Issue link: https://maltatoday.uberflip.com/i/1122280
17 maltatoday | SUNDAY • 26 MAY 2019 INTERVIEW might be interpreted as a crime. Does this affect the way doctors go about their job? I can't give you an evidence- based answer to that, because quite frankly there is no re- search or data that I am aware of. I do not work in the obstet- rics department myself; but I have studied in it, I know doc- tors who work there… I am familiar with the context. And the general sensation is that it is all 'hush-hush'. It's some- thing no one really wants to talk about. There is a lot of se- crecy, a lot of omerta'. What I'm glad about is that recent developments – includ- ing the formation of our own group, but also Voices For Choice, and the pro-choice coalition – have lessened the stigma associated with the is- sue. There is more of a con- versation going on, and I think people have been embold- ened… slightly… by all this. But legally, there is still the sense that, if doctors assist a woman in acquiring a termination of pregnancy, they will be liable to four years in prison. Now: I don't know of any arrests ever having been made. I have spo- ken to lawyers who said 'it is only applicable if the abortion happens on Maltese soil.' So, I don't think it can be ap- plied to cases where patients are referred to clinics abroad. But in terms of a robust system of information, or referrals and counselling… it simply doesn't exist here. I know of cases – an- ecdotally, I must stress – where women have come in, heavily pregnant; bleeding from their genitals; basically, all the symp- toms of a late-term still-birth. In one recent case I've heard about, when the foetus was de- livered, it was found to have a laceration, or incision, around the scapula. It is obvious to anyone with a pair of eyes what happened. Exactly how it hap- pened… whether using a knife, or who knows what else… we might not know for sure. But you don't have to be a doctor to understand what happened to that woman… How are such cases dealt with? The discussion, between the doctors handling this case, was to say… 'Ah, well.' They just documented it, and that's it. But… was that woman arrest- ed? Were the police alerted? No. So the question I want to ask the entire Maltese popu- lation, at this stage, is: do you agree that a woman who tries to terminate her pregnancy – or wants to terminate her pregnancy, and asks questions about it – should be put in prison? Because as it is, the law says that that woman's place is in prison. Do we, as a nation, agree with that? I have a sneak- ing suspicion that a good per- centage of the Maltese people will say 'No' to that. And that is how it works in practice: doctors do not call the police in to arrest women in such circumstances. The law, in practice, doesn't even work. So why not change at least that aspect of it? Why not at last de- criminalise? From the circumstances you describe (and separate evidence), it is clear that 'back-street abortions' do take place in Malta. How serious is the health risk posed to women by the law as it stands today? One of the things that emerged from the European Health Consumer index, pub- lished last February, is that Malta has gone down 10 plac- es – to 27 out of 35 countries – in terms of [public health]. Commenting on this, Health Minister Chris Fearne said that the drop was: 'because we do not offer termination of preg- nancy services in Malta. We have more children with seri- ous medical problems, and that puts us behind'. And he's right. The European average for in- fant mortality is 3.6 per 1,000. In Malta, it's 5.78 per 1,000. That's more than two infant mortalities above the Europe- an average. There are around 4,000 live births per year here. Taking into consideration those extra two mortalities, around 23 live-birth infants die each year. From this, we can extrapolate – though, once again, we have no reliable data – that some of those cases will be due to serous foetal anoma- lies, which in other countries might have been terminated. It would work out at around eight per year… not a scientific con- clusion, granted; but let us, for argument's sake, say that it is eight per year. Those are eight infant deaths more than the European aver- age, which could have been prevented from reaching that stage. Not to mention the oth- er human costs involved that could also have been prevent- ed: from the medical expenses, to all the emotional sacrifices that would have been made by the woman, and the family, with regard to these deaths. That's one thing to consider. But the same report also states that 'legal restrictions to termination of pregnancy do not stop them from happening, but rather turn them into a ma- jor health risk: forcing women to go abroad, or have an abor- tion under obscure, insecure conditions.' That is the conclusion of the European Health Consumer Index study; and it is also what the World Health Organisa- tion, the Royal College of Ob- stetricians and Gynaecologists, and the Federation of Inter- national Gynaecologists and Obstetricians all state in their own, very lengthy evidence- based reports. There is so much evidence indicating that, by making it il- legal, you will not stop it from happening; you will not stop people from seeking it; and you will not stop it from being necessary, from a medical, psy- chological and social dimen- sion. But we're not looking at any of that evidence; we are not adopting an evidence-based approach to this issue. So, I'll return to my previous ques- tion. Is that woman's place in prison? No, it isn't. I think most people will agree with that. not a political issue "When the foetus was delivered, it was found to have a laceration, or incision, around the scapula. It is obvious to anyone with a pair of eyes what happened to that woman"