The statements in the past week by the Maltese bishops and MPs Jeffrey Pullicino Orlando and Leo Brincat at the Council of Europe could not seem any more mind boggling. They protest against the CoE’s resolution that proposes that women are offered the conditions of a free and enlightened choice, and yet we still don’t know why.
Because the evidence on abortion in Europe points towards a different scenario: abortion rates are falling, and it’s because of the increased use of modern contraceptive measures.
But it is even stranger to note that the resolute Maltese stand against a free choice for women is set against a backdrop of incomplete information about how many Maltese women are actually having abortions. In a nutshell, we just don’t know. We do not know the extent of women who have had a legal abortion abroad; more worryingly, we don’t know how many women have been desperate enough to carry out an illegal, and unsafe, abortion here in Malta or elsewhere.
While the pro-life lobby screams blue murder at the non-existent incidence of abortion in Malta, the country’s Criminal Code ostensibly sentences women to death by making it a criminal offence to carry out an abortion on a woman suffering an ectopic pregnancy that will kill her. The yea-sayers in our parliament, people like the unbelievable Pullicino Orlando and Leo Brincat, sound astonishingly ignorant of this reality.

The insufficient data in hand paints a statistically skewed picture of Maltese abortion rates. The sole figures from the UK Department of Health would point towards a low abortion rate, 55 Maltese women having had an abortion in the UK in 2006. And this without knowing how many had an abortion in countries like Spain, Italy, or the Netherlands.
And yet, our families are not getting any bigger. Family planning concerns in Malta have contributed to a decline in the birth rate, the 2005 Census reports, signalling the start of “a marked decline” in annual population growth, increasing by just 0.7% annually between 1995 and 2005.
It’s a clear demographic change – more women are choosing to have fewer children and at a later age; more are seeking employment opportunities over traditional family roles.
So even if our abortion rates are abnormally low – whether by legal restriction or because of the national revulsion to abortion – we can safely assume that more women are using modern methods of contraception that allow them to plan their families better and avoid early pregnancies.
If this were unmistakably true, it would be a reassuring scenario. If more women are using contraception, then they are not having to resort to abortion. Because it’s for that reason that Europe, where countries have the least restrictions on abortion, has the lowest abortion rates in the world: the higher the contraception use, the lower the abortion rate.
The reason Europe’s abortion rate has declined dramatically despite having legal abortion in most countries, is because of the greater use and awareness of contraceptive methods. A study published in the International Family Planning Perspectives journal shows that once the national birth rate stabilises, the use of contraceptives continues to increase and the rate of abortion falls.
This occurs when society changes from that of the large families of the past, when childbearing was not a conscious, calculated choice; to smaller families. It’s a change that occurs as societies develop, become more prosperous, and women gain more opportunities and start seeking smaller families, avoiding pregnancy up to the age of 25 and even over.
And they do this by seeking effective and modern contraceptive methods such as the pill or the condom. The Marton-Cleland study shows that once 80% of the population is using effective contraception, the potential demand for abortion, and its incidence, will fall.
Take the Italian example: abortion was introduced by referendum in 1978. Abortion rates (per 1,000 women of childbearing age aged 15-49) reached their peak in 1982 (26); and then started a steady decline from 1984 right down to 2006. The latest statistics confirm this trend: in 2006 the abortion rate per 1,000 women was 9.4, a reduction of 45.3% since 1982.
There is a reason for the temporary increase in abortion between the introduction of abortion and the stabilisation of the birth rate. The advent of modern contraception destabilises high or “fatalistic” fertility: when more couples decide to have fewer children, the exposure to unwanted pregnancy is still high. This fertility transition stabilises once couples achieve sustained use of effective contraception methods. It’s the gap when contraception is still poorly understood, not as widely available or popular; so abortion rates increase temporarily until modern contraception becomes the norm.
In Turkey, abortion rose sharply after legalisation in 1983 but declined steadily after 1988 (45 per 1,000 women, to 25 in 1998). This decline maps how less effective traditional contraception methods start declining in favour of more effective, modern methods.
Consider the Soviet Union on the other hand. In the USSR, abortion was legal and widely available, but contraceptives in limited supply, leading to a preference for abortion over contraception, estimated in 1990 at the abnormally high 181 per 1,000 women.
The Guttmacher Institute’s presentation on world abortion levels in 2003 supports this thesis, where abortions are shown to have declined more in developed countries where contraception and sex education are more widely available.
Most of the world’s 42 million abortions in 2003 occurred in Asia (62%), where the bulk of world’s population is concentrated. In China alone, with its one-child policy, 9 million abortions took place out of Asia’s yearly 26 million abortions; then Africa (14%), Latin America (10%), Europe (10%), and North America (4%).
However, abortion rates have declined dramatically in Europe between 1995-2003 (from 48 to 28 per 1,000 women), overtaking the other continents. The greatest decline is in Eastern Europe, suggesting the rapid uptake of modern contraceptive methods in the last decade (down from 90 to 44). Russia maintains high rates (45) but Slovakia, the Czech Republic are at 13; Lithuania and Slovenia are 15 and 16 respectively.
Consider the US however, which has the highest teenage pregnancy rate in the developed world (52.1/1,000 – four times the EU average): the abortion rate is higher (23) than in northern and western Europe. Rates are below 10 in Belgium, Germany and the Netherlands, countries where abortion is legal and widely available – but contraception use is high. In the more religious southern European countries, the average rate is 18.
Particularly, the Netherlands, which has the world’s lowest abortion rate, is described by Unicef as a country where “the combination of a relatively inclusive society with more open attitudes towards sex and sex education, including contraception” reduces unwanted teenage pregnancies. The report also finds how rising levels of education, more career choice for women, more effective contraception, and changing preferences, have increased the average age at first birth in all developed countries. In 19 of 28 rich nations under review, births to teenagers more than halved in 30 years.
By contrast, in Africa and Latin America and the Caribbean, where abortion laws are most restrictive and contraceptive prevalence is lower, the rates range from the mid-20s to 39 (in eastern Africa).
The Guttmacher review proves that the legal status of abortion does not predict its incidence. The lowest abortion rates, less than 10 per 1,000 women of reproductive age, are in Europe, where abortion is legal and widely available. By contrast, in Africa and Latin America and the Caribbean, where abortion law is the most restrictive, the regional rates are 29 and 31, respectively.
Since 1991, an average of one Maltese woman has had an abortion in the UK every week. We know nothing of the other abortions they had in the rest of Europe, let alone the backstreet abortions that have butchered their bodies. Our abortion rate could be sky-high and yet we do not even know it. All along, while everyone cries out against abortion, we have been exporting pregnant women abroad to carry out an abortion for decades.
This blissful ignorance has allowed pro-lifers like Paul Vincenti, our Members of Parliament and the Maltese bishops to reiterate their stand against abortion and most notoriously, contraception. Which is why the blame for our teenage pregnancies (237 in 2006, the highest since 2001), and those women whose lives have been ruined by the invasive and highly infectious butchering of backstreet abortions, should be laid squarely at their feet.
Because the Church does not only denounce abortion: it denounces contraception as part of its Humanum Vitae doctrine, even taking the government’s health promotion department head-on by demanding tax money for its campaign to promote sexual abstinence (the former health promotion chief Mario Spiteri had “a serious clash” with the church’s commission for youth KDZ, when they asked for the department’s funding to finance their campaign promoting sexual abstinence. “I was under pressure to give in to the KDZ’s insistent requests for funds but I stuck to my position. My first allegiance is towards the public, and promoting abstinence is something from another era.”)
But teenagers, or anyone else for that matter, will have sex whatever grown-ups or the Church might say, and those who are the least familiar with contraceptives are the most likely to become pregnant. When the Church denounces condoms and the pill, it also seeks to control women as the members of society with an interest in delaying pregnancy until such age as they desire when to start a family.
Even if you disagree with this statement, the truth is that the high contraceptive use across Europe has led to its declining abortion rate. And this during the growing “secularism” and “relativism” that has been taking place in the last decade, according to the bishops’ laments.
That is indeed why, in countries like Africa and Latin America where the Church holds sway and fights contraception, abortion rates are still high. When they bandy about the anathema of abortion, our political and Church leaders enlighten us no further, except for pandering to our primitive ignorance on the real debate on abortion and contraception. People like Jeffrey Pullicino Orlando and Leo Brincat are eager to reiterate the well-worn battlecry against abortion, but they say nothing about the realities of powerless women who cannot speak about their ordeal. Instead of their populist incursions against “baby killing”, they should be talking about contraception and sex education.
As long as we ignore this palpable reality, our abortion rate will be as high as you will imagine it to be. And likewise our unwanted and teenage pregnancies.

mvella@mediatoday.com.mt