A woman who was refused an abortion by Mater Dei Hospital after suffering a miscarriage has called on Malta to end its “barbaric” laws that are preventing doctors from ending an “unviable pregnancy” that is threatening her life.

US citizen Andrea Prudente, who suffered the miscarriage at 16 weeks pregnant, says every day that goes by puts her at a higher risk of a fatal infection.

The case was initially brought to light by Doctors for Choice, an NGO which has advocated for the repeal of Malta’s strict abortion laws.

“A 16-week pregnant woman, a US citizen currently on holiday in Malta, attended Gozo A&E and was later admitted to Mater Dei Hospital after suffering what seemed like a miscarriage, with heavy bleeding followed by breaking waters. An ultrasound showed ruptured membranes (broken waters) and a detaching placenta. However, the fetus still has a heartbeat,” the NGO said in a Facebook post.

“International obstetric guidelines state that in such cases where the fetus is not yet viable (before 24 weeks), termination of pregnancy (ie: abortion) should be offered to avoid the risk of maternal infection and death. Infection can go through the ruptured membranes, into the uterus, then into the blood leading to death,” it continued.

The NGO said that the woman in question requested the termination of her pregnancy but that the request was refused.

“She was told doctors can only intervene if she is imminently dying – not even getting an infection is enough. She was also told doctors cannot even discuss the option of abortion with her,” the NGO said.

The NGO said that the patient is now being “forced to watch and wait at Mater Dei, putting her life at risk.”

“The family is rightly distraught and desperate for a solution. Medical evacuation to the UK is being planned but this may not arrive in time,” the NGO continued.

It said that the woman and her partner wanted the story to be made public in hope of avoiding a tragedy, with the NGO relating this case to that of Savita Halappanavar – a woman who died from sepsis in Ireland after her request for an abortion in similar circumstances was denied on legal grounds.

The outcry after Savita’s death led to a referendum to repeal Ireland’s anti-abortion laws, which ultimately passed by a two-thirds majority in 2018.

“We hope common sense prevails and this woman is allowed to have a termination before it is too late.  We have also heard from Maltese women who were in similar situations but were scared to speak out. This is not right. Women have beating hearts too,” Doctors for Choice said.

In a Facebook post, Prudente said: “I am stuck in Malta and fighting for my life. Malta's barbaric abortion laws prevent doctors from giving me the treatment I need to end an unviable pregnancy which is threatening my life. Every day that goes by puts me at higher risk of a fatal infection.”

She urged people to spread the word about her case, hoping it would attract international media attention. “As you can imagine, I would rather this trauma remain a private matter but I am desperate. I don't want to die here,” she wrote.

Speaking to sections of the media, her partner, Jay Weeldreyer pleaded with health authorities to not risk Andrea’s life. He said they are being “held hostage” while doctors wait for the foetus to die.

Weeldreyer said the couple were told a week ago that the baby would die but they are being refused permission to travel abroad to get an abortion.

He added that Andrea is being monitored and is being administered antibiotics, but the trauma is having a negative effect on her mental health.

 

Life Network Foundation statement

In a short statement, Life Network Foundation Malta said: “We have seen the reports about the clinical situation of a pregnant woman who needs medical care, and who was admitted to Mater Dei hospital. We don’t know the full facts of the case and we understand she is receiving the care that she needs. Malta has an excellent track record of caring for pregnant women. If the life of the mother is at risk, the doctors in Malta have the legal and ethical obligation to do all that they can to save the life of the mother whatever the consequences to the unborn child.

Life Network is willing to help in any way if the mother or her partner need support.

We await further details to be able to comment on the case. We wish the woman and her partner the best outcome in this delicate situation and ask that media reports do not exploit this vulnerable situation.”

 

Doctors for Life statement

Doctors for Life said it is also closely following the case.

“We genuinely empathise with the apprehension of the couple in question and want to emphasise that the practice at Mater Dei Hospital always seeks to ensure that the mother’s life is always protected and given priority. Whenever such a case presents to hospital, a careful assessment is made to assess the severity of the condition. The patient is intensively monitored and promptly treated for any signs of infection. If serious haemorrhage or infection supervenes, then the uterus is always evacuated.”

Doctors for Life said such a decision is taken at the highest clinical level and would involve at least 2 consultants.

“Premature rupture of membranes does not always result in infection and not all such pregnancies end up in a spontaneous miscarriage. This is why not all cases require evacuation of the uterus (induced labour) at the outset. Nevertheless, if it is required then this is done, even if the foetus is too young to survive outside the womb. Each case is assessed and managed on its own merits by the caring specialist.”

“This practice has stood the test of time and our zero percent maternal mortality for the last 12 years attests to that. We hope that the Health department may be forthcoming in providing some details about this case in order to reassure those who may be concerned about the level of care delivered at Mater Dei in such cases.”

 

ADPD statement

Reacting to the case, ADPD-The Green Party said abortion is sometimes necessary to protect a woman's health and therapeutic abotion should be accepted without further delay, in clear language and in black on white by Maltese law, to prevent outdated practices and dangerous situations.

“Most people accept abortion when it is necessary to protect a woman's life. It is the duty of doctors to provide the best care to ensure a woman's physical and mental health. It is clear that Maltese law is being used as an excuse to endanger women's health at the state hospital.”

“It is unacceptable that in the year 2022 the state, Parliament, and ultimately doctors still refuse to do what is accepted all over the world to safeguard women's health, risking patients' health and lives, due to a fundamentalist attitude, without any empathy and sensitivity whatsoever.”

Meanwhile, a protest was held in front of Parliament by the group Young Progressive Beings.