CIVICUS discusses the Women on Waves campaign to expand access to abortion with Dr Natalie Psaila Stabile, a reproductive rights advocate and member of Doctors for Choice Malta, an organisation that campaigns for the decriminalisation of abortion and access to reproductive healthcare.

In April 2026, the international reproductive rights organisation Women on Waves placed safes containing abortion pills at undisclosed locations across Malta, prompting calls from civil society groups opposed to abortion for the authorities to investigate. The intervention coincided with a broader European debate over cross-border access to reproductive healthcare, intensifying scrutiny of Malta’s restrictive legal framework.

What does the Women on Waves campaign reveal about women’s rights in Malta?

The Women on Waves campaign shows how women in Malta are desperate for abortion access. They are willing to retrieve pills left by strangers in locked safes, with no way to verify how the medication has been handled or stored. Critics have warned that the pills sit under Malta’s hot sun without proper cold-chain storage and lack regulated pharmaceutical processes. But this criticism rings hollow. In 2025, 667 women received abortion pills by post from Women on Waves and Women Help Women without complaint. Pills by post also lack regulated protocols.

The desperation stems from systemic failure. Malta has no family planning clinics, contraception is expensive and sex education is poor. In a country with these gaps, the need for abortion access is acute. The Women on Waves campaign simply made visible what has been happening for years. Maltese women cannot access safe, legal abortion, so they find ways to access it anyway, whatever the risk. They see unknown medical risks as preferable to forced pregnancy or criminal prosecution. That’s the measure of their desperation.

What harms does criminalisation cause, and what reform is needed?

Malta is the last European Union (EU) country that still criminalises abortion under all circumstances except grave risk to life. The harms are immediate and practical. Women needing abortion may be trying to escape violent partners, facing financial hardship, or living with medical conditions that pregnancy would exacerbate, such as heart problems, or undergoing chemotherapy. Some are children or adolescents. Those carrying foetuses with fatal anomalies must travel abroad, adding suffering to already devastating circumstances.

Criminalisation drives women to dangerous methods, such as excess alcohol, unknown pills, self-harm or the use of blood pressure medications to force miscarriage. These may cause severe injury or death. Criminalisation also blocks emergency care. Women bleeding heavily after self-managed abortions avoid hospitals for fear of arrest and prosecution. They choose to risk death at home rather than be reported. This year, a woman received a suspended sentence after seeking hospital care for severe anaemia following an abortion. A similar case last year ended in a suspended jail sentence. Women’s fears are justified.

Decriminalisation is urgent. It would make abortion a medical decision between woman and doctor, not a matter investigated by police. It would safeguard the lives of all who can become pregnant. This is not radical. It aligns with European norms and international human rights standards.

How significant is the EU’s decision to make it easier to access abortion services abroad?

The European Commission’s decision to allow member states to use the European Social Fund Plus to finance cross-border abortion access matters more for what it signals than for any immediate practical impact in Malta. Around 50 Maltese women travel to Spain and the UK each year for abortion. Data on travel to the Netherlands and elsewhere is unavailable, so the real number is likely higher. The decision means financial barriers to cross-border access could be reduced.

Even so, impacts in Malta would be limited, because far more women have safe but illegal abortions at home than by travelling abroad. The real significance is what the decision communicates: that the EU recognises abortion access as essential healthcare, not a criminal matter.

The decision also gives the Maltese government political cover for reform, providing evidence that decriminalisation aligns with European values and commitments. Whether Maltese policymakers will act on it remains to be seen, but the decision marks a historic shift in how Europe regards abortion access.

How are attitudes among young people changing, and what does this mean for reform?

The Catholic Church holds enormous influence over Malta’s culture and politics. Around 83 per cent of Maltese people identify as Catholic, and most received religious education, which teaches that abortion is a mortal sin that ‘kills a child’. These teachings produce powerful emotional resistance to reform. There’s no secular opposition to abortion. Resistance flows directly from Catholic doctrine, which shapes public opinion and political will.

Yet significant change is emerging. Surveys show younger Maltese people increasingly support decriminalisation. Abortion is no longer taboo. People speak openly about it in ways that would have been unthinkable a decade ago. Young people see the value in protecting women’s health over enforcing religious doctrine. As this generation enters politics and older opposition weakens, the conditions for reform are being created.

The direction of change is clear. Younger Malta is moving towards abortion access as a health right, not a criminal transgression. Whether politicians will have the courage to act on this shift remains to be seen.

CIVICUS interviews a wide range of civil society activists, experts and leaders to gather diverse perspectives on civil society action and current issues for publication on its CIVICUS Lens platform. The views expressed in interviews are the interviewees’ and do not necessarily reflect those of CIVICUS. Publication does not imply endorsement of interviewees or the organisations they represent.