Why is Malta's move to ease total abortion ban so divisive?

• Malta only EU country with blanket abortion ban
• Planned amendment aims to protect women's live
• Critics fear it could pave way for broader reform

VALLETTA - When Marion Mifsud Mora started miscarrying while visiting her parents in Malta she rapidly developed a serious infection that left her battling for her life.

Back home in Canada doctors would have swiftly ended the pregnancy, but Malta's abortion ban meant medics could not intervene until the foetal heartbeat stopped.

"I was terrified," Mora told the Thomson Reuters Foundation. "My three-year-old daughter could have been left motherless for a baby that had no chance of living."

Malta is the only EU country with a total abortion ban. Any doctor ending a pregnancy risks up to four years in jail.

But lawmakers in the staunchly Catholic country are expected to pass a landmark amendment in the coming weeks aimed at preventing cases like Mora's.

Supporters say the reform, while modest, could save lives. But it has proved highly contentious, sparking one of the biggest protests in decades with critics fearing it will open the door to greater liberalisation.

Under an amendment proposed by the Labour government, terminations would be allowed if a woman's life or health were "in grave jeopardy", but would remain illegal in all other cases, including rape, incest and foetal abnormality.

Moves to ease the Mediterranean island's 1854 law were triggered by an almost identical case to Mora's that made global headlines last summer.

When American tourist Andrea Prudente started miscarrying on holiday in Malta, she had to be airlifted to Spain after doctors refused to end her pregnancy despite the risk of infection.

Prudente is now suing the Maltese government, saying the country's law breaches human rights.

"If this has happened to me and it has happened to Andrea, who else has it happened to?" said Mora. "Why are we gambling with women's (lives)?"

Wiping away tears as she recalled her traumatic ordeal in 2014, the 45-year-old hairdresser said it was "senseless and abusive" to make a woman carry a non-viable pregnancy.

Emergency evacuation

Even as her condition deteriorated, Mora said doctors told her they could not give her certain antibiotics to treat the infection in case they harmed the four-month-old foetus already dying inside her.

She was eventually flown to a Paris hospital by her Canadian health insurance company.

Mora, who is half Maltese and a frequent visitor to the island, joined hundreds of others in September to call for reform in the country's largest ever pro-choice demonstration.

But the protest was dwarfed three months later when thousands marched through the capital Valletta against the planned amendment.

Opponents include the Catholic Church, the main opposition party, hundreds of doctors and former president Marie Louise Coleiro Preca.

The current president, George Vella, himself a former doctor, has previously threatened to resign rather than sign a law allowing abortion, but has not commented publicly on the detail of the amendment.

Critics want the reform restricted to cases where a woman's life is in danger.

"The introduction of the concept of health could lead to terminations for mental health reasons, such as depression," said Tonio Fenech, a former finance minister and member of the anti-abortion Life Network Foundation.

"Other countries have chosen to close their eyes to the horror of abortion. The Maltese people know the truth, that abortion is killing humans in the womb of their mothers."

Pro-life doctors also fear the reform will burden them with the ethical and legal responsibility of deciding what constitutes a grave threat to health.

The government has promised to tighten the definitions of the circumstances permitting a termination before putting the amendment to a vote.

Malta is an outlier in western Europe where abortion is generally legal in at least the first 12 weeks of pregnancy, including in Catholic countries like Ireland which voted to repeal its own ban in 2018.

Commentators say Malta has remained an anti-abortion bastion, partly because there has never been "a trigger" to change public opinion.

In Ireland, momentum for reform escalated after the death of a woman from a septic miscarriage who had been refused a termination.

Attitude shift

Multiple surveys show most Maltese oppose abortion. The most recent, commissioned by the Catholic Church, found while almost 80% agreed with abortion to save the life of a woman, only 23% supported it when a woman's life was not at risk.

But sentiment is changing.

In 2021, independent MP Marlene Farrugia introduced a bill to decriminalise abortion. It did not get anywhere, but such a move would have been unthinkable until very recently.

"It's manifestly unjust that Maltese women lose their rights over their body when they get pregnant, unlike their counterparts everywhere else in Europe and most of the world," Farrugia said.

Former prime minister Joseph Muscat has also said abortion should be a woman's choice.

Polls suggest there is a generational shift. One survey after the Prudente case, found two thirds of 16 to 35-year-olds supported abortion.

Despite the ban, hundreds of women in Malta end pregnancies every year, with growing numbers illegally taking abortion pills ordered online.

Two of the biggest providers, Women on Web and Women Help Women, shipped 424 pills to Malta last year, up from 356 in 2021, according to campaign group Doctors for Choice Malta.

Others go abroad, often spending thousands of euros on trips to clinics in Britain, Italy and elsewhere.

Anna, 35, travelled to the Dutch city Amsterdam for an abortion in September, after learning her unborn baby had anencephaly, a fatal abnormality impacting brain development.

She was careful about confiding in others.

"If you see the posts and comments on social media, those who choose an abortion are called killers in Malta," said Anna, who asked to use a pseudonym.

She was particularly angry to discover that the same doctor who recommended she go overseas had later signed a petition against the amendment.

The proposed reform will not change anything for women like Anna - Doctors for Choice Malta said it would only affect half a dozen cases a year like Mora's.

For a long time after her ordeal, Mora could not bear to return to Malta. She still finds it difficult sharing her story, but hopes it can help shift attitudes in the country she considers her second home.

"I feel really emotional to think that change is so close now for this next generation," she said.

(Reporting by Diana Cacciottolo; Editing by Emma Batha.)