Andrea Prudente experienced a nightmare during her vacation in Malta: The American was 16 weeks pregnant when her waters burst after heavy bleeding. It was only in the hospital that she found out that her unborn baby had no chance of surviving. Doctors then told her they would not perform an abortion on her while the child’s heart was still beating – despite Prudente’s high risk of a life-threatening infection.

The reason for this is the abortion ban in Malta, the strictest in Europe: it bans abortions under threat of imprisonment for pregnant women and doctors, even if the mother’s life could be in danger without the procedure. But a closer look shows that even in EU countries with abortion rights, this is not always guaranteed.

Prudente’s saving grace was her travel insurance, which eventually paid for an ambulance to Spain where the procedure could be performed. The case only became known because Prudente and her partner had made their desperation public.

135 Maltese doctors have now used this attention to protest for a change in their country’s abortion law. Isabel Stabile initiated the protest: “There are a few cases like that of Andrea Prudente in Malta every year. But unlike her, most Maltese women cannot afford to be flown out for the life-saving operation,” she says in an interview with WELT.

Stabile says they are ready to sue the government if the 1850 law is not finally changed.

It’s surprising that in the middle of the EU, abortion is regulated under a 170-year-old law, when many consider Europe a pioneer in the field. The US organization Center for Reproductive Rights writes that European countries have been moving towards more progressive abortion laws for 80 years. And the European Parliament has also described safe access to abortions as a human right.

But the reality is more complicated, as Neil Datta, Secretary General of the European Parliamentary Forum for Sexual and Reproductive Rights (EPF), explains in an interview with WELT: “The right to abortion is not as protected in Europe as many citizens believe.” many countries have outdated laws and some have a number of unnecessary barriers to access abortions that are not medically necessary.

Of course it is important that women are informed in advance about the abortion, says Datta. But forcing them to have a consultation and a waiting period implies that they are not able to make this decision on their own, he criticizes. In order to show specifically what countries should change, his organization published the “Atlas on Abortion Policy in Europe” for the first time in September 2021.

The smallest countries such as Malta, Andorra and Liechtenstein stand out negatively in this atlas: In the ranking, which rates the legal status of access to abortions at zero to 100 percent, Malta and Andorra – where abortions are prohibited under all circumstances – zero percent, Liechtenstein only comes to eleven percent.

Datta explains: “These microstates are all very closely linked to the Catholic Church. They partly derive their legitimacy to exist as a state from these connections, which is why they also base their laws on the canon of values ​​of the church.” It remains to be seen whether the protests by the Maltese doctors can change anything about this self-image.

Poland also stands out negatively with 16 percent colored deep red: In 2020, the constitutional court there abolished almost all exception rules of the already strict abortion law. Since then, abortion has been prohibited even if the fetus is severely damaged. The ban is a highly political issue as the court that issued it is close to the ruling Conservative party.

At the same time there are repeated protests in the country against the new legal situation. They intensified in 2021 when a 30-year-old woman died as a result of complications from her pregnancy. Her family said the doctors didn’t dare to perform an abortion because of the restrictive laws.

Other countries like Germany or Italy are colored yellow on the map. “These are typical examples of countries where the laws have not changed for many years,” explains Datta. He assumes that Germany’s rating will improve with the abolition of paragraph 218A.

This regulates the conditions under which abortions remain unpunished, namely mandatory counseling and compliance with a period of up to the 14th week of pregnancy. But the country will probably not be promoted to the green category – precisely because of this mandatory advice and waiting time.

However, Datta praises the fact that Germany is an example of a country in which old laws are at least “well” implemented. The situation is more difficult in Italy, where there has been a law since 1978 that gives women the right to an abortion. In reality, however, there are regions where it is practically impossible to exercise this right.

The reason for this are doctors who refuse for reasons of conscience: According to a survey by the Italian Ministry of Health, at least 64 percent of gynecologists did not perform the procedure in 2020. And since objectors are not evenly distributed across the country, there are areas where abortion is unfeasible. Here, too, the strong presence of the Catholic Church in the country plays a major role in the high number of objectors.

But there are also many positive examples in Europe: Sweden, for example, which comes out best with 94 percent, but Norway, the Netherlands, France and Denmark also achieve values ​​of over 80 percent because the legislation ensures the right to abortion without unnecessary obstacles.

On a positive note, Datta particularly highlights countries where there is accurate and easily accessible abortion information backed by government sources.