Pregnancy and the law

As a practising gynaecologist, I have been following the ongoing debate in this newspaper regarding pregnancy termination.

As I have stated in a previous contribution, one’s stand on this matter reflects one’s own personal moral and religious beliefs. It is a personal stand and one that cannot really be argued in the theatre of science.

However, the contribution ‘Giving women a choice’ by Christopher Barbara (December 19) requires a clarification.

Barbara quotes the law to state that the termination of a pregnancy is a crimi­nal offence in Malta and proposes that the termination of an ectopic gestation must,  therefore, also be deemed to be illegal and thereby questions the validity of the law or that the age-old practice of performing a salpingectomy in the case of an ectopic  amounts to a criminal act.

What is, however, implied, but not stated, in the law is that it is the termination of a viable pregnancy that goes counter to the law.

So, in a missed miscarriage, where the embryo has been shown to be no longer alive, the evacuation of the pregnancy does not go counter to the law as this is not a viable pregnancy and will never grow into a child. Likewise, a tubal pregnancy is not a viable pregnancy as, unfortunately, the pregnancy has implanted onto a structure that is unable to sustain the growth and deve­lopment of the pregnancy and will inevitably cause rupture to the tube, placing the woman’s life at risk.

Nowadays, with early ultrasound scans and the development of early pregnancy units around the world, ectopic gestation is diagnosed well before the tube ruptures. This reduces the woman’s morbidity dramatically. Expertly run early pregnancy units are an essential part of a gynaecology ser­vice for this reason and a host of many others. One of these being the diagnosis of an ectopic abdominal pregnancy where the risks to the mother are significantly less.

Barbara might argue that the embryo in an unruptured tubal ectopic is actually alive and that the law still holds  but the fact is that it is very, very rare that fetal heart pulsations are visualised in an ectopic gestation. Should we, perhaps, in order to address his argument, wait until the heart beat is no longer visible or the inevitable happens and the tube ruptures and then the mother will suffer the consequences?

Mark Formosa – Sliema

Russian roulette

Photo: Chris Sant Fournier

With the new and apparently much faster spreading COVID-19 strain in the UK, it is welcome news that our august government has woken up and smelled the coffee and suspended flights.

Well, some flights, at least. As usual, the directives are as clear as mud. One wonders though why on earth we still had to be kept at risk until Tuesday when several European countries acted days before this. Perhaps our lot are smarter than them? (Rhetorical question.) After last July’s debacle, one would have thought that even the most obtuse greedy ġidra (nincompoop) would have learned from their mistakes and not risk another irresponsible bout of Russian roulette with our liberty/health/lives if things go rapidly south, as is probable.

One would also have hoped that the prudent approach is to keep UK travel off limits until we know more about how much more of a threat this variant may be and whether or not it will be covered by vaccines. According to BBC reports, all this remains to be seen.

Vaccine or not, scientists overseas are saying that it will take some months to gain some traction against this virus – without this latest ‘surprise’. At this rate, Robert Abela can go on about a May timeline until he’s blue in the face, however, this virus doesn’t give a proverbial ... about what politicians say.

In Australia, they have been phenomenally successful in dealing with COVID, in spite of distorted press reports. Just look at the facts: population of 25 million and 900 deaths, practically down to zero infection and no trace of virus in sewerage testing. It only popped up again in New South Wales because it came in from overseas on the very few flights operating to repatriate people who want to go home for Christmas.

Did anyone get that? Overseas. And started to spread fast. Unlike our fearless leaders, however, they are jumping on this quick smart with contact tracing and closing state borders in order to avoid more drastic measures down the track.

Alas, to err is human but to really stuff things up, it takes the Maltese government.

Anna Micallef – Sliema

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