Issue link: https://maltatoday.uberflip.com/i/1446843
THIS week a judge in Malta dis- missed a case filed back in 2017 by pro-life groups (Life Network Foundation and Save the Em- bryo Protection Act Malta) who opposed the introduction of the morning after pill aka Emergen- cy contraception (EC). Their claim was that EC is abortive and therefore in breach of Maltese criminal law. The judge upheld the Superin- tendent of Public Health's argu- ment that these groups did not have the juridical interest to file that type of case. I am only a gynaecologist, so I will not get into the legal mer- its or otherwise of this decision. But I am also a scientist and I have studied the mechanism of action of EC and I can assure you that it does not cause abor- tion. It cannot. There is extensive scientific literature published in respect- ed peer reviewed mainstream journals showing unequivocally that EC does not, and indeed cannot work, once fertilisation has taken place. The fertilized egg takes about five days to travel down to the uterus and implant there. This means that there is not enough time for EC to make the lining of the uterus so thin as to prevent implan- tation. This is why EC cannot cause abortion. EC works by de- laying ovulation and preventing fertilisation. Life Network have a long his- tory of misleading the Mal- tese public. Not only have they militated against EC, but they also receive government fund- ing to promote unsafe medical procedures such as reversal of medical abortion. Their web- site proudly advertises their allegiance to Agenda Europe, a far right Christian-extremist network, committed to the 'res- toration of natural order'. Their goal is to remove the sexual and reproductive health human rights of women, young people, and the LGBTQI community in Europe. This is so very danger- ous and this is right here, right now. Life Network claim they are pro-life, but all the evidence suggests that they are actual- ly pro-birth. As a pro-choice gynaecologist, it is my duty to provide all those who seek my advice regarding an unplanned pregnancy with the full range of reproductive care available in Malta and/or abroad. These include continuing with the pregnancy and parenting the child when born, adoption and abortion, the latter being illegal on the island. I am personally aware of one woman who was coerced by Life Network into continuing with her pregnancy against her will. She finally re- alised what their true intentions were and escaped abroad! This is what happens when extrem- ists rule the roost. This is the true face of pro-life ideology in Malta: it opposes the availability of EC, reduc- ing women to mere incubators while stripping them of their autonomy by denying them ac- cess to education, contraception and abortion. If Life Network really cared about preventing abortion they would advocate to improve sexual education in schools and promote the avail- ability of contraception. Failing to do so is hypocritical. Before EC was available in Malta women resorted to tak- ing overdoses of contraceptive pills to prevent pregnancy. Al- though the active ingredient was actually the progesterone in the contraceptive pills, the pro- gesterone-only pill (a.k.a. min- ipill) did not exist in Malta at the time and therefore women would swallow massively high doses of oestrogen in order to obtain the minimum effective dose of progesterone. Thank- fully those days are gone. EC is available without a pre- scription because the Medicines Authority in Malta drew upon the analysis of research data of thousands of experts through- out the EU. This system is de- signed to protect consumers from incomplete information. Had there been even a shred of evidence that EC is abortive, the Medicines Authority would never have issued its marketing authorisation. No-one is forced to take EC. Yet those who may need to take it, especially out-of-hours, often have great difficulty obtaining it, because some pharmacists persist in hiding behind "con- scientious objection" as justifi- cation for not stocking and/or dispensing this safe medicine. It is precisely because pharmacists are well trained, science-based professionals and respected, trusted experts in medicines, that one would expect them to base their conscientious objec- tion to EC on science rather than opinion. The crux of the matter is that when deciding to deny patients access to medi- cines to which they have a right, pharmacists should state the scientific rationale on which they are basing this decision. Conscientious objection must always be supported by rational argument. Pharmacists also have a duty to care for individual persons in need of this medication. Indeed, some, but not all pharmacists do refer such patients to nearby pharmacies that will dispense EC. This, however, will not help the person who needs it after 12 noon on Sunday as very, very few pharmacies are open at this time. There are also troubling reports of some pharmacists openly asking for identification as well as medical information without offering a private set- ting to do so. Anyone strug- gling to obtain EC, especially if under 18, should access our online service that offers a tele- medicine consultation and an emailed prescription (https:// w w w . d o c t o r s f o r c h o i c e . m t / morning-after-pill-prescrip- tion). Although a prescription is strictly unnecessary, it should reassure the pharmacist that a medical professional is taking responsibility for having asked all relevant questions. One day, abortion in Malta will be freely, safely and legal- ly available without shame or stigma. That day is soon. But until then, since abortion is still illegal under all circumstances, banning the morning after pill makes no sense at all. Thank you, Mr. Justice Micallef. 13 maltatoday | SUNDAY • 30 JANUARY 2022 Prof. Isabel Stabile is a gynaecologist and member of Doctors For Choice OPINION Isabel Stabile A victory for women's autonomy