Doctors for Choice
Malta's abortion trends and the effects of the pandemic
In this article we examine how the COVID-19 pandemic has changed the ways women and girls in Malta have abortions.
Travel restrictions, lockdowns, and other public health measures enacted to combat the spread of the novel coronavirus have resulted in changes to the way healthcare services are accessed, and abortion is no exception.
The graph below shows the number of abortions by Maltese residents performed in clinics in England and Wales (blue line), and the number of abortion pill kits sent to Maltese residents by Women on Web (red line) in 2018, 2019, and 2020.
England and Wales are not the only nations where women from Malta have abortions, with Italy and the Netherlands also being popular destinations. However, only England and Wales produce accurate statistics on the number of women from Malta who have abortions in their country. It is reasonable to use the figures for England and Wales as a bellweather for the total number of abortions by Maltese residents abroad. Similarly, Women on Web is not the only online telemedicine provider of abortion pills to women in Malta, but their figures can be considered representative of the trend in the number of abortion pill kits sent to Malta.
Between 2018 and 2019, which represents the pre-pandemic period, there was a marginal increase of 9.4% in the number of abortions performed in clinics in England and Wales on women from Malta. There was a much more significant increase of 62% in the number of abortion pill kits sent to Malta by Women on Web.
A plausible interpretation of this data is that the number of women from Malta travelling to abortion clinics abroad was increasing slightly, but the number of women in Malta making use of abortion telemedicine services was increasing at a much faster rate. One explanation is that women in Malta were becoming more aware of online abortion telemedicine services and there was a shift from underground providers of Mifepristone and Misoprostol to online telemedicine services, which tend to be cheaper, more reliable, and safer. Another explanation is that women in Malta were becoming more aware of the option of abortion and this, together with societal change, could be leading to a higher number of pregnant women opting for abortion.
Public health measures to slow the spread of the novel coronavirus were introduced in the first quarter of 2020. Overseas travel became more difficult, and for a few months there was a total ban on non-essential travel. In 2020, compared to the previous year, there was a 66% decrease in the number of abortions performed on women from Malta in clinics in England and Wales. On the other hand, the number of abortion pill kits sent to Malta by Women on Web increased by 89%.
The following graph combines the number of abortions in clinics in England and Wales on women from Malta and the number of abortion pill kits sent to Malta by Women on Web:
A reasonable interpretation of this graph is that the pandemic either mildly accelerated, or had no impact on, the pre-pandemic growth in abortion caseload in Malta. This means that online abortion telemedicine services absorbed the caseload that was shifted away from abortion clinics.
Also of note is that Abortion Support Network, an abortion fund and support service which started offering help to women in Malta in February 2019, saw an increase in help requests by Maltese residents from 75 in 2019 to 126 in 2020.
In the pre-pandemic years there was a strong increase in the number of women in Malta making use of online abortion telemedicine services. The number of women making use of abortion clinics abroad was increasing at a lower rate.
The pandemic brought about an expected shift from abortion in clinic to abortion at home. Abortion telemedicine services appear to have absorbed the caseload of women who would in different circumstances have travelled to abortion clinics abroad.
The total number of women in Malta having an abortion in clinics abroad and through online telemedicine services appears to be on a strong and steady increase, and the pandemic may have led to a mild acceleration of growth in demand for abortion services.
Written by Dr Christopher Barbara
Sources of data:
Figures for England and Wales were obtained from gov.uk
Figures for Women on Web were provided by Dr Rebecca Gomperts
Figures for Abortion Support Network were provided by Mara Clarke