In Japan, abortion is permitted up to 22 weeks of gestation, only if the continuation of the pregnancy or the delivery may significantly impair the woman’s physical health, or due to economic hardships. It is also possible to have an abortion if the pregnancy is caused by assault or threats. Fetal impairment, pregnancy due to incest and preservation of mental health are not grounds for abortion. After 22 weeks, an abortion is only possible if the pregnant woman’s life is in danger.
Most abortions take place between week 7 and 10. The majority of physicians do not perform abortions after week 12, due to the complexity and costs of the procedure and prolonged hospital stay. Legal abortions are performed at the discretion of a gynecologist designated by a prefectural office of the Japan Medical Association following the Maternal Health Act. The “designated doctors” are the only privileged group of gynecologists who are allowed to perform abortions, and they try to prevent women from gaining contraception and abortion rights, using the excuse that they are concerned about women's health. Minors need parental consent and the woman’s partner usually needs to provide his signature on the consent form. Spousal consent is required except "if the spouse is not known or cannot express an intention, or if the spouse no longer exists after the pregnancy". If the pregnancy is the result of a rape, spousal consent is not necessary either, or you can sign yourself if the partner is unknown. The cost varies depending on the facility, but an abortion in the first trimester costs around 100,000 to 200,000 yen (approx. 800-1,600 euros). The cost for the later term of abortion is sometimes double that, or more. Second-trimester abortions include hospital stay for a few days and death certificate of the fetus. Seeing as abortion services are not covered by insurance, women have to pay for the procedure out of pocket, often in cash. The woman needs on average at least three visits, one consultation and examination before the procedure is performed, surgery on the day, and then an appointment post-surgery to check if everything is healing well.
The most common method of abortion in early pregnancy is surgical termination by dilatation and curettage, and some facilities perform an abortion by suction only. The drug mifepristone, commonly known as the “abortion pill”, is not approved in Japan, making medical abortion impossible. However, Women on Web can assist with sending mifepristone via mail so that the abortion can be performed at home. This was an essential lifeline for Yuina, Hina, and Tomoko, who were able to terminate their pregnancies at home with abortion pills. They risk prosecution, as it is a crime to take mifepristone obtained by private importation. The most common method of abortion in the second trimester of pregnancy is to deliver using prostaglandin, a labor inducing drug.
Penal Code: criminalization of abortion
From around the 1600s, abortion and mercy-killing of newborns were conducted by Sanba (today's midwives) and some doctors. However, in 1868, abortions performed by Sanba was prohibited, and in 1880, the old Penal Code criminalized abortion. This is the basis of the current Penal Code crime of abortion.
Articles 212-216 of the current Penal Code (established in 1907) define abortion as a crime that can be punishable with imprisonment both for the provider of the service and the pregnant woman. However, other legislations have overruled the Penal Code that criminalizes abortion, such as the Maternal Health Act.
Legalization of Abortion under the Maternal Health Act
In 1948, the Eugenic Protection Act legalized abortion in some instances as a means to avoid overpopulation due to post World War II turmoil, rape, food, and housing shortages, and mixed-race children under Allied occupation. The Act states that "if a couple wishes to do so, they dare not be punished". The Eugenic Protection Act legalized sterilization and abortion for eugenic reasons. However, since sterilization and abortion based on eugenic beliefs (the belief that disordered genes should be excluded) became problematic, the Eugenic Protection Act was revised to the Maternal Health Act in 1996, with the eugenic clause deleted and the maternal body protection act was left intact.
In other words, while abortion is a crime under the criminal code, pregnancy termination by a designated doctor is permitted under the Maternal Health Act, which means there is a dual structure, where the criminal code of abortion is deterred by justifiable causes of the Maternal Health Act.
Currently, abortion is illegal according to the Penal Code, but the Maternal Health Act legalizes abortion in certain instances. There are judicial movements to repeal the requirement of written spousal consent. Seeing as it is required by law to provide the signature of the spouse on the consent form, some physicians do not want to go through with the procedure if it cannot be provided, even though survivors of rape who fall pregnant do not have to provide the signature. Some physicians may be reluctant to terminate the pregnancy if the “spouse” field on the consent form is left blank, as they do not want to perform the abortion to then be sued by the male predator. This way, they refuse service to pregnant rape survivors, who are then forced to seek their assailant and ask for permission to have an abortion.
There have also been citizen level's movements toward the amendment of the total legalization of abortion, but it is still far from being discussed openly and towards actualizing the goal.
On October 7, 2020, the Japanese government announced that they consider permitting the sale of emergency contraceptives in pharmacies – a hot topic of discussion. However, abortion pills have not even been approved by the state, and the government continues to spread propaganda that the abortion pill is dangerous.
Written by: Tilla Solli for The Women's Museum of Norway
Information collected by the Sex Museum Japan
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