On behalf of every woman in Malta, I salute you for proposing a legal amendment to help women and girls receive treatment, even if it results in an abortion, when facing a grave risk to their health or lives. This will make Malta a little safer for those who can get pregnant.

As you rightly said in Parliament, this proposed amendment is about access to essential life-saving healthcare. Thank you for reminding those who, in their valiant struggle to save fetuses, forget about the woman, that this comes at the expense of women’s lives.

You seem well aware that anyone can have an abortion in Malta, and indeed some 400 women a year do so. Ironically, the only persons who cannot have an abortion are those who are hospitalised. And yes, I agree with you, Prime Minister, only the woman’s doctors should be able to decide whether her health is in serious danger or her life is at grave risk. This should not be delegated to some anonymous board of doctors.

Rather than turning this issue into an occasion to score points with voters while glossing over the actual needs of the women in this country, as the opposition seems intent on, I applaud you for realising that our country is at a crossroads. It can either go down the path of protecting women, or it can cave in to conservatives and continue to put women’s lives at risk.

Prime Minister, do not backtrack or allow the proposed legal amendment to be diluted. What this amendment will not do is very clear. It will not allow women with an unwanted pregnancy to have an abortion. To do that women will still need to order abortion pills online, and that will still be illegal. This proposed amendment does not “introduce abortion” because abortion is already here.

What the amendment will do is allow doctors to intervene when dangerous complications threaten the life or health of women with wanted pregnancies. Women would still be allowed to choose whether to risk their lives or not. However, when given consent, doctors will be able to intervene without the chilling effect of a four-year prison term and loss of their medical license.

Please disregard the opinions of the so-called “academics” who declared that women going through serious mental conditions should not be able to access abortion care under this proposed amendment. They believe that serious mental health issues should never justify the sacrifice of “a baby’s life”. It’s a surprising position for those doctors on this “academics list.”

As the Hon. Minister Fearne eloquently stated, there is no physical health without mental health. People with life-threatening mental disorders should not be denied a legal abortion just because they do not also have a life-threatening physical condition. This stigmatizes and relegates mental illness as less worthy of treatment than physical illness.

As for the statement by other naysayers that the “government’s proposed amendment will be loosely interpreted to allow for abortion on demand through mental health grounds”, which part of “grave risk” did they not understand? I hope you will continue to listen to the advice of doctors who put their patients first by practising evidence-based medicine, rather than to those who put their ideology first at their patient’s expense.

Shockingly, these so-called experts claim that our present law suffices because no one has died as a result of it. Perhaps they are not aware that we have been exporting all of our problems to other countries to deal with. I sincerely hope they realise that, as you stated, if someone does die, that person could be their sister, their daughter, or their friend.

Please do not listen to scaremongering that the amendment will allow abortions until term. Pregnancy complications can occur at any stage, but if a fetus is viable – at around 24 weeks – doctors will do their best to deliver the fetus safely, if prematurely, to save the life of the mother. This is standard medical practice.

Thank you for carefully considering the statement by the Maltese Association of Psychiatrists that “mental illness should not be considered in isolation during such a serious debate. And mental illness should not be considered separately from other illnesses, that is to say: if the criteria for termination are to be considered the threat of loss of maternal life, then that should equally be the standard for psychiatric illness.”

The introduction of the proposed amendment on abortion into our laws is the least that can be done to better protect the health and lives of women and girls on this island. This amendment is for wanted pregnancies that have gone wrong. It has absolutely nothing to do with elective abortion. Opposing it altogether or further diluting what is already a bare minimum will continue to place women’s lives, health and general wellbeing at higher risk.

However, as a Doctor for Choice, I must remind you that since the proposed amendment does not allow abortion in cases of fetal anomaly, rape, incest or unwanted pregnancy, it is not good enough when compared to laws in other countries. These are cases that cause significant hardship to all those concerned - the woman, her family and the child born as a result of an unwanted pregnancy.

You might be surprised to know that the August 2022 survey by Malta Today shows for the first time ever that overall, the majority (53.3%) of respondents agree with the decriminalisation of abortion, with a 6.4% increase between 2021 and 2022. This is greater than the 4.6% margin of error inherent in the survey, and the shift over the past 16 months extends across all age groups

Prime Minister, kindly take a look at www.deardecisionmakers.com. In it you will read over 50 first-hand accounts of the traumatic experiences that persons in Malta have had to endure as a result of the criminalisation of abortion.

So thank you Prime Minister for this small step forward that just shows how far behind we really are. However, you can expect us to continue our pro-choice work until the law is up to international health standards.

Hundreds of people may turn up to demonstrate against your proposal on Sunday, but this is not a popularity contest. Healthcare decisions should never depend on numerical superiority. Every person who has the wellbeing of Malta’s women and girls close to their heart should support your proposed amendment. We should never compromise on women’s health and lives.