Are you considering an abortion,
and you live in Malta?
This page is for women in Malta considering abortion, and has information on how to get an abortion.
We understand this may be a difficult time for you. Deciding whether to have an abortion can be difficult for some women, for others it is a straightforward decision. We have written this page to provide more information about this subject, and allow women in Malta to make their own decision and get an abortion if they need it.
Despite being a basic healthcare need for women, abortion is illegal in Malta under all circumstances, and there are no legitimate abortion clinics in the country. However, each year hundreds of Maltese women have abortions either by travelling abroad or by ordering abortion pills. No woman has been taken to court in Malta for having an abortion in the last five years, and no woman has been imprisoned for having an abortion in the last twenty five years.
Women in Malta have a legal right, as determined by the European Court of Human Rights*, to obtain information about abortion and make arrangements to have an abortion overseas. There is nothing in Maltese law that criminalises having an abortion in countries where it is legal.
* The right to assist women to travel abroad for an abortion has also been ruled to be protected under Article 10 of the European Convention on Human Rights, as decided by ECtHR case Open Door and Dublin Well Woman v. Ireland in 1992.
Obtain information about abortion
Abortion (also known as termination of pregnancy or ToP for short) means stopping a pregnancy so it does not result in a birth. Modern abortion care involves a choice of either medical abortion, which means taking two pills (mifepristone and misoprostol - more information below) that cause a miscarriage, or surgical abortion which is a minor procedure to physically remove the pregnancy through the vagina and does not involve any cutting. Medical abortion is the most commonly performed type of abortion, and can be undertaken by the woman herself at home in the first twelve weeks of pregnancy.
For more information on the different methods of abortion click here.
The following table summarises the methods of abortion available at each stage of pregnancy:
* Not all clinics offer surgical abortion in the very early stages of pregnancy.
You can also use this interactive web application to find the abortion methods and options available to you at your stage of pregnancy.
Abortion is a relatively safe procedure, in fact it is safer than giving birth, but you should be aware of certain complications that may sometimes occur. Infections and incomplete removal of the pregnancy are the most common complications.
After an abortion, it is normal to experience vaginal bleeding and some discomfort, but this should resolve in a few days to weeks.
You should seek medical advice if you experience any of the following after an abortion:
Severe vaginal bleeding
Fever (a temperature)
A smelly vaginal discharge
The UK's national health service (NHS) website has easy to read information on what abortion is, what it involves, as well as possible complications you should be aware of. You can read more here:
Abortion with Pills
Abortion pills can be safely used at home up to 12 weeks pregnancy in most cases, according to the World Health Organisation*. Due to the illegality of abortion, abortion pills are not available in pharmacies in Malta. However, it is a known fact that women order abortion pills online from organisations like Women on Web and Women Help Women. There are some differences between these two organisations which are covered here.
These organisations offer abortion telemedicine services to women in countries where abortion is restricted, including Malta. Ordering abortion pills from these organisations is a simple process, which involves going to their website and completing an online consultation, and after paying a donation they will send you the abortion pill kit by post to the address of your choice. The pills usually arrive in 1 to 3 weeks.
You can find more detailed information on how to order abortion pills on Safe Abortion Malta.
There are two abortion pills - Mifepristone (RU-486, Mifegynae, or Mifeprex) and Misoprostol (Cytotec, Cytotecal). They are usually supplied in a single combi-pack such as Termipil Kit. Mifepristone is taken first, followed by Misoprostol the next day.
Mifepristone is a medication that blocks the natural hormone progesterone. It softens the cervix and prepares the uterus for an abortion. The usual dose is 200mg when used in the first 12 weeks of pregnancy, and it should be followed 24-48 hours later by Misoprostol.
Misoprostol is a medication that causes contractions of the uterus and ejects the pregnancy. The contractions are experienced as strong cramps accompanied by bleeding, similar to a heavy menstruation. Misoprostol is usually taken at a dose of 800mcg, which can be repeated every three hours until miscarriage occurs. Misoprostol tablets are usually kept under the tongue for thirty minutes. Misoprostol can terminate a pregnancy on its own, but it is usually preceded by Mifepristone to make the abortion easier.
The combined use of Mifepristone and Misoprostol is 99% effective at terminating the pregnancy, whereas Misoprostol on its own has a 92-98% success rate. A successful abortion can be confirmed with a negative pregnancy test three weeks after using abortion pills. You can also arrange to have an ultrasound ten days after using the pills.
* You can read the WHO guidance on the self-management of abortion here.
Watch this video on how an abortion with pills is carried out:
Travelling to an abortion clinic abroad
If you have decided that you would like to pursue an abortion in a clinic abroad, you should start by exploring the services offered by abortion providers in different European countries. If you need help booking an abortion trip abroad, contact Abortion Support Network.
If you are going to travel for an abortion you will probably want to opt for a straightforward surgical abortion rather than an abortion with pills. A surgical abortion on pregnancies of up to 14 weeks is performed with vacuum aspiration, which involves giving a local anaesthetic around the cervix and using a cannula to gently suck out the pregnancy. You can expect to be at the clinic for 3-4 hours when having a vacuum aspiration.
A surgical abortion on pregnancies beyond 14 weeks is done by dilation and evacuation. This procedure requires a general anaesthetic, and you will need to be at the clinic for a whole day. You will also need to attend the clinic a day before the procedure for cervical preparation.
When choosing a country in which to have an abortion, keep in mind that different countries have different gestational limits up to which abortion is allowed. In the UK, abortion is allowed up to 24 weeks in most cases, although there is no limit in cases of foetal anomaly or if there is a risk to the woman's life. In the Netherlands the limit is around 23 weeks, and in Italy the limit is 90 days (around 12 weeks) in most cases.
When exploring abortion providers and clinics, keep in mind their location and how easy (or not) they are to access from Malta. You will need to factor in flight, onward travel, and accommodation costs. Most abortion providers have websites that indicate the approximate cost of having an abortion. You should have sufficient financial reserves, because even though they are uncommon, complications can occur after an abortion and your travel or medical insurance is unlikely to cover the costs. If possible, you should travel with a trusted companion such as a friend or family member for support.
Before you travel, make sure you know your own medical history, which medications you take, and whether you have any allergies. If in doubt, ask your local GP for this information. Your overseas care provider will not have access to your local medical record and will rely on you to have this information available.
There are many abortion providers and we will not be making any particular recommendations. However, you may wish to start by looking at the British Pregnancy Advisory Service's (BPAS) website, which has a lot of easy to read information on abortion clinics in the UK and the costs involved. MSI and NUPAS are other providers of abortion services in the UK.
If you cannot travel to the UK due to visa restrictions or other issues, and you need information on abortion clinics within the Schengen Area, please contact Abortion Support Network. You can also find a list of abortion clinics in the Netherlands and Spain that accept women from Malta here.
We recommend exploring and comparing different providers and their prices before booking an appointment. Make sure you have agreed your appointment times and an estimated price with a clinic before you travel.
If you want to speak with someone who is pro-choice: Contact FPAS Malta
FPAS (Family Planning and Pregnancy Advisory Service) offers free and confidential advice to women in Malta who need to discuss their pregnancy options, including abortion. FPAS provides reliable and unbiased information on abortion services and can refer you to other pro-choice organisations if needed.
FPAS is run by pro-choice volunteers and is co-ordinated and supported by three Maltese pro-choice NGOs: Doctors for Choice, the Women's Rights Foundation, and Women for Women.
If you need financial help or overseas abortion advice: Contact Abortion Support Network
Abortion Support Network (ASN) is a non-profit organisation that assists women in Malta with getting an abortion with pills, or abortion at clinics in England and other parts of Europe. They can provide further information on abortion clinics or abortion pills, as well as accommodation and financial assistance if you need to travel.
Have a look at ASN's website to learn more about how they could help:
Finally, if you have any further questions, contact us Doctors for Choice Malta and we will endeavour to answer them.
A word of caution...
Factual information about abortion is often lacking or overly biased in Malta, even within the national health service. We also advise caution before attempting to make contact with local pregnancy crisis services or pregnancy support services; these are often run by anti-choice ("pro-life") groups and there have been reports of women being hindered from accessing abortion. For example, Life Line Malta and Dar Tgħanniqa t'Omm are operated by the local anti-choice organisation Life Network Foundation Malta, and HOPE is operated by Gift of Life Malta. Always clarify who is behind the service and what their values are before giving them your personal information.
Be particularly cautious of anyone offering abortion pill reversal, also known as abortion reversal treatment, to reverse the effects of Mifepristone. Such treatment is probably ineffective and dangerous. Read more here.
If you would like abortion advice or pregnancy advice, be sure to contact a pro-choice organisation like Abortion Support Network, because anti-abortion groups in Malta are known to give false and misleading information to stop women from having abortions.
Frequently Asked Questions
What is an abortion?
Abortion is the termination of a pregnancy so it does not result in a birth. It is performed either by taking medication, also known as medical abortion (the most common method), or by physically removing the pregnancy with a minor procedure in a clinic, known as surgical abortion.
What is a medical abortion?
A medical abortion means ending a pregnancy using pills. The most commonly used abortion pills are Mifepristone and Misoprostol. Abortion pills can be safely used at home up to 12 weeks of pregnancy, according to guidance of the World Health Organisation.
What medications are used for abortion?
A medical abortion is usually carried out with Mifepristone followed by Misoprostol the next day, although Misoprostol could be used on its own.
It is normal to have a heavy period-like bleed and cramps after taking these pills, and it should resolve after a few days but may take up to two weeks. If you have continued severe bleeding, severe pain, or signs of an infection, you will need to seek medical help.
Which websites are abortion pills ordered from?
It is a known fact that Women on Web and Women Help Women supply abortion pills to women in countries where abortion is illegal, including Malta. They usually ask for a donation of 90 Euro and ask you a few questions to ensure that it is safe for you to take abortion pills. We are not in any way involved in the operations of these organisations. Remember that taking abortion pills while in Malta is illegal.
Is it legal to import abortion pills?
This is a bit of a grey area. Mifepristone and Misoprostol are prescription-only medications that have other medical uses apart from abortion. Mifepristone is used to treat certain cancers and Misoprostol is used to treat stomach ulcers.
Customs regulations allow people to import prescription-only medication for personal use. We also know that Women on Web include a prescription by a doctor registered in the EU in the abortion pill pack. We are not aware of any recent cases where abortion pills have been withheld by the authorities.
Does "abortion reversal" or "abortion pill reversal" work?
No. There is no evidence that giving Progesterone, or any other medication, after taking any abortion pills will stop abortion. Such treatment is unproven and potentially dangerous.
Before taking any abortion pills, make sure you are certain you would like to end the pregnancy.
What is a surgical abortion?
A surgical abortion is a minor procedure that involves removing the pregnancy. Contrary to what its name suggests, surgical abortion does not involve cutting or stitches, and the pregnancy is removed through the vagina. There are two main types of surgical abortion:
Vacuum or suction aspiration
This can be done up to 14 weeks of pregnancy.
A tube is inserted into the womb through the cervix (the opening to the womb from the vagina), and the pregnancy is removed using suction. It is usually done under a local anaesthetic with some mild sedation if needed.
Vacuum aspiration takes about 5 to 10 minutes and most women go home a few hours later. Clinic fees for a vacuum aspiration are usually around EUR 800.
This video by BPAS explains what happens during vacuum aspiration:
Dilatation and evacuation (D&E)
This is done after 14 weeks of pregnancy. It involves inserting special instruments called forceps through the cervix and into the womb to remove the pregnancy.
D&E is usually carried out under a general anaesthetic. After a D&E you are likely to be advised to stay at the clinic for most of the day to ensure you recover fully. Clinic fees for dilatation and evacuation are usually between EUR 1,500 and 2,000.
This video by BPAS explains what happens during dilatation and evacuation:
Is abortion legal in Malta?
No. Despite being an essential health service for women, abortion is illegal in Malta in all circumstances. However, it is legal for women in Malta to have abortions in countries where it is allowed. It is also common practice for women in Malta order abortion pills online.
Which abortion clinics abroad accept women from Malta?
Also have a look at the UK's National Unplanned Pregnancy Advisory Service's website for more information on abortion services and providers.
If you cannot travel to the UK due to visa issues and need to stay within the European Schengen Area, please contact Abortion Support Network for guidance on reliable abortion providers in Schengen countries.
What is the limit to have an abortion in other European countries?
In the United Kingdom, the limit is up to 24 weeks of pregnancy for most cases. However, there is no limit in cases of fetal anomaly or when there is a risk to the pregnant woman's life. Abortions after 24 weeks usually require a specialist centre and can be very expensive.
In the Netherlands, the limit is around 22-23 weeks in most cases.
In Italy, the limit is up to 90 days (around 12 weeks) in most cases.
How much does an abortion cost?
It depends on the type of abortion and where the abortion is performed. Women on Web and Women Help Women normally ask for a donation of around 90 Euro from their clients.
Travelling for a surgical abortion abroad usually costs around EUR 800 in clinic fees for pregnancies up to 14 weeks, and this increases to around EUR 1,500 for later pregnancies. The website of BPAS has a price list that gives an indication of how much an abortion costs. This does not include travel and accommodation costs.
I cannot afford to have an abortion. Who can help me?
We recommend contacting the Abortion Support Network on 27780991. Their website is www.asn.org.uk/malta and their email is email@example.com. Abortion Support Network can provide advice, assistance, and financial support.
Should I contact a pregnancy crisis service?
Keep in mind that pregnancy crisis services are usually run by anti-abortion groups with the aim of discouraging women from having abortion, and there have been reports of women being intimidated in Malta after contacting such services to stop them from having an abortion. It is ultimately your decision whether you wish to make use of such services, but we do not recommend it.
If you would like someone to discuss your pregnancy options with, we recommend contacting a pro-choice service like the Family Planning Advisory Service (FPAS).
I have had an abortion and need medical help in Malta. What do I do?
If it is an emergency, for example you have continued severe bleeding, pain, or signs of an infection such as a vaginal discharge or fever, you will need to attend an Accident and Emergency Department. We understand that many women will be reluctant to tell a doctor that they have taken abortion pills in Malta. Not disclosing this information will not usually change the treatment offered, because the treatment for miscarriage is the same regardless of whether it is natural or caused by pills. If you feel you need legal advice, the Women's Rights Foundation may be able to help.
Does an embryo or fetus feel pain when aborted?
No. According to research by the Royal College of Obstetricians and Gynaecologists (RCOG), a fetus does not have the necessary brain connections to feel pain and is unconscious before 24 weeks. Almost all abortions are performed before 24 weeks.
The RCOG research can be accessed here.
I have been told my baby will have a serious abnormality. How can I get an abortion?
A diagnosis of fetal anomaly can be devastating for the couple involved, and abortions in these circumstances often happen in the later stages of pregnancy. Couples who receive this diagnosis and want to opt for abortion will have to travel outside of Malta. The UK does not have a gestational limit for abortions in cases of fetal anomaly. A later term abortion is often more technically demanding than earlier abortions, and a post mortem examination of the fetus may be needed to identify what the abnormality was and whether it could be prevented in future pregnancies. The costs for these services can run into several thousand Euros, and you should discuss your options with Abortion Support Network.
Why do you inform women on how to access safe abortion?
As an organisation, the safety and wellbeing of women and the population of Malta as a whole are our priority. Restricting women's access to abortion forces women to undertake unsafe abortions either with less qualified providers, or without adequate supervision. The World Health Organisation states that banning abortion does not reduce the rate of abortions, it only makes them less safe. The World Health Organisation recommends that abortion services form part of every healthcare system, along with affordable contraception and comprehensive sexuality education.
We feel that we have a duty to prevent unsafe abortions by informing women on how to access safe and legal abortion abroad. We do not believe this would encourage more women to have an abortion; it would only help ensure that those women who have already decided to have an abortion do so legally and safely.