Malta's infant mortality rate was Europe's highest in 2017, with authorities attributing the disproportionately high rate to Malta's abortion ban.
The number of infants in Malta who died before reaching the age of one totalled 6.7 for every 1,000 births in 2017, official data has revealed.
This rate was the highest in Europe, with Malta and Romania topping the list.
Published on Saturday by the European Union’s statistics office, Eurostat, the figures show that while the number of babies who died before reaching the age of one in-creased by only 0.1% in a decade, Malta’s rate has remained at the top spot.
And despite Malta sharing the top spot with Romania, the Eurostat data showed that while the Maltese rate persisted in its upward trend, the Romanian one has been slashed to almost half in the decade under review.
Abortion's impact on the statistic
Malta's abortion ban, which forbids doctors from terminating pregnancies for any reason, is the main reason Malta's infant mortality rate is higher than that in neighbouring countries.
The ban means that babies who have a high chance of not surviving due to a congenital defect are born, with a consequent impact on mortality rates.
In countries where abortion is legal, many such pregnancies end up terminated.
A Health Ministry official said as much.
The Eurostat indicator does not make any distinction between babies “unlucky enough to have a congenital abnormality or condition which, therefore, puts them at a disadvantage in terms of chances to live and babies who would potentially be otherwise healthy," a Health Ministry spokeswoman said.
“As it is, the indicator is estimated using the number of babies who die after livebirth, out of all babies born alive” she said.
“This means that, if in a country, babies detected to have a congenital abnormality are referred to have the pregnancy terminated, such babies will not be registered in the neonatal mortality rate, as they were not even given the opportunity to be born alive.
“On the other hand, in countries where this is not the current practice and all babies, however healthy or not they are, are allowed to be born and given a chance at survival, such babies would be included in the statistic,” the spokeswoman explained.
Babies born with such problems have a much higher rate of mortality than their healthy counterparts, even if many still survive and benefit from care provided by the local health system.
“Such a disproportionality higher risk of death in this group pushes up the overall neonatal mortality rate,” she said.
It is not the first time that high infant mortality rates have been linked to the lack of abortion in Malta. In 2014, an international report had warned that more research was needed to better understand Malta's high rates.
A lack of abortion alone "may not fully explain such high mortality rates,” the Health Systems in Transitions report had argued.
How infant mortality has changed
The statistics office collates the infant mortality rate by working out the ratio of the number of deaths of children under one year of age to the number of live births in the reference year. The value is expressed per 1,000 live births.
According to Eurostat, in 2017, the year under review, around 18,200 children died before reaching one. This was equivalent to an infant mortality rate of 3.6 deaths per 1,000 live births.
While Eurostat found that the rate for Malta went up slightly during the 10-year period from 2007 to 2017, the infant mortality rate in the EU fell from 4.4 deaths per 1,000 live births to 3.6.
The indicator is intended to reflect the quality of maternity care
Extending the analysis to the last 20 years, the office noted that the infant mortality rate was almost halved – there were 6.8 deaths per 1,000 in 1997.
Eurostat did not provide details on what had led to the babies’ deaths.