Abortion in Japan

Memorandums and information about abortion situations and problems in Japan

A LONG AND WINDING ROAD : TO SAFER ABORTION IN JAPAN

*Presentation material for IWAC 2019

 

Here is a powerpoint file used for my presentation at The 4th International Congress on Women’s Health and Unsafe Abortion (IWAC 2019) held in Bangkok, Thailand on February 21, 2019.

 

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Artificial Interruption of Pregnancy Law of Japan

*Partial Revision of the Eugenic Protection Law and the Problems of the Motherhood Protection Law

Here is the link to an explanation written in English by Japan Association of Obstetricians and Gynecologists:

https://www.jaog.or.jp/about/project/document/%e6%af%8d%e4%bd%93%e4%bf%9d%e8%ad%b7%e6%b3%95%e3%81%ae%e8%aa%ac%e6%98%8e%ef%bc%88%e8%8b%b1%e6%96%87%ef%bc%89/

Cost of abortion in Japan

The study we conducted in 2010 revealed the prices for abortion in Japan for the first time.

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The price ranges from JPY60,000 to 200,000, or $600 to $2,000 (average JPY101,000, or $1,010, if $1 =JPY100) for an early-term abortion, while a mid-term abortion ranges from JPY90,000 to JPY600,000, or $900 to $6,000 (average JPY285,000, or $2,850).

 

Abortion is not covered by national health, so every clinic decides their price at their will.  

Fighting for the pill in Japan

*BBC interview to Yoriko Madoka, an long-time activist in Japan 

Fighting for the pill in Japan

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Fighting for the pill in Japan


After decades of campaigning in Japan, the pill was finally legalised in 1999.

In contrast, the male impotency drug Viagra was approved for use in just six months, and legalised before the contraceptive pill for women.

Politician Yoriko Madoka tells Witness History how she pushed hard for the right to take the pill, and says sexism and male dominance in Parliament is why it took so long.

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Childbirth and Childcare Lump-Sum Grant

*IBM Japan

What a generous benefit packaget of Big Blue!?

No, it's not special.  Every women working or deopending on a worker who pays health insurance in Japan is entitled to this national system of the childbirth and childcare lump-sum grant when she has a misscarriage or a mid-term abortion at and over 12 weeks of pregnancy.  

Due to the fact this grant is paid for the stillbirth including mid-term abortion, sometimes doctors advise girls with no money to wait until 12 weeks of pregnancy to have a mid-term abortion and take a fee from this grunt. What a pitty!

 

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“The Childbirth and Childcare Lump-Sum Grant” is paid when an insured person gives birth and “the Dependents' Childbirth and Childcare Lump-Sum Grant” is paid when a dependent family member gives birth.

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When an insured person gives birth

Childbirth and Childcare Lump-Sum Grant 420,000 yen**

When a dependent family member gives birth

Dependents' Childbirth and Childcare Lump-Sum Grant 420,000 yen**
  • ** For childbirth (including stillbirth) after at least 22 weeks of pregnancy under the medical administration of a medical care institution or other institution that is a member of the maternity medical care compensation scheme; 404,000 yen for childbirth at an institution that is not a member of the maternity medical care compensation scheme.
  • ** Paid per child for multiple births

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Measures drawn up to protect pregnant women from COVID-19

*Japan Times

 

Japanese society with declining birth-rate is relatively friendly toward pregnant women but cold to women who seek contraceptives and abortion.  Sigh!

 

www.japantimes.co.jp

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The health ministry has compiled measures to prevent pregnant women from being infected with COVID-19, sources have said.

The ministry will call on companies and business organizations to promote teleworking and staggered commuting, create an environment in which pregnant women find it easier to take leave when they feel unwell and take measures to prevent group infections among employees including such women, according to the sources.

 

 

In addition, the ministry will distribute a booklet detailing infection prevention measures to pregnant women through municipal governments.

The booklet will say there have been no reports that the new coronavirus that causes COVID-19 is prone to cause fetal abnormalities or lead to stillbirth or miscarriage.

But it will cite the possibility of pregnant women suffering severe symptoms if they get pneumonia, calling on them to take thorough measures to protect themselves from the virus, such as avoiding crowds and washing hands frequently, according to the sources.

The ministry plans to provide cloth masks to pregnant women through municipal governments, separately from a government program to distribute two such masks to each of the over 50 million households in the country.

Meanwhile, the Japan Society for Reproductive Medicine said Wednesday that it recommends postponing fertility treatment until COVID-19 is under control in Japan.

In a statement posted on its website, the society calls for treatments as artificial insemination, external fertilization and embryo transfer to be reconsidered until a preventive or curative medicine for the new virus is developed for use during pregnancy or the danger of its spread decreases.

The statement said pregnant women may suffer severe symptoms if they catch COVID-19 and that some drugs being tested on patients cannot be used during pregnancy.

The society also expressed concerns about the possibility of infections during hospital visits for fertility or other medical treatments.

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International Campaign for Women's Right to Safe Abortion

*JAPAN/INDIA – abortion access in the context of COVID-19

www.safeabortionwomensright.org

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Abortion in Japan before Covid-19 and the way ahead

In a conversation with ASAP member Dr Kumi Tsukahara, a part-time lecturer at Kanazawa University, she reported that manual vacuum aspiration is the only safe abortion method approved in Japan while dilatation & curettage (D&C) is still the first and only prerequisite method taught in training, and remains the most prevalent procedure for abortion. Termination of pregnancy of less than 12 weeks LMP costs about US$928. Mifepristone has not been registered for use in Japan. It is under evaluation in clinical trials but the approval may take two or three more years. The current law authorizes the Japan Medical Association to designate abortion providers who can perform abortion legally. Low-dose contraceptive pills were approved in 1999, but have not been widely used until now due to poor accessibility and high price. Condoms are still the number one contraceptive method in Japan, and cause many unwanted pregnancies. The emergency contraceptive pill was approved in 2011, but is only available after seeing a doctor and getting a prescription. Women in Japan are demanding that EC be made available on an over-the-counter basis.

From April 2020, the Ministry temporarily lifted these strict conditions because of Covid-19, so every Ob-Gyn doctor is now allowed to prescribe both contraceptive pills and emergency contraceptive pills to any woman who seeks them by telephone or internet. However, the Ministry is not actively publicising this decision, so most women do not know about it.

SOURCE: Asia Safe Abortion Partnership, 23 April 2020

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'Abortion in Japan before COVID-19 and the way ahead' An ASAP

ASAP was formed to promote, protect and advance women’s sexual and reproductive rights by reducing unsafe abortions and its complications. 

 

I am a Japanese member of ASAP, and they issued an article about Japanese abortion situation by interviewing me.  

https://discussionsasap.wixsite.com/asapblog/post/abortion-in-japan-before-covid-19-and-the-way-ahead-an-asap-conversation-with-dr-kumi-tsukahara

Measures drawn up to protect pregnant women from COVID-19

In Japan where decreasing birthrate and aging population, the government is gentle for pregnant women.   However, there is NO public discussion to save those who need contraception and abortion in the mistd of the pandemic. 

Unfortunately, the reproductive health is only for women to give birth for most of Japanese policymakers who have pronatalist beliefs.  

www.japantimes.co.jp

A Report for Preparation of the List of Issues and Suggested Questions for the 9th Periodic Report of the Government of Japan

This is the NGO report we sent to CEDAW on February 3.

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To the Committee on the Elimination of Discrimination against Women

A Report for Preparation of the List of Issues and Suggested Questions for the 9th Periodic Report of the Government of Japan


Contraception and Safe Abortion Care Project,
Professional Women's Coalition for Sexuality and Health
https://pwcsh.or.jp/

February 3, 2020


The Professional Women's Coalition for Sexuality and Health (PWCSH) is an NGO that has been working voluntarily to improve Japanese women’s health and reproductive healthcare since 1997. Submitting this report is one of the PWCSH’s working groups. It is currently implementing a project to improve reproductive healthcare options such as contraception and abortion. Here is some information and suggested questions for the Japanese government.

 

Abortion methods

In Japan, Dilatation and Curettage (D&C) under General Anesthesia has been a main abortion method during first 12 weeks of pregnancy since abortion was virtually legalized after World War II.
The first publicly-funded national research for abortion methods conducted in 2010 on OB-GYN doctors reveals that 88% of respondents have been using D&C either with or without Vacuum Aspiration (VA) for abortions during first 12 weeks of pregnancy. The rate of those who use VA without help of D&C is 11%. Manual Vacuum Aspiration was introduced in October 2015, but it has not been widespread yet.
For abortions after 12 weeks, an induction by prostaglandins is typically used. The safety of this process has not been confirmed and is not one of the safe abortion methods recommended by the World Health Organization.
Abortion methods mainly used in Japan are not the safe abortion methods recommended by World Health Organization.


Suggested questions about this issue:

Please describe what measures have taken to promote Japanese women’s reproductive health concerning provision of safe abortion to them.

 

Cost of abortion

The 2010 study also reveals the prices for abortion. The price ranges from JPY60,000 to 200,000, or $600 to $2,000 (average JPY101,000 or $1,010, if $1 =JPY100) for an early-term abortion, while a mid-term abortion ranges from JPY90,000 to JPY600,000, or $900 to $6,000 (average JPY285,000 or $2,850). The fact that abortion is not covered by national health insurance hinders its accessibility and availability, especially for young women and poor women.


Suggested questions about this issue:

Please clarify what measures have taken to increase accessibility and availability of safe abortion to Japanese women in need.

 

Invalid warning

Abortion pills are believed to be dangerous by many Japanese people, and even medical doctors don’t have correct knowledge about them. The above-mentioned study shows that more than half of the OB-GYN doctors believe RU-486 (Mifepristone) is “dangerous”, or “somewhat dangerous”.
Such attitudes may be reflected by the fact that the Japan’s Ministry of Health, Labor and Welfare keeps warning on the danger of abortion pills acquired through Internet since 2004. The ground of this warning was fatal accidents of women having had abortion pills in USA in 2004, but FDA immediately investigated the cause and soon after denied the causality between the deaths and abortion pills.
However, the Japanese MHLW has not withdrawn the invalid warning, and this has been repeatedly mentioned in media reports of a woman who sought medical help for her health troubles after having acquired abortion pills illegally.
The scientific facts surrounding reproductive health should be taught publicly.


Suggested questions about this issue:

Please clarify what measures will be taken to provide scientifically correct information to Japanese public, including medical personnel’s concerning safe abortion methods.

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[Reference] CEDAW General Recommendation No. 24.
Recommendations for government action
29. States parties should implement a comprehensive national strategy to promote women's health throughout their lifespan. This will include interventions aimed at both the prevention and treatment of diseases and conditions affecting women, as well as responding to violence against women, and will ensure universal access for all women to a full range of high-quality and affordable health care, including sexual and reproductive health services. (20th session, 1999)