Yet the number of people in Malta who support abortion rights is still small, Dibben says. An online poll from 2018 showed that 95 percent of Maltese people are against legalizing abortion in the first 12 weeks of pregnancy; that same poll showed that 27 percent of people were against it if the mother’s health was at risk.

“From when you are young, from when you are a child, you go to school and you learn that abortion is murder,” Dibben says, referring to the general view of abortion on the island. “And that is a widespread notion that you don’t even challenge.”

Hundreds of women living in Malta travel overseas for an abortion each year, spending more than $1,000 (the abortion alone can cost about $500). Because the procedure is done abroad—usually in Britain or in Italy—women receive no follow-up appointments. These short trips are often done alone and in secret, or under false pretexts, in large part because abortion is still such a taboo. Abortion-rights activists say some women illegally order abortion pills online, which are safe to use up until the tenth week of pregnancy.

But understanding why Malta has such strict views on abortion in the first place is more complicated. Many of the people I spoke with, from activists to doctors to bartenders, said Maltese people simply don’t like to speak up against the status quo; some pointed to the country’s position as a small island in the Mediterranean Sea, geographically isolated from the rest of the world and therefore less likely to be exposed to other countries and ideas. But everybody agreed on one thing: the influence of the Catholic Church.

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It’s hard not to come across the small ceramic icons of the Virgin Mary hanging outside people’s homes in Malta, or the statues of saints standing over passersby on various street corners. Cars driving past usually have a cross dangling from their rearview window. In all, Malta has about 365 churches, “one church for every day of the year,” as one waitress put it, and the country’s national identity is very much tied to that.

“Our social, cultural background is very firmly rooted in a Catholic doctrine,” Dibben says. “We still have in our constitution that Malta is a Roman Catholic country.”

One gynecologist in Malta, speaking on condition of anonymity because her career could be at risk if she came out publicly as supportive of abortion rights, said the number of women who have approached her with questions or concerns after getting an abortion (either abroad or by taking the pill) has increased in recent years—she receives at least one visit every week.

“Part of my job is to support women and give them options,” she told me over the phone. “My personal view is that abortion should be the last option. We should focus on the morning-after pill, on sex education, on contraception. But when all else fails, abortion should be available.”