On behalf of all obstetricians who came to Malta from the US and, undoubtedly, the “particular Maltese obstetrician” referred to by Tony Mifsud (‘Obstetricians and abortion’, August 12) allow me to proudly admit that not only do I show women in Malta how to take abortion pills but I also provide advice and support before, during and after their self-managed abortions.
I do this together with my colleagues in Doctors for Choice.
Mifsud disingenuously quotes maternal mortality statistics claiming that no woman has died in pregnancy since 2020, in an attempt to misinform readers.
Whatever you might think about abortion, let us not be naïve.
The accuracy of this data depends on whether the doctors completing death certificates possess all information about the patient. For example, if the doctor writing the death certificate is not aware that the person was pregnant six weeks before her death, they would have no reason to suspect the death is related to pregnancy.
The major difficulties in relying on maternal mortality to demonstrate excellence in healthcare are that maternal deaths remain generally under-reported and that considerable statistical variation results from the small numbers of births recorded in Malta.
Also, an estimated 500 pregnancies in Malta are already being aborted by using pills ordered online or by surgical abortion abroad.
Had abortion been completely inaccessible, the rate of avoidable serious complications and maternal death would likely be greater.
Indeed, the Commonwealth Fund, an independent organisation researching health policy in the US, reported that, in 2020, states which restricted or banned abortion have 62 per cent higher maternal death rates than those where abortion was more accessible.
I also believe that maternal death is a very low bar to set when discussing women’s reproductive health. Among those who cannot access an abortion in a timely manner, some will go on to develop preventable life-long health problems.
An estimated 500 pregnancies in Malta are already being aborted
An unfortunately common and often unseen example are those women who remain legally bound to their abusers because they were tricked into pregnancy. They would not show up as a maternal death but their lives will have been irrevocably changed.
Does Maltese society care about the psychological and physical impact on women who must see their non-viable pregnancy through to the end because the law says so?
What kind of entitlement on the body of another does a human have? Are the ones insisting that abortion is always wrong sure that they are trying to save the pregnancy rather than control women?
It is telling that those insisting that a woman must be told what to do with her body and that the law should punish her if she does not comply are not outraged at the lack of comprehensive sex education or freely available contraception, both of which will undoubtedly decrease the number of women having abortions in Malta.
In my view, we should not only consider what is best for an individual but also for families and for society as a whole. Indeed, abortion deeply impacts the person who can get pregnant, other family members and society, for the better.
Denying legal access to abortion is equal to withholding access to essential and life-saving healthcare. It is disingenuous at best, and negligent at worst, to claim that our present law suffices because no one has died as a result of it.
I do not live in the US, I am not of childbearing age and, although Maltese law regarding abortion does not affect me personally, I do have two daughters and three granddaughters. I do not know what my personal choice would have been if I had ever had an unwanted pregnancy.
However, it is hypocritical for others to find solace in a low maternal death rate, only to then put women’s lives at risk by depriving them of autonomy and stripping them of the ability to take decisions that have a direct impact on their health.
You may wonder how I reconcile the fact that I am a gynaecologist and a grandmother with being pro-choice. The answer is simple. It is only after becoming a mother that I realised I could not force motherhood on anyone who was not willing, ready or able to have this experience.
I am pro-choice because I come from privilege and could afford to have a safe legal abortion had I ever needed one. I am pro-choice because abortion care is healthcare.
I’m not old but I’m too old to work on things that don’t really matter.
Looking around me, I realise that one of the most pressing problems we have in Malta is lack of kindness and compassion. Supporting those having an abortion is an act of kindness.
So let me be perfectly clear about what motivates me to assist before, during and after abortion: I want what’s best for those who are pregnant and only they can decide what that is. I think, I feel, I decide.
Isabel StabileIsabel Stabile is a gynaecologist and a founding member of Doctors for Choice.