[WATCH] 'Bill 28 protects doctors, not women'

The abortion amendments passed by parliament offer no protection to women and only protect doctors in circumstances where an abortion is necessary, says pro-choice activist Natalie Psaila. 

Psaila is a specialist in family medicine and co-founded the NGO Doctors for Choice, an advocacy group. Just a couple of weeks ago she was included in the BBC top 100 list of the most influential women. 

 As I sit with her for this interview, she speaks of how she was surprised and honoured to have made it to the top 100 list. “Despite knowing about the nomination, confirmation came as a surprise on the day of the announcement,” she tells me. 

On the government’s amendment to Malta’s abortion laws, known as Bill 28, which was approved unanimously by parliament, Psaila said it was disappointing to see a watered-down version of the bill being passed months after its announcement. “Bill 28 does not protect women, it protects doctors,” she says bluntly. 

Psaila points out that the new law introduces cumbersome requirements, mandating the involvement of three doctors with specific specialties before a procedure can be carried out. 

This, according to Psaila, can pose a challenge, and possibly threaten a woman’s life when she’s at risk. 

Psaila spoke about the abortion doula service that she set up with Prof. Isabel Stabile. The helpline offers support to women before, during and after undergoing an abortion. Psaila says she speaks to women everyday through the helpline, in the hopes of preventing complications throughout the procedure.   

While the government amended its abortion law, its sexual health policy is still to be updated. Psaila suggests that sexual and reproductive health is not a high priority for policymakers, otherwise the policy would have been drafted a long time ago. However, she hopes that the policy will be an improvement on the current one, which was drafted in 2010.  

Psaila also highlights the importance of a comprehensive sex education, combined with free access to contraception, to prevent unwanted pregnancies and abortions. 

She authored a book on sex education targeted at 10- to 13-year olds, emphasising its potential to prevent unwanted pregnancies. However, she said the book has not been widely adopted in schools, with the Education Department advising teachers against using it.  

The full interview can be watched on maltatoday.com.mt, Facebook or Spotify. 

Read excerpts of the interview below:

How did it feel to see yourself on the BBC top 100 list of the most influential women?  

Well, it was a big surprise. I was not expecting it. Actually, someone from the media contacted me that morning and said, ‘Do you know that you're on this list?’. It was massive news. I had known about the nomination because the BBC had gotten in contact with me a few months back, but they never told me whether I actually made it on the list or not.  

It's a great honour and I think it's an honour that I share with my fellow pro-choice activists who have been working for so many years on this. 

The achievement comes a year after the government floated its initial amendment to the abortion laws. Was it disappointing when, a year later, the government tabled a watered-down version of the same amendment?  

Let's be very clear about this - Bill 28 does not protect women, it protects doctors. Before the bill came through, doctors were carrying out abortions and terminations of pregnancy. When the woman's life was at risk, they would do it at their own discretion and do whatever is needed.  

With this new law, now we have to wait for three doctors with very specific specialties. You need the gynaecologist taking care of the of the patient, you need another gynaecologist, probably the one who would be carrying out the procedure, and a specialist within the condition that the woman is suffering from. And we need these three doctors to agree between themselves. And then the procedure can be carried out, all while the woman is at risk.   

It's a nightmare, and it was so disappointing to see a decently good bill which would protect women, even in cases of serious health problems. 

Is asking for information on abortion illegal in Malta?  

Providing information is never illegal. Nowadays you can find any information you want about abortion in a medical textbook, which you can buy in a local bookshop. You can find information about abortion on the internet. So, information is never illegal, and we aim to provide this information to those who need it. This is why Prof. Isabel Stabile and I have set up the abortion doula service helpline, where every day we speak to women who are having abortions. We provide information before these people have abortions, and even during the process. Sometimes they call us saying that they're in a lot of pain or they're seeing a lot of blood, or they took the pills, and they vomited soon after.  

We're trying to provide support to these people because they're undergoing a medical procedure on their own, with possible complications. Generally, a medical abortion is quite safe, however complications can arise, and we don't want a situation where a woman is too terrified to go to hospital because she might be reported, and so she bleeds to death at home. 

The government has been planning to update the national sexual health policy for years, but it hasn’t been launched yet. What do you think is causing the delay?  

It's obvious that sexual health and reproductive health is not high on the list for policymakers, because otherwise we would have had an updated sexual policy much earlier.  

Thankfully, it's happening now, and I know that that some studies have been carried out to help it be a bit more relevant to today's needs. I'm hoping that we see some improvements, because if you want to prevent abortions, what you need to do is have a basic solid sex education in schools, which is why I authored a book for 10- to 13-year-olds about sex education, published by Doctors for Choice.   

It's also disappointing to see that it has not been taken up by schools, because the Education Department has asked teachers not to use it. I'm not sure why because it does not mention abortion. However, it does mention different types of contraception, which is another thing which could prevent abortions. Once you have free contraception and good sex education in schools, then you can start preventing abortions.  

Right now, what we can see is one-track journey for women to get pregnant, because they don't know what they're doing, or they're not taught how to take care of themselves. We don't provide contraception for free, and then once you get pregnant, you can't stop that pregnancy.  

It's quite bleak for women in Malta.