The missive by my esteemed colleague and expert in pathology, which dismisses the need for Bill 28 amending the abortion law, fails the test of “Speak the truth, the whole truth and nothing but the truth”.

James DeGaetano (‘Abortion – the medical scenario’, December 21, 2022) states that “...there have been no maternal deaths in the past 12 years...” and this is a true assertion.

He continues to say “...and a total of two in the past 20 years...”, which is a false statement. Are we looking at the same National Obstetric Information System (NOIS) statistics? As far as we know, there were two deaths in 2001, one in 2008 and another in 2010.

So that’s four deaths in the past 20 years, not two.

Speak of leaving out the whole truth. Consider the statement: “There have been eight deaths since 1995.” This refers to when Malta began keeping records of maternal deaths.

However, you won’t find pro-choice activists declaiming these eight deaths because we all know that maternal healthcare has improved since 1995. We cannot compare what happens in 2022 with what used to be standard practice 27 years ago. 

How sure are we of these numbers?  Consider this scenario. A 45-year-old woman with known heart disease dies at home. A pregnancy, as yet undisclosed to her family, has pushed her heart over the limit. The GP certifying her death has no idea of her pregnancy. There will be no mention of this on the death certificate.

Should this be classified as a maternal death? Yes, because it happened within six weeks of being pregnant from a cause that was aggravated by pregnancy. Will it be reported as such? Not unless the GP is aware of the pregnancy and makes the report.

My point is that statements like “No deaths have occurred in so many years” are misleading. We can only record what has been reported. 

 I must also take my colleague to task for the statement “Never in living memory has a woman in Malta died due to failure to abort”. Has anyone published the cause of death of all eight women who have died in the past 27 years? If so, I ask DeGaetano to please cite the reference. If not, I ask him to refrain from making statements that cannot be verified. 

Allow me to cite maternal deaths due to complications that could have been prevented with timely abortions in other countries.

Women in Malta who develop cancer while pregnant are not allowed to terminate their pregnancy- Isabel Stabile

Savita Halappanavar died in 2012 in Ireland. Izabela and at least five others died in Poland since 2020.  Valentina Miluzzo died in 2016 in Italy after doctors refused to give her a therapeutic abortion on the basis that it went against their personal morals.

One must emphasise that, due to the current ban on abortion, women in Malta who develop cancer while pregnant are not allowed to terminate their pregnancy. They may either have their treatment postponed or are given inferior treatment when standard treatment cannot be used during pregnancy.

As the study by Hanna et al (2020), published in the BMJ clearly shows, every month that cancer treatment is delayed raises the risk of death by 10 per cent. This can cost women their lives. Bill 28 will hopefully change current practice and reduce these risks.

I must mention that there is one statement that DeGaetano makes with which I agree wholeheartedly provided the fetus is healthy. He says: “There are essentially no instances where a foetus needs to be aborted in the third trimester to deliver the best care possible.”

This is because, as every junior obstetrician knows, standard medical practice is to deliver the foetus as soon as viability is reached, usually around 24 weeks.

Isabel Stabile on behalf of Doctors for Choice Malta.

Article amended January 9, 2023: A sentence was modified at the author's request to include the words "provided the fetus is healthy".