Abortion Abortion is the early termination of a pregnancy by removal or expulsion of an embryo or fetus. Abortions that occur without intervention are known as miscarriages or "spontaneous abortions", and occur in roughly 30–40% of all pregnan ...

is allowed in Japan under a term limit of 22 weeks for endangerment to the health of the pregnant woman, economic hardship, or rape. Chapter XXIX of the

Penal Code of Japan The Penal Code (刑法 ''Keihō'') of Japan was passed in 1907 as Law No. 45. It is one of six Codes that form the foundation of modern Japanese law. The penal code is also called “ordinary criminal law” or “general criminal law” as it r ...

makes

abortion Abortion is the early termination of a pregnancy by removal or expulsion of an embryo or fetus. Abortions that occur without intervention are known as miscarriages or "spontaneous abortions", and occur in roughly 30–40% of all pregnan ...

de jure In law and government, ''de jure'' (; ; ) describes practices that are officially recognized by laws or other formal norms, regardless of whether the practice exists in reality. The phrase is often used in contrast with '' de facto'' ('from fa ...

illegal in the country, but exceptions to the law are broad enough that it is widely accepted and practiced. Exceptions to the prohibition of abortion are regulated by the Maternal Health Protection Law that allows approved doctors to practice abortion on a woman if the pregnancy was the result of rape or if the continuation of the pregnancy endangers the maternal health because of physical or economic reasons. Anyone trying to practice abortion without the consent of the woman will be prosecuted, including the doctors. If a woman is married, consent from her spouse is also needed to approve abortions for socioeconomic reasons, although the rule doesn't apply if she is in a broken marriage, suffering abuse, or other domestic issues. Despite the partner's consent not being necessary for unmarried women and women who were impregnated by abusive partners or through rape, many doctors and medical institutions seek a signature from the man believed to have made the woman pregnant for fear of getting into legal trouble, rights advocates say. In April 2023,

medical abortion A medical abortion, also known as medication abortion or non-surgical abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical (also called procedural or instrumentation) a ...

was approved in Japan for pregnancies up to 9 weeks of gestation. The Japanese health ministry approved an abortifacent from British pharmaceutical company Linepharma. Women who have a medical abortion are required to stay in the hospital for the abortion to be confirmed by the prescribing physician. Any other person who is not a certified gynecologist or obstetrician who aborts a fetus using abortifacients that is not approved by the Japanese Health Ministry will be penalized. Abortions are not covered under Japanese insurance. Surgical abortions can cost between 100,000 yen and 200,000 yen; the total cost of the abortion pill and a medical consultation would be around 100,000 yen, according to the

NHK , also known by its Romanization of Japanese, romanized initialism NHK, is a Japanese public broadcasting, public broadcaster. It is a statutory corporation funded by viewers' payments of a television licence, television license fee. NHK ope ...

. Since the approval of the Mefeego pill pack in April 2023, the government conducted a survey that concluded there were no severe side effects and complications as a result of the newly approved medication. In August 2024, the Ministry of Health announced it is now considering the expansion of medical abortion to outpatient clinics that can coordinate inpatient facilities in the case of emergencies.

History

In 1842, the Shogunate in

Japan Japan is an island country in East Asia. Located in the Pacific Ocean off the northeast coast of the Asia, Asian mainland, it is bordered on the west by the Sea of Japan and extends from the Sea of Okhotsk in the north to the East China Sea ...

banned induced

Edo Edo (), also romanized as Jedo, Yedo or Yeddo, is the former name of Tokyo. Edo, formerly a (castle town) centered on Edo Castle located in Musashi Province, became the '' de facto'' capital of Japan from 1603 as the seat of the Tokugawa shogu ...

, but the law did not affect the rest of the country until 1869, when abortion was banned nationwide.Norgren, Tiana. ''Abortion before Birth Control: The Politics of Reproduction in Postwar Japan'' Princeton, NJ: Princeton University Press, 2001.Obayashi, M. (1982). Historical background of the acceptance of induced abortion. Josanpu Zasshi 36(12), 1011-6. Retrieved April 12, 2006. However, the crime was rarely punished unless the conception was a result of adultery or the woman died as a result of the abortion procedure. According to the scholar Tiana Norgern, the abortion policy under the

Meiji government The was the government that was formed by politicians of the Satsuma Domain and Chōshū Domain in the 1860s. The Meiji government was the early government of the Empire of Japan. Politicians of the Meiji government were known as the Meiji ...

was similar to that of the

Edo period The , also known as the , is the period between 1600 or 1603 and 1868 in the history of Japan, when the country was under the rule of the Tokugawa shogunate and some 300 regional ''daimyo'', or feudal lords. Emerging from the chaos of the Sengok ...

, and was fueled by the belief that a large population would yield more military and political influence on the international stage. In 1868, the emperor banned midwives from performing abortions, and in 1880, Japan's first penal code declared abortion a crime. The punishments for abortion grew more severe in 1907 when the penal code revised: women could be incarcerated for up to a year for having an abortion; practitioners could be jailed for up to seven. The Criminal Abortion Law of 1907 is still technically in effect today, but other legislation has overridden its effects. In 1923, doctors were granted legal permission to perform emergency abortions to save the mother's life; abortions performed under different, less life-threatening circumstances were still prosecuted. In 1931, the Alliance for Reform of the Anti-Abortion Law (''Datai Hō Kaisei Kiseikai'') was formed by

Abe Isoo was a Japanese Christian socialist, parliamentarian and pacifist. He largely contributed to development of baseball in Japan, and was called "Father of Japanese baseball." He created a baseball club of Waseda University. Early life and educa ...

and argued that "it is a woman's right not to bear a child she does not want, and abortion is an exercise of this right". This organization believed that abortion should be made legal in circumstances in which there was a high chance of

genetic disorder A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosome abnormality. Although polygenic disorders ...

; in which a woman was poor, on public assistance, or divorced; in which it endangered the woman's health; and in which the pregnancy was a result of rape. In 1934, the Fifth All-Japan

Women's Suffrage Women's suffrage is the women's rights, right of women to Suffrage, vote in elections. Several instances occurred in recent centuries where women were selectively given, then stripped of, the right to vote. In Sweden, conditional women's suffra ...

Congress wrote up resolutions calling for the legalization of abortion as well as contraception. This did not result in any immediate reaction from the government at the time, but after the war, these resolutions were consulted when drafting legislation legalizing abortion. Fearing a decline in birth rates in the following decades, the nationalist Konoe cabinet decided to implement a series of pro-natalist measures. On 22 January 1941, the was approved, which included among its policies the prohibition of abortion. In 1940, the National Eugenic Law stopped short of explicitly calling abortion legal by outlining a set of procedures a doctor had to follow in order to perform an abortion; these procedures included getting second opinions and submitting reports, though these could be ignored when it was an emergency. This was a daunting and complicated process that many physicians did not want to deal with, and some sources attribute the fall in abortion rate between 1941 and 1944 from 18,000 to 1,800 to this legislation. After World War II, Japan found itself in a population crisis. In 1946, 10 million people were declared at risk of starvation, and between the years 1945 and 1950, the population increased by 11 million. In 1948, in the wake of the Miyuki Ishikawa case, Japan legalized abortion under special circumstances. The Eugenic Protection Law of 1948 made Japan one of the first countries to legalize induced abortion. In 1949, a revision passed which provided abortion in the case of extreme physical or economic distress to the mother. A further stipulation was added in 1952 requiring that the mother meet an economic threshold of poor living conditions to obtain an abortion. The whole law was revised as the Maternal Health Protection Law in 1996.

Statistics

Abortion statistics

File:中絶件数推移.png, Number of abortions File:中絶実施率.png, Abortions per 1,000 women File:年齢別中絶件数推移.png, Number of abortions by age group File:人工妊娠中絶率の推移.png, Abortions per live births Overall, in 2019, the total number of abortions officially reported was 156,430, representing a 56% decrease from the number reported for 2000. The overall abortion rate changed from 22.3 to 15.3 abortions per 1,000 women aged 15–39 years. Going further back, there were 598,084 abortions in 1980 and 1,063,256 in 1960. In 2019, 49 abortions were reported for girls aged 13 and under, and a further 3,904 for girls aged 14–17. Some 39,805 abortions were performed on women aged 20–24. In 2020, according to the

health ministry A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entity, Subnational entities, such as State (administrative division), states, county, counties an ...

, there were 145,340 abortions, down 7.3% from the previous year. According to researchers, in more than 99 percent of cases, the reason reported for performing an abortion was to protect the woman's health; this percentage remained constant during 1975–1995.Goto, A., Fujiyama-Koriyama, C., Fukao, A., & Reich, M. "Abortion Trends in Japan, 1975–95". ''Studies in Family Planning'', Vol. 31, No. 4 (December 2000), pp. 301–308. Population Council. The same researchers also suggest that while official figures may be lower than the true rate of abortion due to under-reporting by doctors in order to lower tax bills and protect patient identities, trends may be "reasonably accurate".

Legislation

Background

The whole law was enacted as the Eugenic Protection Law in 1948 and revised as the Maternal Health Protection Law in 1996.

The content of Maternal Health Protection Law

Source: *Chapter 1 – General Provisions (Articles 1–2) Chapter 1 sets forth the purpose of the Act, which is to safeguard the life and health of mothers by establishing regulations concerning sterilization and induced abortion. Under the former Eugenic Protection Law, the stated objectives included the prevention of the birth of offspring deemed genetically inferior from a eugenic perspective, in addition to the protection of maternal life and health. *Chapter 2 – Sterilization (formerly referred to as Eugenic Surgery; Articles 3–13) Under the previous legislation, eugenic surgery (i.e., sterilization) could be carried out on individuals or their spouses in cases involving hereditary psychiatric disorders, hereditary physical conditions, or

leprosy Leprosy, also known as Hansen's disease (HD), is a Chronic condition, long-term infection by the bacteria ''Mycobacterium leprae'' or ''Mycobacterium lepromatosis''. Infection can lead to damage of the Peripheral nervous system, nerves, respir ...

. It was also applicable to genetic relatives in cases of hereditary mental illness. Moreover, in instances involving specific hereditary mental or physical conditions, if a medical practitioner deemed it necessary for the public good to prevent transmission of such disorders, sterilization could be performed—irrespective of the individual’s or their spouse’s consent—following deliberation by the Prefectural Eugenic Protection Review Board. In contrast, the current Act permits sterilization to be conducted without formal examination, provided there is consent from both the individual and their spouse. Additionally, Articles 4 through 13 of the previous legislation have been repealed. *Chapter 3 – Maternity Protection (Articles 14–15) Article 14 provides that designated physicians may perform induced abortions with the consent of the individual and their spouse if any of the following conditions are met: # Continuation of the pregnancy or childbirth is likely to pose a serious threat to the mother’s health, whether for physical or economic reasons. # The pregnancy occurred as a result of sexual assault involving violence or intimidation, or during circumstances in which the individual was unable to resist or decline. *Chapter 4 – ''Repealed'' (Formerly established the Prefectural Eugenic Protection Review Board) *Chapter 5 – ''Repealed'' (Formerly established Eugenic Protection Counseling Centers) *Chapter 6 – Notification, Prohibitions, and Other Provisions (Articles 25–28) *Chapter 7 - Penalties (Articles 29 to 34)

Contraceptive use

A scenario study was conducted to assess the extent to which the

unintended pregnancy Unintended pregnancies are pregnancies that are mistimed or unwanted at the time of conception, also known as unplanned pregnancies. Sexual activity without the use of effective contraception through choice or coercion is the predominant caus ...

rate in Japan, for the period when

oral contraceptive Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control. The introduction of the birth control pill ("the Pill") in 1960 revolutionized the options for contraception, ...

s (OC) had not yet been legalized for family planning purposes and couples relied mainly on

condom A condom is a sheath-shaped Barrier contraception, barrier device used during sexual intercourse to reduce the probability of pregnancy or a Sexually transmitted disease, sexually transmitted infection (STI). There are both external condo ...

s, might change if more women were to use OC. Data provided by the 1994 Japanese National Survey on Family Planning were used to construct scenarios for national contraceptive use. Annual failure rates of contraceptive methods and nonuse were applied to the contraceptive use scenarios, to obtain estimates of the annual number of contraceptive failure-related pregnancies. Subsequently, contraceptive practice situations assuming higher OC use rates were defined, and the associated change in the number of contraceptive failure-related pregnancies was estimated for each situation. It emerged that OC use rates of 15% decreased the expected number of unintended pregnancies by 13–17%, whereas use rates of 25% resulted in decreases of 22–29% and use rates of 50% in decreases of 45–58%. The findings were reasonably robust to variation in the assumptions that were made. In conclusion, each theoretical percentage increase in the OC use rate in Japan was found to lead to a roughly equivalent percentage decrease in the number of unintended pregnancies.

Oral contraceptives Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control. The introduction of the birth control pill ("the Pill") in 1960 revolutionized the options for contraception, ...

were legalized in 1999. Emergency contraceptive pills were approved by the Ministry of Health, Labour and Welfare of Japan in 2011.“Sosei Receives Approval From Japan MHLW for NorLevo(R) TABLETS 0.75mg Emergency Contraceptive Pill”, Sosei Group Corporation press release, 23 February 2011
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References

{{DEFAULTSORT:Abortion In Japan Health law in Japan

Women's rights in Japan Birth control in Japan Healthcare in Japan Buddhism and abortion