Malta’s proposed abortion law is abortion on demand up to birth

Many of us can sympathise with abortion when a woman’s life is at risk. But the proposed law in Malta goes far far beyond this, opening the door to abortion on demand.

I graduated from the University of Oxford medical school and for the last 5 years have been a researcher at the University of Oxford working specifically in abortion policy, as well as working in hospital. I can tell you with full assurance that the proposed law in Malta would be a wide open gate to abortion on demand. I know this because I am a doctor and abortion researcher in a country which legalised abortion only for ‘health’ reasons.

In my country, 1 in 4 pregnancies (excluding miscarriages) end in abortion, nearly half of which are repeat abortions – in some cases people have 10 or more abortions. In my country, 200,000 abortions occur for ‘health’ reasons every single year – enough to wipe out the population of Malta in just two and a half years.

Fewer than 100 of these are because the woman’s life is at risk. 98% are for ‘mental health’ – which can mean anything at all (they explicitly say ‘mental disorder – not otherwise specified’). If you say that having a baby girl (as opposed to a boy) would affect your mental health, you can have an abortion in the UK, as our Doctors for Choice organisation has clearly stated. We know that babies are aborted because they are intersex as well. I know of cases where abortions have occurred because a pregnancy would interrupt with someone’s beach body during the summer. Our biggest abortion provider explicitly says that any reason except sex-selection is an acceptable reason for them: ‘any reason other than the sex of the baby is a valid reason to us, but we need to attach it to a legal reason such as, emotionally it’s not the right time for you.’ ‘Health’ clauses are far too vague and allow abortion on demand – from which there is no coming back.

All this is legal up until 6 months of pregnancy in the UK – even beyond viability. But in the proposed Maltese law, there is no gestation limit at all. Abortion would be legally permitted for virtually any reason up until the moment of birth, or even during birth. Most of the other safeguards in the UK law – limited though they are – are missing in the proposed Maltese law as well.

This law is also unnecessary. Abortion is already legal (by common law, not by statute) in Malta if a mother’s life is in danger – this is why women who have chorioamnionitis or other life-threatening conditions with a previable baby have those babies delivered prematurely in Malta, with the babies sadly passing away. The top judges and top gynaecologists in Malta have consistently and repeatedly said that this is the case. If that law is not followed, it is either because the mother’s life was not really endangered, or because of clinical malpractice. It is impossible to determine which is true without all the details – which is why those advocating for abortion will never release the details of the cases they are using to justify changing the law. Either way, neither of these situations requires abortion on demand to solve – at most, they need better clinical guidance for doctors. If Maltese court precedent needs to be explicitly stated in the law, there are far better ways to do it, with far more safeguards and far less chance of abuse, than the proposed law here.

Those are just the headlines. But in case you are not convinced and want to know more, here is just some of the evidence that this will open up abortion on demand:

First, this is what UK politicians and doctors explicitly said even just within a few years of the ‘abortion for health reasons’ law being passed in 1967. By 1970, the Royal College of Obstetricians and Gynaecologists said:

“When the Abortion Bill was under discussion its advocates repeatedly assured the Houses of Parliament that abortion on demand was not their object. Had they done otherwise it is unlikely that the Bill would have become law. Once the Bill was passed, however, there has been a persistent and intense

campaign which has had the effect of making the public believe that any woman has a right to have a pregnancy terminated if she so wishes… Had our advice on the phrasing of the Bill been heeded many of the abuses which are now worrying its sponsors’ would have been prevented. They were anticipated by this College, and its representatives repeatedly gave warning of them.”

As Professor John Keown wrote in his Cambridge University Press book on the history of abortion law in England, within just 4 years of the law concern about abortion on demand was being raised everywhere within the medical profession – by the British Medical Association, the Royal College of Obstetricians and Gynaecologists, and in all the leading medical journals. They noted that in the private sector, only 1% of requests for abortion were refused.

Indeed, the abuses of the Bill were so clear that even the author of the Bill himself, David Steel, stated that “Abortion is, I am afraid, being used as a contraceptive. The present level is too high.” Elsewhere he noted: “It is odd that so many women present for repeat abortions, some more than twice, which does suggest they are treating abortion as contraception. This was never the purpose of the 1967 reform.”

More recently, the former CEO of BPAS, the UK’s leading abortion provider, said that “Despite being one of the most restrictive laws in the developed world on paper, it is one of the most liberal in the way it can be interpreted. Although the Act does not formally permit allow abortion on request, that is close to what it allows in practice.”

Likewise, the editor of the British Medical Journal Sexual and Reproductive Health said: “The idea of predicting mental health outcome with confidence, against a woman’s own testimony, is inconceivable for most practitioners. Applying the law as it stands, we can at best inform a woman of what the law requires, inquire sensitively whether she believes it to be fulfilled in her case, explore doubt conscientiously, inform her of risk, and trust her response.” (Italics added)

When abortion activists were campaigning for legal abortion in Gibraltar a few years ago, the leading Member of Parliament seeking this change explicitly copied the UK and said that: “The proposed new section 163A.(1)(a) will provide for abortion to be lawfully provided where two ‘registered medical practitioners’ certify that a pregnancy has not exceeded 12 weeks and the continuance would involve a greater risk to physical or mental health than if the pregnancy were terminated of injury to the physical or mental health of the pregnant woman. It mimics the letter of the law of other jurisdictions including the UK. But we all know that this is a loophole through which abortion happens on-demand within the established time parameters”.

Second, we know that in many cases – perhaps even usually – women are not seen or spoken to by a doctor when abortion is considered in the UK. Government guidance says: ‘there is no statutory requirement for either doctor to have seen and/or examined the woman’. A newspaper investigation found that abortions were being signed off after 22 second phone calls, with women saying nothing other than ‘I just don’t want the baby’.

Third, we know that there was even a practice at one of our leading providers of pre-signing abortion forms en masse before the doctor had even spoken to the woman. They were given a slap on the wrist – but it is a clear indication that this is abortion on demand.

The same abuse has occurred in many other countries. In Ethiopia, abortion is officially allowed if ‘the continuance of the pregnancy endangers the life of the mother or the child or the health of the mother’, but leading pro-abortion researchers in the country declared that ‘all women know that safe abortion is available and legal for many indications’ and that ‘In most cases, a woman’s statement is sufficient to establish the legal indication for, and allow her to obtain, the abortion’.

In New Zealand, until recently abortion was allowed if ‘the continuance of the pregnancy would result in serious danger (not being danger normally attendant upon childbirth) to the life, or to the physical or mental health, of the woman or girl’. But 97% of abortions – nearly 13,000 – were done for mental health reasons under this clause in the country – a country of only 5 million people.

Many other examples could be cited (e.g. Ghana and Australia), but the evidence is clear: ‘health’ includes ‘mental health’, and when this is included as a reason for abortion, virtually any reason for abortion counts, as long as the doctor is willing – and there is always a doctor willing.

The fact that the proposed Maltese law refers to a woman’s life being put in ‘grave’ jeopardy is not a real safeguard. First, it explicitly says that an abortion can be done if the woman has a condition which may put her health in grave jeopardy – not if it is likely to be put in jeopardy. This is an extremely low bar – any condition at all, including pregnancy, could put someone’s health in grave jeopardy – that does not mean it is at all likely. This would allow abortion for any reason at all.

Indeed, it was precisely this kind of argument which British doctors used to perform abortion on demand after legalisation. Another British abortion law from 1967 allows abortion if there is a risk to the woman’s life from the pregnancy, greater than the risk of abortion. Some doctors reasoned that pregnancy is always riskier – though still very low risk – and therefore abortion is always allowed at any stage in pregnancy. As Keown points out, these doctors carried out this principle in practice, performing abortion on demand for any reason at any point in pregnancy – and were legally allowed to do so.

Second, these qualifiers typically have no clear legal meaning, and are rarely, if ever, upheld legally. The New Zealand law mentioned above requires a risk of ‘serious’ danger and even explicitly says that this should not be ‘danger normally attendant upon childbirth’, and yet still clearly allowed abortion on demand in practice. Likewise, the UK law allows abortion up to birth if there is a substantial risk of a ‘serious’ handicap to the baby – but in practice any disability is grounds for an abortion, including cleft lip or cleft palate.

In fact, when scholars warned that the UK law could allow abortion for cleft palate, David Steel called this idea ‘totally discreditable’, and other MPs said that it was scaremongering and that the scholars should be reported to the Bar Council. The authors of the Bill claimed that it was only meant for children who were ‘incapable of living any meaningful life’. But we know that abortions occur for cleft lip, cleft palate, and a quarter of disability abortions are for Down Syndrome. The disability does not even have to be proven – there merely needs to be a risk.

All this shows that the Maltese law, as currently drafted, is profoundly dangerous. Most likely, it is an attempt to legalise abortion on demand by stealth. If not, then the government must allow a re-drafting by legal and medical authorities who value unborn life – including the finest medical and legal minds in Malta. These people all support evacuation of the baby when the life of the mother is threatened, and would be happy to help draft an alternative law. The failure of the government to defer to them would demonstrate a clear motivation to legalise abortion on demand by stealth. Pro-lifers cannot allow this to happen under the false guise of protecting women’s lives.

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