by Aleksandar Dimitrijevic, director of Men against Violence
The first step towards resolving a problem is admitting that you have one.
High infant mortality rates coupled with stories of women travelling for abortion procedures abroad show that Malta has an abortion problem. The next step is figuring out the size of the problem and quantifying it.
And there we hit a snag. Abortion is illegal in the country, there are no (and there cannot be) official statistics, so all we have is patchy data which just begins to depict what the real picture is.
We don’t know, we cannot know, so therefore it’s easy to pretend it does not exist. So, how can we go about it and find out what is really happening? The best we can do is to combine what we do know and then compare it with countries that are or were in the similar situation like Malta – and make an educated guess.
First, what do we know?
We know that in the last 10 years, an average of 57 women from Malta had an abortion in the UK per year.
We also know that women travel from Malta to Italy (usually Sicily) for abortions, although we do not know the numbers. Italy does not keep the statistics on nationality. Here we can make our first guess: considering the proximity of Sicily to our little island, it is probably fair to assume that the number of women travelling there is higher than UK, but for this exercise let us assume that the number is on average same as UK.
An average of 200 women contact Women on Web in order to purchase abortion pills for home abortion every year. It is not clear how many women purchase the pill from other providers, most notably Women Help Women. Here we have to make two more adjustments: Women Help Women probably delivers fewer pills than Women on Web and not all women that contact them manage to obtain the pills in time.
So, 57 in UK, 57 in Italy, 150 (est.) Women on Web, 50 (est.) Women Help Women and we have an approximate figure of just around 300 a year. Carmel Caccopardo, Chairperson for Alternativa Demokratika came up with the same figure after talking to a number of Maltese doctors and it’s the same figure at least one of the “pro-life” group’s leader accepts as the annual number of abortions by Maltese women.
In comparison with European average, that would mean that the rate of abortions for Malta is very low. Average abortion ratio for WHO Europe region is around 200 abortions per 1000 live births. Considering that Malta has around 4000 live births a year, that would mean that if Malta is in the European average, the figure should be closer to 800 a year rather than 300. If we apply this ratio to 2016, when we had 4476 live births in Malta, it would translate to 895 abortions for that year.
But that is too simplistic.
Considering that as confirmed by the WHO and UN, abortion bans have not reduced abortion rates in any other country in the world, the figure of 300 a year is in all probability way too low, unless one is to believe that Malta is like no other country in the world.
On the other hand, the figure of 800 + creates a gap of five hundred that is rather big for us to take any of these figures as more likely correct.
Next thing we can do is check the data from countries/territories that had the same or similar restrictions on abortion, but had better way of knowing the extent of the problem.
Here we can use data from Ireland and Northern Ireland. Similarities are easy to see: islands with heavy Catholic influence and English speaking. Both had strict abortion laws like Malta, but the vast majority of women were travelling for abortion to UK. Therefore, the authorities kept figures and had a pretty good idea of the numbers involved. We can therefore extrapolate their figures of number of abortions for women of childbearing age (15-44) to the same population cohort in Malta and see what Maltese numbers would be.
Exactly 3265 Irish women travelled to UK for abortion in 2016 (1). Irish women also travelled to the Netherlands for abortion, at a rate of around 30 a year (2). That brings the total to 3295.
Total of 724 women from Northern Ireland travelled to UK for abortion in 2016 (1). We have a report that around 700 women from Northern Ireland purchased the pill, again, from a single source (3). A study conducted in 2016 shows that around three women purchased the abortion pill every day from a single source in Ireland (4). That is confirmed by Women on Web and that puts the number at 1100 every year (5).
Extrapolating figures to Maltese population of women of childbearing age, we get that, if Malta is more “like” Northern Ireland, total number of abortions is 369 a year and that if Malta is more like Ireland, the figure is 441 a year.
Still, there are two things that we need to keep in mind:
a) There are no doubts that there are pregnancies that are carried to term in Malta that in other places wouldn’t – at least some of them. High teenage pregnancy rates and high infant mortality rates in Malta points to that.
b) These are still conservative estimates. They do not include abortion pills purchased by other suppliers or travel to other countries, which would push the estimates up.
Therefore, one could state that the number of people having an abortion is actually around 300+ (if we consider point (a) to carry more weight), or that the real number is at closer to 500, if we think that point (b) has higher effect.
Now, just a note for those who might thing that 500 is way too many. In 2016 Malta had 4532 live births. If Malta had 500 abortions in 2016, that would mean that abortion ratio for Malta is 110 abortions per 1000 live births. Now consider that this ratio in 2016 was 125 in Germany (lowest in EU), 154 in Netherlands and 224 in Norway, all countries that have better sex education, better access to contraception and do better in preventing unwanted pregnancies than Malta. Unless you believe that Malta is a country like no other, figure of 500 a year is not unrealistic.
In any case, the figure we started off with, around 300, is way too low, even based of the actual numbers we already have. The comparison with Ireland and Northern Ireland confirms this. For that number to be correct, we would have to assume that number of abortions in Italy is the same like in UK rather than higher, that women do not travel to other countries for abortion and that no pills are bought from other places bar two most popular ones.
…and we have not even addressed the fact that abortions are performed in Malta illegally and what that figure might be.
In conclusion, all this was, obviously, a speculative play with numbers because real numbers don’t exist.
But as stated at the beginning, that’s exactly the point. We don’t know and therefore we can pretend that it does not exist. Abortion is a reality in Malta that many refuse to accept and we continue to bask in our obliviousness.
In the meantime, anything between 300 and 500 women in Malta will bear the brunt of this willful ignorance every year.
Data drawn from: