The reality of abortion in Japan is very complicated and not well understood by people inside nor outside of Japan.
First of all, the Japanese Penal Code, which was enacted in 1907, includes the crime of abortion, and abortion is generally prohibited even now.
On the other hand, the Eugenic Protection Law, created in 1948, defines the grounds for dismissing the illegality of criminal abortion. The Eugenic Protection Law was reborn in 1996 as the Maternal Body Protection Law, which removed all eugenic provisions that were criticized as discriminatory and retained only the provisions on abortion.
The Article 14 of the Maternal Body Protection Law provides for legal abortion as follows:
Chapter III Maternal Health Protection
(Induced Abortion with Doctor's Approval)
Article 14 (1) A doctor designated by a medical association that is a public interest incorporated association established for the area of a prefecture (hereinafter referred to as a "Designated Doctor") may perform an Induced Abortion on a person who falls under any of the following items after obtaining consent from the relevant person and the spouse:
(i) a person for whom the continuation of pregnancy or delivery may significantly damage the person's physical health due to bodily or economic reasons; and
(ii) a person who was raped in a violent or threatening manner or at a time when the person could neither resist nor refuse and becomes pregnant.
(2) As for the consent provided in the preceding paragraph, the consent of the spouse is not necessary if the spouse is not known or cannot express an intention, or if the spouse no longer exists after the pregnancy.
The condition (i) is further divided into two categories: (a) the continuation of the pregnancy may significantly damage the woman's physical health due to bodily reasons, and (b) the continuation of pregnancy or delivery may significantly damage the person's physical health due to economic reasons.
The idea of (a) "the damage to the physical health due to bodily reason" is interpreted very narrowly, and is intended for cases in which the physical health is severely deteriorated (leading to death) for strictly medical reasons. In other words, very few abortions fall into this category, but they are covered by health insurance.
On the contrary, (b) "the damage to the physical health due to economic reasons" is interpreted very broadly. It is commonly referred to as the "economic clause", which allows a woman to have an abortion if her doctor deems it "economically difficult" for her to bear and raise a child. Even abortion on the grounds of fetal disability is also performed under this "economic clause". Naturally, abortions based on this reason make up the majority of abortions in Japan. And in this case, abortion is not covered by any public funds.
There are also very few abortions performed under the condition (ii), partly because the stigma against rape victims is so strong that few people report it to the police. If she can report it to the police, the abortion would be free of charge.
All of the above abortions are "legal", but most of them are not covered by public funds. More than that, there is a problem that abortion in Japan is very expensive. According to our 2010 survey, early abortions (<12weeks) cost 60,000-200,000 yen, and mid-term abortions (≥12weeks) cost 90,000-600,000 yen. Women and girls in Japan have to pay for these expensive abortions on their own.
Two separate studies have shown that D&C is still used in 80% of abortions in Japan, and VA only in 10-20% of procedures. For mid-term abortions, an expensive prostaglandin (a product called Preglandin) have been used since the 1980s. To use Preglandin for midterm abortions, doctors use expensive dilation materials such as Laminaria. This is another reason why midterm abortions in Japan are very expensive.
Mifepristone is unapproved and is currently undergoing clinical trials, but it's hard to expect it to be approved anytime soon. Japanese feminists are worried that the price will be high, as it was for low-dose pills, due to the very time-consuming and labor-intensive clinical trials. (In Japan, both the birth control pill and the emergency contraceptive pill are very expensive and very inaccessible because they can only be obtained through medical examination and numeral tests by a designated doctor.)
The abortion issue in Japan is so broad and deep-rooted that this is still just the tip of the iceberg.
