How to Get an Abortion
This video (in Maltese) gives a summary of the abortion options available to people in Malta.
Abortion, also known as termination of pregnancy, means stopping a pregnancy so it does not result in a birth. If you have an unwanted pregnancy and are seeking an abortion, this page is for you. This page gives a summary of the key facts about abortion, the various safe abortion options available to people in Malta, and the main reputable providers of early medical abortion pills and surgical abortion treatments.
There are two main types of abortion:
Medical abortion is carried out using pills and could be undertaken at home. It is the most common method of abortion used by women in Malta.
Surgical abortion is a straightforward procedure to remove the pregnancy, and is performed in a clinic abroad. This interactive app will tell you which abortion options are available at your stage of pregnancy.
Abortion is only legal in Malta if the pregnant woman has a complication that may lead to death. However, it is still possible to get a safe abortion. Despite the legal ban on abortion hundreds of women in Malta have an abortion each year. The two main ways women in Malta get an abortion are by ordering abortion pills online, or by travelling to abortion clinics abroad.
Abortion is considered a safe procedure. Statistically, abortion has less risk of complications than giving birth. Having an abortion does not increase the risk of cancer, or of developing mental illness. It also does not affect your chance of becoming pregnant again in the future. For more information refer to the NHS UK website.
When looking for information about abortion, make sure you consult pro-choice sources and organisations. Anti-abortion (also known as "pro-life") organisations in Malta are known to spread misinformation about abortion to stop women from having abortions. It is not true that many women regret abortions, in fact over 95% of women who have abortions feel relief and believe abortion was the right decision.
Abortion with Pills
Abortion pills can usually be used by the woman herself at home up to 12 weeks* of pregnancy, but keep in mind the pills may take a few weeks to arrive. If an abortion is needed after 12 weeks, it is usually carried out surgically in countries that allow abortions after 12 weeks, such as the UK and the Netherlands.
Many women in Malta order abortion pills from Women on Web or Women help Women. These are reputable organisations that are known to send authentic pills, they take care to ask you questions to make sure it is safe for you to use abortion pills, and they send the pills from within the EU which means you will not have to deal with customs. They usually ask for a donation of around EUR 90 to cover the cost of the pills and postage. The pills usually take one to three weeks to arrive. You can find more information on how to order abortion pills on the website of Safe Abortion Malta. Beware other sites on the internet that claim to sell abortion pills, because they might be unreliable and the pills might not be authentic.
There are two abortion pills - Mifepristone (Mifegynae, Mifeprex, or RU-486) and Misoprostol (Cytotec). They are sometimes supplied in a single combipack (such as Termipil Kit). Mifepristone 200mg is usually taken first, followed by Misoprostol 800mcg the next day. Mifepristone is swallowed, whereas Misoprostol is held under the tongue or between the gum and cheek for thirty minutes. Bleeding usually starts a few minutes to a few hours after taking Misoprostol. If bleeding does not start, another dose of Misoprostol can be taken.
It is normal to have heavy bleeding with clots and strong cramps after using abortion pills. Nausea is also a common side effect. Painkillers of the NSAID class such as Ibuprofen (Nurofen), Mefenamic acid (Alfoxan or Ponstan) or Diclofenac (Catafast) are effective at relieving pain during an abortion. If you do not have any of these you can use Paracetamol (Panadol).
It is recommended to have someone you trust with you when using abortion pills at home. If during or after the abortion you develop severe bleeding (for example you fill more than four maxi pads in two hours), severe pain that does not respond to painkillers, a smelly discharge, or a fever you will need to seek medical help.
Abortion pills will successfully terminate a pregnancy in over 98% of cases. To check whether an abortion with pills was successful, you can either do a pregnancy test after two to three weeks, or have an ultrasound.
* Important: When counting the number of weeks of your pregnancy, you must count from the first day of your last period. For pregnancies of more than seven weeks, you could have an ultrasound to accurately date the pregnancy.
Women on Web also provide abortion pills to people who are not pregnant in case they need them in the future. You can find more information about this service here.
How to get medical help
Less than 5% of those who use abortion pills in the first 12 weeks of pregnancy will need medical help. However, you should know how to get medical help, just in case you need it.
The Abortion Doula Support Service is a free service by Maltese pro-choice doctors who provide medical help and support before, during, or after an abortion, regardless of where or how the abortion is done. They can help you identify complications that may need treatment, and tell you how to get help.
If you are experiencing an emergency, please head straight to Mater Dei Hospital if you are in Malta, or Gozo General Hospital if you are in Gozo. If you are not sure whether the healthcare professional you are seeing is pro-choice, you do not have to say you have taken abortion pills and you can say you are having a miscarriage.
Abortion in Clinic
Travelling to abortion clinics abroad is the other main way women in Malta obtain abortions. Clinic prices start from around EUR 800 for pregnancies of up to 14 weeks, and increase to over EUR 1,000 for later pregnancies. Remember that apart from abortion clinic costs you will also need to pay for flights, living expenses, and accommodation.
If you are going to travel it is usually better to choose a surgical abortion which is a quick procedure in most cases. Clinics vary in the point at which they begin to offer surgical abortion - some begin to offer it at 6 weeks, others insist on trying abortion pills first if you are less than 10 weeks pregnant. Be sure to check with your clinic before you travel.
Up to 14 weeks, a surgical abortion involves removing the pregnancy through the vagina using suction (vacuum aspiration). It can be done with a local anaesthetic and mild sedation (if needed), and you can expect to be at the clinic for a few hours. For later pregnancies, a surgical abortion involves removing the pregnancy using forceps and suction (dilation and evacuation) under a general anaesthetic. For this procedure you can expect to be at the clinic for a whole day, and you may be kept overnight for observation. The clinic will explain to you exactly what to expect before, during, and after a surgical abortion at your stage of pregnancy.
Different countries have different rules on up to what stage of pregnancy abortion is allowed and under what circumstances. The UK and the Netherlands allow second trimester surgical abortions. If you are not a Maltese national, you may need a visa to enter the UK. If you require a UK visa, we recommend you seek clinics in EU countries such as the Netherlands instead. Here is a list of European abortion clinics that offer their services to women from Malta.
If you would like to travel for an abortion but cannot afford the cost, Abortion Support Network may be able to help you. You can call Abortion Support Network on 2778 0991 or 2034 1685. They can also help you find flights, choose appropriate clinics, and book accommodation.
Before you travel, make sure you have booked an appointment with an abortion clinic and have agreed a price, you know your medical history and allergies (if any), you have booked accommodation for long enough to cover the procedure itself and any follow-up appointments, your travel documents are valid, and you have travel insurance and a European Health Insurance Card (if you are an EU national).
Below is a list of abortion clinics and providers that offer their services to women from Malta. The clinics are, where possible, located close to airports and train or bus stations. Many of these clinics charge discounted prices to women travelling from countries like Malta where abortion is illegal and some of the English clinics provide a taxi service to and from the nearest airport or train station. These clinics work with Abortion Support Network in case you need help to fund your abortion.
Frequently Asked Questions
Abortion is illegal in Malta. Can I get in trouble if I have an abortion?
Taking pills to end a pregnancy is illegal in Malta. However, it is very rare for a woman to be prosecuted for having an abortion. If you would like legal advice from pro-choice lawyers, you can contact the Women's Rights Foundation.
Abortion pills have other medical uses. For example, Mifepristone is used to treat certain types of cancer, and Misoprostol is used to treat stomach ulcers.
If you have an abortion abroad in a country where it is legal (which is almost all other EU states), then you cannot be prosecuted in Malta.
Can abortion pills be used at home?
Yes, abortion pills can be used at home with pregnancies of up to 12 weeks, according to the World Health Organisation.
The risks of a medical abortion are the same as those of a miscarriage. About 15% of all pregnancies end in a miscarriage, most of which do not happen in a hospital. Most women will deal with early miscarriages themselves and only seek medical attention in case of problems, such as prolonged heavy bleeding or fever. A medical abortion resembles a miscarriage and can occur safely at home.
How effective are abortion pills?
Mifepristone and Misoprostol successfully terminate the pregnancy in 99.5% of cases. In 97% of cases, the woman's body eliminates all the pregnancy remains naturally.
It is normal to see bleeding with clots for 1-3 weeks after an abortion. If you have extreme pain, prolonged heavy bleeding, smelly vaginal discharge or fever, it might be a sign that you have a complication and should get medical help.
How long do abortion pills take to arrive in Malta?
Abortion pills from Women on Web and Women Help Women generally arrive in one to two weeks. However, delivery times vary because the organisations often use different methods of postage. If the pills do not arrive or are late, please contact the organisation you ordered them from.
Can I use painkillers during an abortion with pills?
Yes. Cramping pains are to be expected during an abortion and Ibuprofen (Nurofen) is the most effective painkiller. Paracetamol (Panadol) can also be used but may be less effective.
Nausea is also common during abortion and tablets like Motilium can help.
Will I see an embryo come out after an abortion with pills?
Most probably not. You will see blood and tissue (clots) but it is very unlikely that you will see an embryo. For abortions done in the first 8 weeks of pregnancy, the embryo usually is too small to be seen. Beyond 8 weeks, an embryo or parts of it may be seen, although these are usually obscured by blood and tissue.
I have taken abortion pills and I need to see a doctor. Can they find out I used abortion pills?
Not unless you tell them. There is no test they can do to check whether you took abortion pills, unless they find the pills themselves. Women on Web advise that Misoprostol is put under the tongue instead of inside the vagina, so that no residue of the pills can be found.
If you have taken abortion pills and you think you need medical help, for example you feel very weak, have bled too much, or have a fever, you should seek help immediately.
What happens if I vomit after taking Mifepristone or Misoprostol?
If you vomit in the first 90 minutes after swallowing Mifepristone, it may be less effective. However, as advised by Women Help Women, you can still continue with the abortion and take Misoprostol the next day.
If you vomit 90 minutes or more after swallowing Mifepristone, then it has already been absorbed and you do not need to worry.
Since Misoprostol is held under the tongue for 30 minutes and you do not have to swallow it, vomiting is less likely to be a problem. However, if you do vomit during those 30 minutes you should take another dose of Misoprostol. Putting Misoprostol inside the vagina is also an option.
Nausea is very common during the abortion process. You can take medicines like Motilium to help with this.
What happens if I forget to take Misoprostol after Mifepristone?
Misoprostol can be used as late as 72 hours (3 days) after Mifepristone. If you do not take Misoprostol at all after taking Mifepristone, you could have one of three outcomes:
1. You could have a complete abortion anyway.
2. You could have a missed abortion (an unviable fetus that remains in the uterus) and this will have to be removed with a minor surgical procedure.
3. Your pregnancy could continue.
There is no evidence that the effects of Mifepristone can be reversed using Progesterone or any other drug.
How do I know if the abortion pills worked?
A few hours after taking Misoprostol you should start to see blood, which should be at least as heavy as a period. Since the pregnancy hormones take a while to come down after an abortion, a pregnancy test may remain positive for up to three weeks after an abortion.
You could have a pregnancy test at 2 weeks after taking abortion pills: If it is negative, then the abortion definitely happened. If it is positive at 2 weeks, it does not necessarily mean the abortion did not work - you should take another test a week later (3 weeks after the abortion pills). If it is still positive at 3 weeks, then the abortion may have been unsuccessful and you may have to repeat the process or opt for a surgical abortion.
An ultrasound can also be used to tell whether an abortion has been successful.
When should I start using contraception after an abortion with pills?
You should start using contraception straight away, because ovulation can happen soon after an abortion. If you use the contraceptive pill, you can start a new pack the day after taking Misoprostol. If you start the pill more than three days after taking Misoprostol, you should use a condom during the first 9 days.
Will an abortion affect my fertility?
No, an abortion will not affect your ability to have children in the future. However, if you develop a complication you will need to seek help immediately to prevent damage to the uterus.
Can an embryo or fetus feel pain when aborted?
No. According to research by the Royal College of Obstetricians and Gynaecologists (RCOG), a fetus does not have the necessary brain connections to feel pain and is unconscious before 24 weeks. Abortion with pills at home are performed in the first 12 weeks of gestation.
The RCOG research can be accessed here.
When should I NOT use abortion pills?
You should not use abortion pills if:
Someone is forcing you to end your pregnancy against your will.
You are not sure about wanting to end your pregnancy.
The first day of your last menstrual period was more than 12 weeks ago.
You have an allergy to Mifepristone, Misoprostol, or prostaglandins (this is very rare).
You have one of the following diseases: Chronic adrenal failure, Hemorrhagic disorders or bleeding disorders/diseases, Inherited porphyrias. (These diseases are very rare.)
You have an ectopic pregnancy (a pregnancy outside the womb).
You are alone. You should ask a partner, friend or other trusted person to stay with you while you use the medicines.
You are under the influence of alcohol or drugs.
I'd rather have an abortion in a clinic than at home. What are my options?
There are no legitimate abortion clinics in Malta so you would have to travel abroad. The usual destinations for women in Malta are England (UK) and the Netherlands. Italy has been popular in the past but keep in mind that the limit for abortions in Italy is only 90 days. You can find a list of abortion clinics here.
How is a surgical abortion in a clinic performed?
For pregnancies of up to 14 weeks, it is performed with a local anaesthetic and involves inserting a small tube into the uterus and aspirating the pregnancy. For this procedure you can expect to be at the clinic for a few hours.
Beyond 14 weeks you will need to attend the day before to have cervical preparation, and on the day of the procedure the cervix is dilated and the pregnancy is removed with forceps and suction under a general anaesthetic. For this procedure you can expect to be at the clinic for a whole day.
How much does a surgical abortion in clinic cost?
An aspiration (up to 14 weeks pregnancy) usually costs around 800 Euro. A dilation and evacuation (beyond 14 weeks pregnancy) usually costs between 1,500 and 2,000 Euro. Keep in mind that you will also have to pay for travel and accommodation expenses.
Remember, if you need help paying for your abortion abroad, Abortion Support Network may be able to help you.
How quick is the recovery from a surgical abortion?
Recovery is usually very quick and most women return to work after a day or two. Bleeding after a surgical abortion can continue for 1-2 weeks and usually resembles a normal period. Bleeding is usually less heavy than after a medical abortion (abortion with pills), and some women experience only some spotting until their next period.
When can I travel after a surgical abortion?
You should avoid travel for at least 24 hours after having a surgical abortion.