Frequently Asked Questions

Abortion

I live in Malta. How can I get an abortion?


For pregnancies under 12 weeks, an abortion using pills at home is possible. Organisations like Women on Web and Women Help Women are known to send abortion pills to Malta. Please remember that abortion is illegal in Malta, but it is a known fact that the illegality of abortion does not stop women from having abortions. For pregnancies over 8 weeks, you could have a surgical abortion in a clinic abroad. If you can afford to pay for this privately, you can make your own arrangement and contact overseas abortion providers, like BPAS or Marie Stopes in the UK. If you cannot afford all the costs, Abortion Support Network may be able to help - you can call them on 27780991.




Abortion is illegal in Malta. Can I get in trouble if I have an abortion?


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. Taking abortion pills in Malta is illegal, however we are not aware of any women who have been taken to court recently. However, this could happen if you get caught. If you would like legal advice from pro-choice lawyers, you can contact the Women's Rights Foundation. Abortion pills themselves are not illegal, and they have other medical uses. For example, Mifepristone is used to treat certain types of cancer, and Misoprostol is used to treat stomach ulcers.




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. You do not have to tell anyone you took abortion pills, because the treatment for abortion and natural miscarriage is the same.




What happens if I throw up 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. 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 up to 72 hours (3 days) after Mifepristone, so you should take it as soon as you remember. 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.




Can I use painkillers during an abortion with pills?


Yes. Cramping pains are to 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 anti-sickness 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.




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.




When should I start using contraception after an abortion?


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.




How are abortion pills used?


In summary, Mifepristone 200mg is swallowed, and then 24 hours it is followed by Misoprostol 800mcg (usually 4 tablets of 200mcg each) placed under the tongue or between the teeth and cheek for 30 minutes. For pregnancies of over 9 weeks, the dose of Misoprostol may need to be repeated after 3 hours. Bleeding should start within a few hours of taking Misoprostol. For more information click here.




Will an abortion affect my fertility?


No, an abortion will not affect your ability to have children in the future.




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 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.




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.




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. Almost all abortions are performed before 24 weeks. The RCOG research can be accessed here.




How long do abortion pills take to arrive in Malta?


From what other women have told us, abortion pills from Women on Web generally arrive in 2-3 weeks, while from Women Help Women they take around 4 weeks. However, delivery times vary because the organisations often use different methods of postage.




I live in Malta. How much does an abortion cost?


If you decide to order abortion pills online, Women on Web and Women Help Women will usually ask for a donation of around EUR 100. If you have trouble paying this, they might reduce it or send them for free. If you decide to opt for a surgical abortion in a clinic overseas, it will be significantly costlier. You will need to consider the cost of abortion, which is around EUR 1,000 in most cases, as well as the cost of travelling and accommodation. Contact overseas clinics like BPAS UK and Marie Stopes UK for more information.





Morning After Pills

Which morning after pills are available in Malta?


There are various types of morning after pills in Malta. All of them are found in many pharmacies across Malta and Gozo and do not require a prescription. EllaOne contains the ingredient ulipristal acetate. It prevents pregnancy by modifying the action of the natural hormone progesterone. It should be taken as soon as possible after sex, although it can still work up to five days (120 hours) after sex. Levonelle and Escapelle are two morning after pills that contain levonorgestrel, which is a type of hormone that prevents pregnancy. The pills that contain levonorgestrel can be taken up to 3 days (72 hours) after sex.




How much do morning after pills cost in Malta?


They are usually between EUR 20 and EUR 25 per pill.




Which pharmacies in Malta and Gozo sell the morning after pill?


A list of pharmacies that sell the morning after pill can be found here:
https://www.pharmacy.com.mt/morning-after-pill/
If you are buying the morning after pill on a Sunday or public holiday, not all pharmacies will be open on that day. Check the roster of which pharmacies are open on Sundays and public holidays here.




What if a pharmacy does not sell the morning after pill?


Individual pharmacists are allowed to refuse to sell the morning after pill. If they refuse, they must refer you to someone who sells them. If you are pressed for time, you may wish to call the pharmacies before you go to see if they will sell you the morning after pill. You can report abuse to the Medicines Authority by filling in the complaint form here.




How quickly must I take a morning after pill?


The sooner a morning after pill is taken after unprotected sex, the more likely it is to work. EllaOne can be used up to 120 hours (5 days) after sex. The other morning after pills can be used up to 72 hours (3 days) after sex.




I am obese, will the morning after pill still work?


EllaOne is the recommended morning after pill for women who are obese, and it does not need a dose adjustment (one pill is enough). Levonogestrel based morning after pills may be less effective in obese women at the standard dose of 1.5g. Some guidelines recommend that obese women take two pills (3g) of levonogestrel based morning after pills.




What can I expect after taking a morning after pill?


Side effects like nausea, breast tenderness, and spotting are common after taking morning after pills. For a more detailed list of side effects, consult the leaflet that comes with the medication. Serious side effects are very rare. If you rely on the oral contraceptive pill for birth control, you must use another contraceptive (like a condom) until your next period. This is because some morning after pills, particularly EllaOne, may make the regular contraceptive pill less effective.




How many times can I use the morning after pill?


There is no limit to how many times you can use the morning after pill, even in the same month. However, if you find that you are having to use the morning after pill regularly, you may wish to invest in a safe and reliable contraceptive method like the implant or IUD.




Can the morning after pill cause an abortion?


No, the morning after pills do not cause abortion, and there is no robust scientific evidence to support claims that they do.




Can the morning after pill affect my fertility?


No, the use of morning after pills is not associated with any reduction in fertility.





Please note: FPAS aims to provide accurate and reliable information to the best of our volunteers' abilities. However, FPAS advice is not formal medical advice, and should not be considered as such. If you want formal medical advice you should speak to your doctor. We could also refer you to doctors known to us if you wish.