Women on Web, an organisation that provides abortion telemedicine services to women around the world, including Malta, has informed us that during the first twelve months of the pandemic, that is from March 2020 to March 2021, they have shipped 227 abortion pill kits to women in Malta.
This number does not include all the ways by which women in Malta obtain abortion pill kits. Other reputable organisations, notably Women Help Women, also provide abortion telemedicine services to women in Malta and are not included in this figure. There will also be women who obtain abortion pills from friends or family abroad, and women who are provided with pills via underground channels in Malta.
Abortion telemedicine means that medical consultations for an abortion are conducted remotely and women are provided with abortion pills to use at home. It allows women to end an early pregnancy without having to travel to a clinic, and only seek in-person medical care if needed.
Abortion telemedicine has become an important tool in ensuring women have access to abortion during the pandemic. Restrictions on international travel have meant that women living in countries where abortion is illegal could no longer access clinics abroad as easily. Intra-country restrictions on travel, such as stay at home orders, also impacted access to abortion clinics in countries where abortion is legal, which is why in many countries where abortion is legal there has been renewed interest in abortion telemedicine.
Research published in the BMJ Sexual and Reproductive Health by Dr Rebecca Gomperts among other authors, has identified Malta as one of the countries where demand for abortion telemedicine services from Women on Web has increased during the pandemic (see figure below.)
The outlier in this research is Great Britain, where laws and policies were amended to make access to abortion telemedicine easier during the pandemic within the country itself, and therefore there were less requests being made to Women on Web.
A study looking at the impact of abortion telemedicine in Great Britain has found that the new telemedicine arrangements reduced waiting time from referral to treatment by an average of 4.2 days, and a higher proportion of abortions happened in the first 6 weeks of pregnancy (40% with telemedicine vs 25% with in-person care). There were no differences in treatment success, incidence of serious adverse events, or incidence of ectopic pregnancies between telemedicine and in-person care. Abortion telemedicine also proved popular with service users, with 96% reporting satisfaction with the service and 80% stating that they would use it again if needed.
Women in Malta who make use of safe and effective abortion telemedicine services continue to be criminalised by outdated laws. There is no evidence to suggest the prohibilition of abortion in Malta reduces the rates of abortion, and tentative estimates have found the abortion rates in Malta to be similar to those of other EU countries. However, the criminalisation of abortion may make women in Malta who make use of abortion telemedicine more reluctant to seek help in local hospitals or with local doctors if they experience complications, which may increase the risk to their health and safety.
By Dr Christopher Barbara