Exporting Abortion quantified abortion access in Europe for the first time – and how, despite the progress made in the attainment of this right, thousands of women across Europe are forced to cross the borders of their home countries to access an abortion.

Locally, the investigation, authored by Joanna Demarco, revealed how, among other findings, Spain has surpassed the UK in the number of women from Malta travelling there to have an abortion, and that there were over 2,000 self-managed abortions in Malta in the last five years, despite the country’s near blanket ban.

The report also further revealed how abortion pill shipments into Malta had also doubled in four years, in a climate where travelling for abortion is up to 25 times more expensive.

On 11th March, the same day the award was won, a woman was sentenced to an 18-month prison term, suspended for three years, after being found guilty of inducing her own abortion using medication in 2024.

The investigation was coordinated by Público (Spain) and was conducted by journalists from across the continent and published by 11 media outlets. 

The United Kingdom is no longer the primary destination for Maltese residents seeking abortions abroad. Official data analysed by Amphora Media, as part of the European cross-border investigation Exporting Abortion, coordinated by Público (Spain), reveals that Spain has now surpassed the UK in the number of women from Malta travelling there for the procedure.

Public records and freedom of information requests show that Spain has seen a rise in numbers from Malta over the past few years, despite the UK historically being the ‘classic’ choice.

According to experts, the Netherlands is also a common destination among Maltese women, though Dutch authorities do not document specific figures for Malta, among other countries.

Why Are More Women Choosing Spain?

The number of Maltese residents travelling to the UK for abortions began to decline in 2020, coinciding with the COVID-19 pandemic. However, the shift in abortion travel patterns appears to have been influenced by multiple factors.

According to abortion researcher and Abortion Support Network volunteer Liza Caruana Finkel, this trend may also have been influenced by Brexit, which could be complicating visa requirements for non-EU nationals residing in Malta. 

One other significant factor is the increased awareness and use of abortion pills for early pregnancy terminations (up to 12 weeks). However, for women seeking abortions after this period, travelling abroad is the only option.

Malta has the strictest abortion laws in the EU – allowing a legal abortion only in cases where  a woman has a medical complication which may put her life at immediate risk or that places her health in grave jeopardy which may lead to death.

While between 2010 and 2019, an average of 55 Maltese residents per year travelled to the UK for abortion services, this number dropped dramatically to 20 in 2020, just 4 in 2021, and 13 in 2022. The figures for 2023 have yet to be published.

Meanwhile, Spain has steadily increased, rising from 7 in 2019, to 14 in 2022 and 27 in 2023.

The Exporting Abortion investigation found that Spain is one of the European countries that receives the most women seeking abortions. 

An analysis of different European laws and country-specific situations by the investigative team highlights that Spain is likely a popular country of choice due to several factors: it is in the European Union, it is one of the countries with easier access to abortion (upon request till 14 weeks, however relatively easy to access abortion until 22 weeks in some regions) and the procedures are cheaper than in countries like the Netherlands and the UK(which have longer timeframes than Spain for abortions on request).

Additionally, a change in legislation in Spain in 2023 now permits 16- and 17-year-olds to access abortion without parental consent, and Spain and Malta are well-connected by air travel.

5 Women Have Had Abortions in Malta Under New Law

A total of five women have had legal abortions in Malta following Malta’s 2023 legal amendment. A freedom of information request has revealed that four of these abortions took place in 2024 and one in 2023. There have been no procedures so far in 2025.

According to the law, a medical team consisting of two gynaecologists or obstetricians, one of whom would be the professional to carry out the termination, and a third specialist in the field related to the health issue affecting the woman must give the go-ahead prior to the procedure being carried out. 

However, the Health Ministry’s Department for Policy in Health could not provide the number of times when a decision by the doctors’ committee did not result in the termination of a pregnancy, saying that they “have no visibility of additional ‘unsuccessful’ discussions.”

The 2023 legal amendment came about in reaction to the case of US national Andrea Prudente, who was denied an abortion in Malta in June 2022, despite experiencing severe pregnancy complications and the risk of infection after her fetus was deemed non-viable. A non-viable fetus is one that cannot survive outside the womb.

Prudente had to be medically evacuated to Spain to terminate the pregnancy. The case threw Malta’s extremely restrictive abortion laws in the spotlight and sparked international criticism.

The bill slightly shifted criminal law surrounding abortion from a total blanket ban to allowing for the procedure in cases where women’s lives are in imminent danger. 

Activists had argued that the revised bill does not sufficiently safeguard women’s health, as it excludes situations where her health is severely compromised. Malta’s abortion laws remain the most restrictive in the EU, making no exceptions to survivors of rape or incest.

More than 5,000 European women have to travel abroad every year to get an abortion

The international investigation Exporting Abortion quantifies for the first time how, even today, thousands of women across Europe cross the borders of their home countries to access an abortion, due to the obstacles that still exist in many states when it comes to termination of pregnancy – even in cases where abortion in their home countries is legal.

The reasons behind this phenomenon vary. Sometimes women realise they are pregnant after the legal deadline for abortion has passed in their country. In other cases, the fetus presents a malformation that local doctors do not consider serious enough to justify terminating the pregnancy.

Exporting Abortion exposes the journeys European women take to access abortion services in other countries. The highest flow is from Germany to the Netherlands, followed by Portugal to Spain. The third most common route is from France to the Netherlands.

Additionally, it shows how women don’t just travel abroad to access abortions. There’s also a growing trend of women ordering and taking abortion pills on their own in countries where abortion rights are highly restricted. This occurs outside the formal healthcare system, leaving women without medical supervision. This trend is particularly evident in countries like Malta and Poland.

Explore the wider investigation here.

Top graphic credit: NSUE Studio

This investigation was developed with the support of Journalismfund Europe.

Exporting Abortion is a cross-border journalistic investigation coordinated by Público (Spain) in collaboration with European media and journalists from across Europe. 

The journalists who have participated in this investigation are, in alphabetical order: Joana Ascensão (Portugal – Expresso), Kristina Bohmer (Slovakia), Magdalena Chrzczonowicz (Poland – OKO.press), Mayya Chernobylskaya (Germany), Nacho Calle (Spain – Público), Maria Delaney (Ireland – The Journal Investigates), Joanna Demarco (Malta), Armelle Desmaison (France), Emilia G. Morales (Spain – Público), Bru Noya (Andorra), Apolena Rychlíková (Czech Republic), Órla Ryan (Ireland – The Journal Investigates), Sergio Sangiao (Spain – Público), Margot Smolenaars (Netherlands – Follow The Money).

• Abortion Pill Shipments Double in Four Years
• Four Police Reports, Two Arraignments Linked to Abortion Pills Since 2018
• Traveling for Abortion Up to 25 Times More Expensive Than Pills

“I remember sitting on the edge of the bathtub, Googling ‘abortion in Malta,’ then panicking, thinking they were going to trace my search back to my IP address… Imma paranojja ridikula. Well, it’s not ridiculous because it’s not unrealistic…”

*Stephanie was 25 and had just begun a new scholastic year working as a secondary school teacher when she unexpectedly became pregnant, despite using contraception.

Her abortion was one of over 2,000 cases in Malta in the past five years for which women have used pills shipped from international organisations that provide them, according to data kept by the two main abortion pill suppliers and shared with Amphora Media through local NGO Doctors for Choice. The data was shared as part of the European cross-border investigation Exporting Abortion, coordinated by Público (Spain). 

The numbers signal that Malta’s near-total abortion ban has not stopped women from seeking abortions. Rather, access to abortion pills is increasingly leading to more self-managed terminations.

Yet, the framework of illegality and stigma fosters a climate of fear, risk, and isolation as these procedures continue to take place outside the healthcare system.

In an interview with Amphora Media, held in a private location, Stephanie described the experience of having an abortion within this climate as triggering “all the worst emotions” — fear, anger, shame and mistrust; including towards her siblings, her gynae and even her GP.

“You feel angry at the state, frustrated, you are nauseous and worried about the actual abortion and worried about being caught. So there are a lot of layers to the upset, because it is distressing… And that is what made the whole thing difficult. Not the procedure,” Stephanie said.

Dr Natalie Psaila Stabile, a specialist in family medicine and co-founder of Doctors for Choice Malta, speaks to women daily who want to have, or have had, abortions, through the NGO’s Abortion Doula Support Service that she helps run. The service offers women free, confidential abortion information and support.

Without hearing the interviewee’s story, she echoed Stephanie’s fears as ones expressed by the women she talks to. 

“People get very concerned about the pills being stuck at customs or being found out… Some fear being reported by family members, partners, or even their ex-partners. Some are in abusive relationships where their partner wants them to keep the pregnancy, and they don’t — as this ties them down even more”.

The safety of pills purchased online, potential complications, and how to recognise excessive bleeding or failed procedures are other concerns the women who speak to Dr Psaila Stabile raise.

Psaila Stabile’s mother, Professor Isabel Stabile, a gynaecologist and the co-founder of Doctors for Choice Malta, told Amphora Media that from a medical point of view, the pills are safe, save for a “rare” occurrence of very heavy bleeding, which would require hospital care.

The latter is the scenario which women taking the pills fear – having to need to go to hospital and risk the chance of being found out.

Four Police Reports Linked to Abortion Pills Since 2018 – Two Arraigned

While the fear of being reported to the police is a main concern for women using abortion pills, since 2018, only four reports have been filed with the police in relation to the pills –two in 2023 and two in 2024.

Through a freedom of information request, Amphora Media found that two reports led to arraignments in court, one did not lead to any charges, and one is currently being investigated.

Additionally, a recent report by  Voice For Choice revealed that between a longer timeframe – 2012 and November 2024 – three of seven reports on abortions that were sent to the police, were made by healthcare professionals, while the remaining four reports were filed by partners, former partners or family members.

Under Maltese law, it is legal to purchase the pills, possess them, and even consume them. It is only illegal to consume them while pregnant.

Malta has the strictest abortion laws in the EU – allowing a legal abortion only in cases where  a woman has a medical complication which may put her life at immediate risk, or that places her health in grave jeopardy which may lead to death.

Under the Criminal Code, a woman who causes her own miscarriage or consents to an abortion can face 18 months to three years in prison. No one has been imprisoned for having an abortion in the last 25 years.

Abortion Pill Shipments Double in Four Years

The data provided to Amphora Media by Doctors for Choice lists shipments from the two main organisations that provide abortion pills: Women on Web and Women Help Women. The figures specifically account for pills ordered for immediate use, excluding precautionary or “advanced provision” orders.

Professor Stabile stated that the pills shipped “are taken”, thus making them a reliable indicator of how many abortions are occurring in Malta each year.

The numbers have surged, more than doubling since 2020. In 2024 alone, 590 shipments were made, almost double the 289 in 2020. Analysis shows that from 2020 to the end of 2024, there were over 2,000 instances women in Malta taking abortion pills. 

However, due to the legal risks, these abortions happened without medical supervision and often without the support of a loved one.

“They are literally on their own, alone in the bathroom, bleeding with no one around them. That’s not the way to do it,” Stabile said.

The increase in the use of abortion pills has also been noticed through first-hand experience by Dr Psaila Stabile through the Doula Support Service.

A sample of logbook entries from 2024 shared with Amphora Media shows that a majority of calls are made during early pregnancy and are mostly inquiries about the abortion pill.

Stabile also highlighted specific cases she is aware of in which travel was not possible and access to pills has been crucial. In one instance, a migrant woman living in Malta’s detention centres ordered abortion pills after allegedly being raped at a detention centre in Libya. In Malta, abortion remains illegal in cases of rape and incest.

It is important to note that these 2000+ cases also do not include the number of pills that could have been purchased on the black market or from other providers. They also don’t include other potential instances of self-managed abortions.

Traveling for Abortion Up to 25 Times More Expensive Than Pills

Despite users knowing that it is illegal, women are still choosing to have abortion pills in Malta for practical and financial reasons, Professor Stabile explained.

“Women in Malta are generally not travelling in early pregnancy. They’re not. They don’t because it’s just so much easier to get the pills here,” she said.

Traditionally, Maltese women seeking abortions during early pregnancy would travel to countries such as the UK. However, the growing awareness of overseas medical abortion providers has offered a cheaper and more accessible alternative.

While the numbers for travelling in early pregnancy have dwindled and changed, women still travel for procedures following the 12-week time limit catered for by the pills.

The abortion pills – mifepristone and misoprostol – which are considered as safe options by the World Health Organisation cost 25 times less than traveling abroad for a procedure. While a medical abortion costs between €80 and €120, traveling for an abortion can cost between €2,000 and €3,000 (not including time taken off work, childcare costs, etc.)

Echoing Professor Stabile, Stephanie told Amphora Media that she decided to choose the pills over travelling, despite the illegality, for practical and financial reasons. “It’s less hassle, as you don’t have to look into flights and accommodation and coordinate your schedule with someone else to join you for support,” she said.

“It’s cheaper, because you don’t need flights and accommodation, and it’s less disruptive on life and responsibilities, at that time I also couldn’t afford to take a week off.”

“It’s a struggle not being able to trust anyone when you need help… (and) although that is what you decide — no one wants to go through having an abortion.. and it was made more difficult than it had to be simply because of the laws that affect it. It didn’t have to be like that,” she said.

Amphora Media reached out to Health Minister Jo-Etienne Abela for comment, however received no reply.

*the interviewee’s name was changed to protect her identity.

This investigation was developed with the support of Journalismfund Europe.

Exporting Abortion is a cross-border journalistic investigation coordinated by Público (Spain) in collaboration with European media and journalists from across Europe. 

The journalists who have participated in this investigation are, in alphabetical order: Joana Ascensão (Portugal – Expresso), Kristina Bohmer (Slovakia), Magdalena Chrzczonowicz (Poland – OKO.press), Mayya Chernobylskaya (Germany), Nacho Calle (Spain – Público), Maria Delaney (Ireland – The Journal Investigates), Joanna Demarco (Malta), Armelle Desmaison (France), Emilia G. Morales (Spain – Público), Bru Noya (Andorra), Apolena Rychlíková (Czech Republic), Órla Ryan (Ireland – The Journal Investigates), Sergio Sangiao (Spain – Público), Margot Smolenaars (Netherlands – Follow The Money).