Doctors for Choice in Malta gather to advocate for a bill to decriminalize abortion in Malta.

Abortion is illegal in Malta. Activists are trying to increase access.

On the predominantly Catholic island, abortion is illegal under all circumstances. During the pandemic, activists have strengthened networks to increase access to abortion information and services.

The World

Doctors for Choice in Malta gather to advocate for a bill to decriminalize abortion in Malta. 

Courtesy of Doctors for Choice in Malta 

Last September, gynecologist Isabel Stabile stood outside the Maltese Parliament with a group of activists on International Safe Abortion Day, holding signs that said: “Abortions are safe and necessary” and “My body is not a political playground.” 

As they livestreamed the protest on Facebook, some activists took out a box of fake abortion pills and swallowed them.

“Malta is the only country in the whole of Europe where abortion is still illegal, under all circumstances."

Isabel Stabile, abortion rights activist, Doctors for Choice, Malta

“Malta is the only country in the whole of Europe where abortion is still illegal, under all circumstances,” said Stabile, as the camera zoomed in on her. “We are here to show you how easy and simple this process can be.”

The protest was small — and later met by a bigger crowd from anti-abortion protestors — but it signals a growing abortion rights movement in the small, predominantly Catholic island of Malta in the Mediterranean, where more than 90% of the population are against abortion, on religious grounds. 

Related: Catalonia's temporary tele-abortion services are a game-changer

Unlike Poland, where abortion is difficult to access, but still legal in cases of rape and incest, the abortion law in Malta doesn’t make any exceptions — even when the mother’s health is at risk.

As a result, an estimated 300 pregnant people travel abroad every year to seek abortion services in places like the United Kingdom and Italy, but when the COVID-19 pandemic hit in March of 2020, travel restrictions made such trips nearly impossible.

Stabile, who is part of the advocacy group Doctors for Choice, said that’s when calls to the organization shot up significantly.

“What happened at that point is that women became desperate,” Stabile said. “And it pushed us as pro-choice doctors to set up a service.”

The Family Planning Advisory Service (FPAS) was launched last August, and is run by trained volunteers providing medically-based information about reproductive health care — fertility, contraception or abortion. 

Under Malta’s abortion law, doctors can face up to three years in prison for providing abortion services, so FPAS volunteers figured out a work-around: They inform callers of the travel restrictions for countries where abortion is legal and tell them about reliable nongovernmental organizations that ship abortion pills — although it is illegal to consume them on Maltese soil.

Related: In Italy, religious organizations' 'fetus graves' reignite abortion debates

“We have effectively created a telemedicine service. ... People are now no longer needing to travel as often.”

Isabel Stabile, abortion rights activist, Doctors for Choice, Malta

“We have effectively created a telemedicine service,” Stabile said. “People are now no longer needing to travel as often.”

Stabile said that within the first six months of launching, FPAS received more than 200 calls — in a country with a population of less than 500,000 people. What’s more, the number of abortion pills ordered online from organizations like Women on Web and Women Help Women doubled from 2019 to 2020.

But taking the abortion pills Mifepristone and Misoprostol is only considered safe up until the 12th week of pregnancy. For people needing an abortion past 12 weeks, including those who have found out about a fetus abnormality, taking a pill is no longer a possibility.

For people who are more than 12 weeks pregnant, taking a pill is no longer a possibility, which often applies to pregnancies with fetal abnormalities, as well. 

Mara Clarke, from the Abortion Support Network, said those are the people who continue to travel for abortions — despite the pandemic. Clarke’s organization helps fund pregnant people’s trips to the UK from countries where abortion is illegal or severely restricted.

“At the beginning of the pandemic, we really didn’t know what was going on,” Clarke said. “They were closing airports, we would book flights and they would get canceled, people were scared about traveling.”

There were nonstop hurdles: border closures, shut hotels, no child care. It was especially hard for Maltese people, who live on an island and are geographically isolated. 

Related: Abortion increasingly hard to access in Turkey 

Nowadays, Clarke said, traveling is somewhat easier, but mandatory PCR tests make it more expensive and constantly changing measures make it more difficult. 

“Prior to COVID, the Draconian abortion laws were an inconvenience for women and pregnant people with money, and they were only a catastrophe for people without money or resources or support networks."

Mara Clarke, Abortion Support Network

“Prior to COVID, the Draconian abortion laws were an inconvenience for women and pregnant people with money, and they were only a catastrophe for people without money or resources or support networks,” Clarke said.

“But suddenly, you have a global pandemic, and literally everybody understands what it means to live in a country with really a bad abortion law.”

According to the UK’s National Health Service, the number of Maltese people who traveled there for abortions decreased by two-thirds from 2019, when 58 abortions were registered, to 2020, when 20 abortions were registered.

As part of an ongoing collaboration, Clarke is now funding a helpline at Malta’s Family Planning Advisory Service.

Dr. Christopher Barbara, another member of Doctors for Choice, said the goal of FPAS is to fill the void left by the lack of a government-established family planning programs.

“We feel that people have a right to that information because, if nothing else, it’s a harm-reduction exercise."

Dr. Christopher Barbara, Doctors for Choice, Malta

“We feel that people have a right to that information because, if nothing else, it’s a harm-reduction exercise,” said Barbara. “If a woman can’t get the abortion pill safely, she’ll just end up getting them from unverified sources.”

To this day, no major political party in Malta has come out in favor of abortion rights — but some individual politicians are starting to speak up.

This May, one parliament member introduced a bill to decriminalize abortion, though it didn’t pass. President George Vella later responded to this move, saying he’d rather resign than sign a law that “involves the authorization of murder.”

Abortion is still very much taboo in Malta — and abortion rights activists who speak publicly about it often face online harassment from anti-abortion groups. 

But Barbara said public discourse is starting to shift — websites like Break the Taboo, which tell the stories of people in Malta who had an abortion, are hoping to destigmatize the topic.

And Barbara said it’s working. In 2016, the morning-after pill was legalized, and in 2018, the first abortion rights group in Malta was founded. 

Since then, similar organizations have emerged and local media are increasingly covering the abortion debate.

“People are starting to realize that you can personally be against abortion, but at the same time, an abortion ban is not the right way to go,” Barbara said. 

This story was produced in partnership with the International Women’s Media Foundation.