American pro-life attention since June 2022 has focused on the legal status of abortion in the aftermath of the Dobbs decision, removing Roe v. Wade’s straitjacket on states that wanted to protect prenatal life. Fewer people know that during the same period, a similar pro-life fight played out on the Mediterranean island nation of Malta, one of Europe’s last two countries (alongside Poland) that provide substantial legal protection to unborn life.
What happened in Malta is instructive, because it mirrored the pro-abortion playbook around the world, namely, using an extreme case to attack all pro-life legislation. While hard cases may make bad law, they generate good “narratives.”
Malta’s most recent abortion debate started with the case of Andrea Prudente, an American tourist who was 16 weeks pregnant when her membranes ruptured. She was admitted to a Maltese hospital.
The clinicians, per normal protocol, monitored her and her baby, ensuring that at no point was she endangered: Malta has had a zero percent maternal mortality rate for over a decade. Such cases are delicate and take time, and sometimes the fetus survives. There was another case like Prudente’s at the time: The mother was treated, and the baby survived. Prudente, however, chose to be airlifted to Spain and terminated her pregnancy. In Malta abortion is illegal.
Prudente’s case—like the 2012 death of Savita Halappanavar in Ireland, which became a symbol for the pro-abortion referendum that stripped protection for prenatal life from the Irish Constitution—is the latest example of a current twist on an old standby. Prior to Roe, protective pro-life laws were accused of being responsible for unsubstantiated “thousands” of deaths each year. Today, claims that pro-life laws intimidate medical personnel from providing the best active care in miscarriage cases is the new wedge designed to carry all other abortions in its wake. That claim, for instance, underlay a case brought against Texas’s pro-life law that led to an August 4 judge’s decision that the Lone Star State’s medical exceptions were “uncertain.”
Malta’s government succumbed to criticism and international pressure over the Prudente case and promised a review of “abortion law.” The Labor Government sent a bill to “clarify” the law in November 2022. The clarification included language stipulating that abortion be permitted if medical complications “may” endanger a woman’s “health”—language similar to that used in the UK’s Abortion Act, 1967, which was intended to limit the scope of abortion but in fact would become a very permissive loophole.
Pro-life groups in Malta saw the “health” provision as a backdoor way to erode Malta’s pro-life legal safeguards and sprang into action. Life Network Foundation organized broad opposition, including an historic, massive protest on December 4, 2022. Position papers from experts defending the law were drafted and published. Prominent public figures, including former President Marie Louise Coleiro Preca, spoke out. The Catholic Church drafted its own paper, addressed the topic in sermons across the Catholic island, and wrote a pastoral letter to parliamentarians. The Opposition party came out clearly against the abortion amendment. Current President of Malta, Dr. George Vella, stated publicly that he would not endorse the introduction of abortion.
Government plans to enact its abortion bill by Christmas 2022 were derailed and, in June 2023, it reversed course and adopted clear pro-life amendments to the bill, which was signed into law June 30. Those amendments caused an uproar in pro-abortion groups, who thought that abortion was going to be allowed in some instances.
It’s clear that defenders of pro-life laws will increasingly need to address claims that such protective legislation endangers women’s lives by either banning proactive medical treatment in complicated pregnancies and/or chilling physicians from employing such treatment out of fear of legal liability.
Malta has shown that pro-life laws and competent medical care for life-threatening pregnancies are not incompatible. As noted, Malta has not seen a maternal death from pregnancy in over a decade. That said, extreme cases such as this create impressions that are not readily dissipated by fact-based discussion. It’s clear that such arguments are a new front in the war against pro-life laws. In the United States, it’s an argument used against states that try to legislate greater protections of the unborn post-Dobbs. In other countries—like Malta—it will be an argument to weaken pro-life laws where they remain. Prolifers cannot shy away from addressing these claims, with facts, and empathy.