Countries Abortion Profile

Japan

1. Law related to Abortion

Brief history of the law:

Abortion in Japan is governed by two pieces of legislation. The first is the Criminal Code, which was first enacted in 1880 and in its present form dates from 1908. It prohibits the performance of all abortions; a woman who performs her own abortion is subject to up to one year’s imprisonment, and a person who performs an abortion on another is subject to up to two years’ imprisonment. Medical personnel are subject to harsher penalties. This prohibition against abortion reflects primarily the desire of the Japanese Government in the late nineteenth and first half of the twentieth century to increase the nation’s rate of population growth in order to support Japanese expansion.

The second piece of legislation governing abortion is the Eugenic Protection Law. This Law has its source in eugenics legislation that was enacted in 1940 and is patterned on similar National Socialist German legislation of the 1930s. In its original form, the Law had a two-fold purpose: 1) to increase the number of Japanese; and 2) to prevent the birth of genetically inferior offspring and promote a genetically healthy population. It permitted sterilization only for the prevention of hereditary diseases, and abortion only to save the life of the pregnant woman.

The current Eugenic Protection Law was approved in 1948 and, as amended in 1949 and 1952, was in effect with largely the same wording until 1996. The Law was a product of socio-economic conditions in Japan in the years immediately following the Second World War, when the country faced a serious imbalance between its rapidly growing population and war-shattered economy.  The need to limit family size became increasingly apparent and there was a high incidence of illegally induced abortion.  The Government responded by promoting family planning through the methods then available, which were mostly traditional, and by legalizing abortion.

In addition to authorizing sterilization on a variety of grounds, the Law allowed abortions to be performed in five situations: (1) when the pregnant woman or her spouse suffered from a hereditary disease or mental disease; (2) when a relative to the fourth degree of either spouse suffered from such a disease; (3) when either spouse suffered from leprosy; (4) when the health of the mother might be seriously affected from the physical or economic viewpoint; and (5) in the case of sexual crime.  Appended to the Law was a list of medical conditions that justified the performance of an abortion under (1) and (2).

Under the Law, an abortion could be performed only in a medical facility by a physician designated by the local medical association. The consent of the woman and her spouse was required unless the spouse was unascertainable, unable to express his will or had died after conception of the foetus. If the woman who was to undergo the abortion was insane or mentally retarded, consent had to be given by the woman’s guardian.

Owing to the provision in the law of socio-economic grounds for abortion in (4) above, abortions became available virtually on request since the pregnant woman needed only to find a physician who was willing to perform the operation. The time limit for the performance of abortions was not specifically set by the Law. Rather, the Law designated viability as the limit for all abortions. Subsequently, notices issued by the Ministry of Health and Welfare moved the point of viability from an initial eight months to 23 weeks. Although these notices, technically, do not have binding legal effect, they indicate the Government’s understanding of the Law and are almost universally followed.

There have been two recent changes to Japan’s abortion law, one minor and one major. The minor change was the issuance by the Minister of Health and Welfare in 1991 of a new notice lowering the Government’s understanding of the point of viability to 22 weeks. This change is apparently in accord with the Government’s view of progress in the development of the medical technology necessary to keep prematurely born children alive.

The major change involves a large-scale rewriting of the Eugenic Protection Law. Owing in part to the requests of organizations representing the disabled, as well as to modern scientific knowledge about inherited diseases, in 1996 the Government proposed and quickly enacted revisions to the law designed to remove its eugenic features. All references to the word “eugenic” have been removed from the Law, which is now known as the Maternal Protection Law.  Also removed were the provisions of section 1 of the Law stating that its purpose was to prevent an increase in inferior descendants, and the parts of the Law that dealt with procedures for obtaining official approval for eugenic operations, the Eugenic Protection Committee, eugenic examinations and payment of expenses. The Law no longer authorizes the involuntary sterilization of mental patients and those with mental weaknesses. Most significantly, legislators dropped from the Law the eugenic indications for sterilization as well as abortion and the list of medical conditions appended to the Law that served as grounds for sterilization and abortion on eugenic grounds. Thus, abortions are now permitted only when the health of the mother may be affected from the physical or economic view and in cases of sexual offences.

Changes in the Law were supported by all political parties and were welcomed by advocates for the disabled, particularly after it became known that over 16,000 people with hereditary or mental disorders had been sterilized between 1949 and 1994 under the former version of the Law. However, some women’s groups were displeased that the legislative changes had not been more extensive and that they had not been consulted prior to enactment of the changes. Some hoped for the passage of wide-ranging reproductive health legislation, stressing the rights of women in this area.

With the liberalized law enacted in 1948, abortion became the primary mode of fertility control in Japan.  Abortion played a significant role during the early years of the overall fertility decline, with contraception subsequently playing a greater role. According to health authorities, the number of induced abortions in Japan continued to increase after the 1948 law was enacted.  A peak was reached in 1955, when more than 1,170,000 abortions were reported against about 1,731,000 officially registered live births. Thereafter, the number of induced abortions gradually decreased.  As of 1983, slightly over 567,000 cases—about half of the number of abortions that were performed in 1955—were reported.   

The vast majority of abortions in Japan have been performed under the maternal health protection indication, which is in effect a combination of medical and socio-economic reasons. Nearly all abortions have occurred within the first trimester. In contrast to the general declining trend in the total incidence of abortion, the number of abortions obtained by women with low parity and by teenagers has been increasing since the late 1970s. As reported by one study in 1990, pregnancies among adolescents in Japan occur at a rate of about 22 per 1,000, and most of them end in abortion.

The high incidence of abortion in Japan is believed to be due in part to Government restrictions on contraceptive use. Oral contraception was illegal in Japan until 1999.  Until then, it could be obtained from physicians for the control of irregular menstrual cycles and for other medical purposes but not for birth control. The intrauterine device was legalized in Japan only in 1974 after its effectiveness and safety had been proved abroad.  The National Survey on Family Planning in Japan conducted in 1986 found that about 80 per cent of contraceptive users relied upon the condom. The survey results also demonstrated a relatively high rate of contraceptive failure; about 31 per cent of the women surveyed had undergone one or more abortions.

Adapted from “Abortion Policies A global review” by United Nations

Short summary of conditions within the law:
Additional requirements:

Induced abortions are allowed only within the first 22(the description in “Abortion Policies A global review” is wrong) weeks of gestation.  All legal abortions must be performed within medical facilities at the discretion of a physician designated by a local medical association.  The consent of the woman or her spouse is required, while the consent of a mentally retarded woman can be given by her guardian.  When the pregnancy is a result of rape or incest, the abortion can be performed without the legal consent of the woman.

Analysis of it being restrictive if at all.

2. Policy

As a countermeasures to the falling birthrate, under the influence of the right wing administration, the reform for safe abortion, such as the abolition of the article of the Criminal Code which punishes a woman who performs her own abortion and the abolition of the Law for Protection of Mothers’ Bodies which requires spouse’s  consent on abortion, become more difficult.

3. Second Trimester Abortion

4. Practice

Medical abortion is not approved in Japan. Only doctors can carry out operations of abortion. 

5. Reproductive Health Perspective

Japanese government signed ICPD and ratified CEDAW.

6. Abortion Statistics

Total  less than 300 thousand (276,352 cases in 2006 )
1st TM; 261,719 cases (94.7%)
2nd TM; 14561 cases (5.3%)

There is no data about unsafe abortion.
The ratio of abortions in the teenage population was 10.5 out of 1000 females in 2004 in Japan.
27,367cases out of 276,352 (9.9%)
Septic abortions

7. Public sector

Abortion services available
1st Trimester
Cost: about 1000 US$
 

Most of public hospitals do not accept the woman who wants to have an abortion due to being busy with attending delivery.

8. Private sector

Abortion services available
1st Trimester 1000~2000US$
2nd Trimester  3000~5000US$

9. Methods used

D&C, EVA, MVA, MMA with Mife Miso, MMA with Miso alone, MMA with Methotrexate Miso
D&C is main method in Japan.
2nd Trimester with Ethacridine lactate , Misoprostol, D&E, Hyterotomy
It  is said that the use of Prostaglandins is standard  method in Japan.

10. Provider level allowed for surgical and medical abortion

Ob and Gyn.

11. Abortion related morbidity mortality statistics

MMR in Japan is 6/100,000, so abortion related mortality is very rare.

12. Manufacture and/or availability through import of abortion equipment (MVA syringes, EVA equipment)

N / A

13. Manufacture/ import of Mifepristone, Misoprostol

Mifepristone is not approved.
Misoprostol is approved only for gastric ulceration or rheumatoid arthritis.

14. Facility and provider certification norms in brief

The medical association certifies doctors who can carry out abortion-operation.
The certified doctors have to go along the norm made by the Health, Labour and Welfare Ministry.

15. Information available in national service delivery standards

N / A

16. Informal / illegal providers – if present who are they

There are few informal / illegal providers who carry out nonqualified abortion-operation or support importing abortion pills.

17. Population urban/ rural: Demography of the country, with an analysis of availability of abortion services ratio to population

N / A

18. Role of government

Rather restrictive because of low birthrateand under the influence of the right wing administration.

19. Role of religion/ religious leaders

Rather restrictive.

20. Local Ob Gyn societies

Some doctors are thinking abortion earnestly from the point of women, but many doctors are judging the abortion from the points of morals or profit.

21. Current status and potential of research

N / A

22. Awareness amongst community members

In Japan, most of women do not want to talk about abortion because of stigma.
Although most of feminists are interested in backlash issue and Prenatal diagnosis issue, few feminist are interested in safe abortion issue and Medical Abortion issue.

23. Role of member organization/ individual

N / A