Malta’s abortion doula service

“Hi Dr, I’m having an abortion right now can you please help me?”

“I am bleeding very heavily and I don’t know what to do.”

“I’m in a lot of pain, what shall I do?”

“Is this normal?”

These are some of the questions that those having an abortion in Malta have asked of myself and Dr Natalie Psaila through our recently inaugurated Abortion Doula Service.

The word "doula" originates from Ancient Greek and it means "a woman who serves." In the modern context, an abortion doula is someone trained to provide information, help, and support to people going through an abortion. 

These common medical questions clearly show how abortion care is healthcare, which everyone deserves. Medical abortion is carried out by licensed pills, even safer than some over-the-counter medications like paracetamol which can destroy your liver in high doses. Although complications are very rare, anyone going through an abortion is naturally anxious.

Those who call our helpline can expect us to answer all their questions, including signposting Women on Web, a reputable organisation that can deliver pills by post within one to two weeks. On average, we receive some two to three calls a day asking for medical advice and support.

I have never met any person who decides to have an abortion and is not anxious about the procedure. Understandably, they always have many questions, and because no one else is providing this, we decided to step in and fill the gap.

We know of doctors who privately agree that abortion is necessary and safe, but yet fail to provide information or support to those who turn to them for help. Some will even completely wash their hands of their patient for fear of being implicated in some way, essentially shirking their responsibility for their patients. We are not like that.

None of what we do is illegal. In fact, the police have yet to take any action on the numerous reports made against us. It should be plainly obvious why they have not. We provide healthcare because we are doctors and we believe that everyone deserves the best possible health care under all circumstances, even if what they are doing is illegal under the country’s laws. All the information we provide is freely available on the internet for anyone to find, but patients need to hear this from a doctor they trust.

Let me give an example of what providing support before an abortion is like. Imagine yourself halfway through an apparently normal and much wanted pregnancy and being told at a routine prenatal visit that your foetus has no skull, and the brain is exposed. You are told that your foetus will not survive beyond birth for more than a few hours, at most.

In such cases, we explain the options to help them make sense of a stressful decision. We also discuss logistics including making referrals to reputable clinics abroad. Although we know that many doctors are caring, very few will help their patients access abortion for medical reasons such as a fatal foetal anomaly. Instead, patients have to turn to us for help.

Having a medical abortion in Malta can be a very lonely and distressing process. Many women go through it alone for fear that those close to them might report them. Indeed, there was a case this year where the partner reported the person who was then found guilty by our courts of law.

Picture yourself also being in severe pain and bleeding heavily, and uncertain how long it will take, while looking after your child, and also hiding this from your nearest and dearest. You are unsure whether you will be able to get back to work tomorrow. These are the types of scenarios that we try to help with.

Now that the worst of the pain and bleeding is over, you can’t wait to find out if it worked. Perhaps you are still bleeding heavily with cramps, several days after taking medical abortion pills. This is very rare, but it might indicate that the abortion is not complete. Or imagine not bleeding at all and being worried that the pills have not worked. These people need an ultrasound. We conclude our consultation by providing information about contraception.

We tell anyone who is considering an abortion that they are not alone, that they can call us at any time, and that we will always help them, whatever happens. They are reassured that medical abortions are safe, and we provide the patients with physical and emotional support. Unlike what may happen at local hospitals, women who turn to us know that we will never report or abandon them.

Anyone in Malta who needs help before, during or after an abortion can call us on +356 20341683 or +356 27782758.

This abortion doula service is offered free of charge. Why? Because it is the right thing to do and because those having abortions in Malta have no one else to turn to. We will continue helping women and nothing will stop us until abortion is decriminalised and regulated under healthcare law.

Listen to how the abortion doula service helps women.

Prof. Isabel Stabile is a member of Doctors for Choice