Malta has been dominating headlines after news broke that an American woman was vacationing there before experiencing a tragic pregnancy complication. As Malta is a pro-life country, abortion — the direct and intentional homicide of a human being in the womb — was not permitted, and the propaganda machine immediately sprung into action to criticize Malta’s pro-life policies.
According to the BBC, Jay Weeldreyer and Andrea Prudente were vacationing in Malta for a babymoon. Prudente, who was 16 weeks pregnant at the time, suddenly began bleeding, so the couple headed to the hospital. Prudente told the Guardian she was given a drug to prevent miscarriage, but two days later, her water broke, and doctors told her that her placenta had become partially detached. Another two days later, an ultrasound said there was no amniotic fluid left, but because the baby still had a heartbeat, they couldn’t intentionally end the child’s life.
Weeldreyer and Prudente then sought a way to get to the United Kingdom where her child could be legally killed.
“I just want to get out of here alive,” Prudente said. “I couldn’t in my wildest dreams have thought up a nightmare like this. … I feel like I’m being actively traumatised.”
Prudente was being checked on daily and was receiving antibiotics in the COVID-19 ward, as she had tested positive for the virus. She was allegedly diagnosed with preterm premature rupture of membranes (PPROM). “It’s an inconceivable form of emotional and psychological torture,” Weeldreyer said. “Part of me still celebrates hearing the heartbeat… and at the same time, I don’t want that heartbeat there because this is just leading to more suffering for this woman that I love.”
Malta’s Women’s Rights Foundation demanded Prudente’s medical records from Mater Dei Hospital, which they have received. She will receive an airlift to Mallorca, Spain, to undergo an abortion, while abortion advocacy groups have seized the opportunity to exploit the case. Doctors for Choice complained that doctors “can only intervene if she is imminently dying,” which Prudente is not. The pro-abortion group went public with the couple’s story (anonymously) before the couple came forward themselves.
“She was told doctors can only intervene if she is imminently dying – not even getting an infection is enough,” Doctors for Choice wrote. “She was also told doctors cannot even discuss the option of abortion with her. 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.”
Yet does Prudente urgently need an abortion? Is that typical medical practice for PPROM? According to Dr. Calum Miller, the answer is no.
READ: Abortion is never the solution to complications during pregnancy. Here’s why.
Miller graduated from Oxford University and works as a doctor in the United Kingdom. He took to Twitter to write an explanation of the situation on Thursday, saying the couple’s case is rife with misinformation (emphasis added below). Keep in mind that early delivery to save a mother’s life does not intentionally kill a child and is therefore not an abortion, by definition:
There has been a lot of media attention – and dare I say misinformation – given to a current situation in Malta where, it is claimed, a woman is being denied an abortion which would save her life.
What is the reality?
This is very difficult to know because all we have are a few public reports with minimal clinical detail. *Anyone* who claims to know with certainty what treatment this lady needs, other than those with direct access to her full clinical record, simply cannot be trusted. These clinical situations are complex and cannot be speculated about on the basis of one or two details reported in the media, mainly by abortion activist groups with a vested interest. Any judicious and conscientious clinician (or reporter) would refrain from commenting in detail about what is needed in the specific case.
Maltese law and medical practice clearly allow premature delivery of the child where the woman’s life is at risk — regardless of whether the baby is alive, has a heartbeat, and regardless of whether it is viable. Maltese doctors have for years, in many cases (though these cases are still very rare) delivered the child early, in some cases with the child subsequently passing away, in order to save the mother’s life. None of them have ever needed to worry about legal repercussions. Pro-life obstetricians do this in every country around the world.
This has been made abundantly clear by Malta’s leading judges, including Giovanni Bonello, formerly a judge at the European Court of Human Rights.
Hence whatever the true clinical picture, it is simply false to claim that the law is to blame. The law is absolutely clear: where a woman’s life is at risk, premature delivery is permitted, regardless of any other factors.
It is in part for this reason that Malta has the *lowest maternal mortality ratio in the world*, far lower than in pro-abortion countries like the UK or France. In fact, there has been not a single maternal death in Malta in the last 10 years. This is astonishing.
The likelihood is, therefore, that in this case, the clinical scenario does not warrant a delivery, because the mother’s life is not at risk. This needs some explanation – an explanation that the patient deserves.
Preterm premature rupture of membranes (PPROM) is a clinical condition where the gestational membranes break early, before 37 weeks. In itself it is not life-threatening, but it can lead to an infection, which will become life-threatening. Once there is evidence of an infection, the child should be immediately delivered to save the woman’s life.
Until there is sign of an infection, the standard approach after viability is not to deliver the baby as soon as the membranes rupture – it is to manage expectantly (i.e. not intervene) for as long as possible to give the baby the best possible chance of survival.
Before viability, the chances of the baby surviving are significantly lower, but they are not zero. It is possible to keep a pre-viable baby alive in this situation until viability, and babies have been been born alive as a result, even though the chances are slim.
Hence there is no specific need to deliver as soon as the membranes rupture. In pregnancies of viable gestation, the ‘watch and wait’ approach is routinely taken, and does not put women’s lives seriously at risk. The woman needs careful monitoring for signs of infection, and if there is a sign of chorioamnionitis she should be delivered immediately – but until then it is not necessary.
Other complications, such as placental abruption, may be present in cases of PPROM, and may also warrant early delivery. But again, this depends on the specific clinical details: it cannot be asserted to be warranted simply on the basis of a vague line in a report by abortion activist groups. The clinical details are necessary.
Miller further pointed out that there is a small possibility that the doctors treating Prudente don’t fully understand the law, and Maltese law does allow a baby to be delivered prematurely to save the mother’s life, even if the child dies as a result of being born too soon.
Already, abortion advocates are comparing this case to that of Savita Halappanavar, who died in Ireland — ostensibly, after being denied an abortion. But the little-mentioned reality of Halappanavar’s case is that an abortion would not have saved her life; she died of sepsis after a severe case of medical neglect and mismanagement. Doctors missed signs of infection and then, sepsis after not monitoring her as they should have; this is what led to her death.
By Prudente’s own acknowledgement, doctors in Malta were checking her daily and giving her antibiotics, which did not happen with Halappanavar.
Malta, as the last remaining pro-life country in the European Union, has come under immense pressure lately to legalize abortion. This case will almost certainly make that pressure even worse; Maltese politicians must stand firm against it, and recognize that abortion is never medically necessary — and they must continue to steadfastly protect all lives.
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