A Maltese court has ruled that the fundamental rights of American national Andrea Prudente were not violated when doctors refused to terminate her pregnancy in 2022.

Prudente was holidaying in Malta when she started having a miscarriage but doctors at Mater Dei Hospital refused to terminate the pregnancy while a foetal heartbeat was still present. She later filed a constitutional case claiming her human rights were breached.

On 1 July, the court dismissed all of Prudente's claims, concluding that she received appropriate medical treatment throughout her stay at Mater Dei Hospital. Judge Miriam Hayman ruled that Prudente's life was never in imminent danger while she was in Malta. The court also ordered Prudente to pay the costs of the proceedings.

Prudente travelled to Malta with her partner, Jay Wheeler, while 14 weeks pregnant in 2022. During their holiday, she began miscarrying and was eventually admitted to Mater Dei Hospital after suffering bleeding, rupture of the amniotic sac and prolapse of the umbilical cord.

Doctors informed the couple that the foetus had an extremely poor prognosis but, because a heartbeat remained detectable and Prudente showed no signs of life-threatening infection, they continued with conservative medical management rather than terminating the pregnancy.

Unable to obtain the treatment she wanted in Malta, Prudente was medically evacuated to Spain, where her pregnancy was terminated.

In her constitutional application, Prudente argued that Malta's blanket abortion ban at the time exposed her to serious health risks, forced her to endure inhuman and degrading treatment, interfered with her private life and discriminated against her as a woman. She asked the court to declare that the relevant provisions of the Criminal Code breached her constitutional and convention rights and sought compensation.

The court rejected those arguments after hearing extensive evidence from Prudente, her partner and several obstetricians and gynaecologists involved in her care.

The court found there was no evidence that Prudente received substandard medical care or that hospital staff mismanaged her treatment. Instead, the judgment states that she was continuously monitored, given antibiotics, underwent repeated blood tests and remained under close observation for any signs of infection. According to the medical evidence accepted by the court, her white blood cell count, and inflammatory markers remained normal throughout her admission and she never developed sepsis or any indication that her life was in imminent danger.

The court accepted expert testimony that, although the foetus had a poor chance of survival, there remained a possibility that the pregnancy could continue. It noted that medical staff would have intervened immediately had Prudente shown signs of severe infection or imminent risk to her life, but found those circumstances never arose while she remained in Malta.

In its reasoning, the court also criticised what it described as pressure placed on Prudente by pro-choice activists during the ordeal, stating that she had been "used" to advance broader legal arguments on abortion while she was experiencing an emotionally traumatic miscarriage.

Addressing the constitutional claims, the court ruled that there had been no violation of Prudente's right to life, protection from inhuman or degrading treatment, right to private life or protection against discrimination under either the Maltese Constitution or the European Convention on Human Rights.

On the discrimination claim, the court held that Malta's abortion prohibition applied equally to all women and therefore did not amount to discriminatory treatment. It further observed that abortion remains a legally and ethically contested issue internationally, with different jurisdictions adopting different approaches.

The court therefore dismissed Prudente's constitutional application in its entirety, upheld the remaining government defences on the merits and ordered her to bear the costs of the case.

Prudente was represented by lawyer Lara Dimitrijevic.

Judge Miriam Hayman presided over the sitting.