A pregnant American woman who suffered an incomplete miscarriage while on holidays in Malta was receiving treatment Friday in a hospital on the Spanish island of Mallorca because Maltese law prohibits abortion, the woman’s partner said.
Jay Weeldreyer said that doctors at the Son Espases University Hospital in Palma de Mallorca were preparing his partner, Andrea Prudente, for a procedure to remove the remaining fetal tissue because she was at risk of a life-threatening infection.
A medical evacuation flight transported the couple from Malta to Mallorca late Thursday.
Prudente's life had been in grave danger, Weeldreyer told Euronews, after after Maltese doctors refused to grant her a potentially life-saving abortion following a medical emergency.
The couple were in Malta celebrating their "babymoon" when Prudente's waters broke prematurely last week.
Despite her 16-week-old foetus no longer being viable and the acute risks to her life, doctors told Prudente, 38, from the Seattle area, she could not have an abortion as it is illegal in Malta, according to Weeldreyer.
He said staff at Mater Dei hospital in Msida informed them that she must instead wait until her foetus' heartbeat stops or there is an imminent risk to her life before it can be removed.
There are no provisions in Maltese law that will allow abortion, even in cases where the mother's life is at risk.
Under Maltese law, those found to have terminated a child or "caused a miscarriage" can face imprisonment for up to three years. This includes both pregnant women and medical professionals.
Her lawyer, Dr Lara Dimitrijevic, told Euronews that Prudente is to be evacuated to an undisclosed location in Spain, possibly sometime on Thursday.
Mater Dei hospital has not responded to Euronews' requests to comment on this case, nor has the government in Malta.
'We have lost our daughter'
“The way the Maltese are talking about this is that it is an abortion, the truth of the matter is that it is an incomplete miscarriage,” Weeldreyer told Euronews. “There is no possibility that this pregnancy results in a viable baby.
“We have lost our daughter,” he added. "I haven't had a chance to grieve yet."
The pair had come to Malta to celebrate their babymoon. “We wanted to come here and have a romantic, connecting and loving two-week holiday to celebrate having a family,” said Weeldreyer. “Instead we are having to face Andrea’s peril.”
Malta is the first European country they have visited.
Prudente was in a stable condition during the week in Malta's only state hospital, while staff monitored her condition for any potential health complications.
Weeldreyer said that mentally and emotionally it had been "pretty brutal," and that his partner was "exhausted, frustrated, angry."
Prudente first visited a hosiptal in Gozo at 4:00 am Sunday morning, after suffering heavy vaginal bleeding. Her waters broke two days later during the 16th week of her pregnancy.
After much “back and forth” between emergency rooms, an ultrasound scan on Thursday confirmed that her baby could not survive outside the womb.
Doctors at Mater Dei told Prudente they could not remove the foetus, despite the threat to her life, due to Malta's criminalisation of abortion. They could lose their medical licences if the procedure is performed.
Dr Isabel Stabile, a gynaecologist helping the couple, pointed out that, alongside "very significant mental stress", Prudente was facing "two big risks".
One was an infection, such as sepsis. The other was haemorrhaging since the placenta can separate at any time and start bleeding.
Dr Stabile says that Prudente was "essentially being asked to watch and wait."
Although the foetus still had a heartbeat, it had a zero chance of survival and is brain dead, said Weeldreyer. There was no amniotic fluid left in Prudente’s womb as its membranes had ruptured and her placenta was partially separated.
Weeldreyer described the situation as a "catastrophic loss," noting that the baby was going to die and there was a good chance it was suffering."
Dr Stabile told Euronews before the flight to Mallorca that Prudente was medically stable, but that could change very quickly, which is the reason she needed medical evacuation.
Politicians from Malta’s two main political parties -- Labour Party and the Nationalist Party -- are both in favour of criminalising abortion, claiming it offers legal protection for unborn babies.
'Every minute is life-threatening'
Weeldreyer had been working all week to try and organise a medical evacuation to another country, saying the options facing the couple were "grim" as it was taking time to process the paperwork through their travel insurance provider.
Any evacuation flight also carried the risk of further medical complications for Prudente.
The alternative was for the couple to stay in Malta “until the miscarriage completes” or the “baby's heart stops”, said Weeldreyer, which exposes Prudente to the risk of potentially fatal blood poisoning.
Weeldreyer told Euronews that the couple's choices were either "a slow death through infection staying in Malta or getting on a plane and the quick death of bleeding out.”
International obstetric guidelines state that in critical cases where the foetus is not yet viable, before 24 weeks, abortion should be offered to pregnant women to avoid maternal infection and death.
Dr Stabile, along with Dr Dimitrijevic, a Maltese lawyer and head of Women for Choice, has written to the country's ministry of health and prime minister asking them to intervene.
They are yet to receive a response.
"I think this is barbaric," said Dr Dimitrijevic. "This falls way below the standards of a European Union country. We can do far far better than this."
"We had hope that a sense of humanity would reign," she said. "[That there would be] compassion and understanding because the trauma that Andrea and her partner are being put through is absolutely unacceptable. It is a torturous and inhumane situation."
'I have no adjectives at this point to describe the situation'
Both doctors placed blame on Maltese law for the situation Prudente and her partner faced.
"My opinion is that the law should come second," said Dr Stabile. "First we should be thinking about her life and her wellbeing."
Dr Stabile claims she is the only openly pro-abortion gynaecologist in Malta.
Malta has some of the strictest anti-abortion laws in the world.
It is the only EU country to prohibit abortion entirely, without exceptions. The criminalisation of abortion is rooted in British colonial law, established on the island during the 19th century.
"Obviously this draconian law is not fit for purpose," said Dr Stabile. "It needs to change. If a woman's life is at risk, there must be an exception."
Anti-abortion arguments often posit that life begins at conception, implying that the foetus is a living person and cannot be terminated on moral grounds.
Dr Miriam Sciberras, chairwoman of Life Network Malta, a Catholic pro-life organisation said: "Malta has an excellent track record of caring for pregnant women."
"If the life of the mother is at risk, the doctors in Malta have the legal and ethical obligation to do all that they can to save the life of the mother whatever the consequences to the unborn child."
"We wish the woman and her partner the best outcome in this delicate situation," she added.
According to the Times of Malta, an estimated 300-400 Maltese women travel abroad to have an abortion each year. Many other Maltese women are unable to access foreign clinics for financial and practical reasons.
"We have had enough," said Dr Dimitrijevic. "We have reached the end of our tether with this situation. It has to change."