ARJC Asia & Pacific Regional Webinar: Challenges in Reproductive Justice around Asia and the Pacific held on November 17, 2023
Presentation manuscript by Kumi Tsukahara PhD
Thank you very much for inviting me today. I am Kumi Tsukahara. I’m researching on the issues of abortion in Japan. Today, I would like to give a brief overview of the situation of reproductive health and rights in Japan, focusing on abortion. [1]
In the late 19th century, Japanese imperial government created its first criminal code which banned abortion in 1880, and soon it re-issued a new criminal code in 1907 that regulated abortion more strictly, and it’s still in effect today. In 1948, faced with poverty and a rapidly increasing population after the defeat of the war, Japan established the Eugenic Protection Law (EPL), which provided forced sterilization to the disabled and legalized abortions for several reasons. [2]
In 1952, they added an economic clause, and a single designated doctor gained the authority to decide whether or not to perform legal abortions. By loosely interpreting this clause, the doctors performed a large number of abortions. Abortion became a lucrative business for them. This is the base of our problem. [2]
This graph shows the dramatic change in the number of abortions in Japan. The official numbers of abortions were over 1 million per year for nine straight years. Other nations banning abortions at that time criticized Japan as an “abortion paradise.” [3]
In addition, the forced sterilization articles of the EPL came under attack as discriminatory toward disabled people. So, Japan revised the law in 1996 as the Maternal-body Protection Law (MPL), having only abortion articles remain. [2]
This graph shows the evolution of contraceptive use in Japan and how the approval of the birth-control pill in 1999 did not contribute to an increase in use of contraceptive pill among Japanese. Birth control pills are rarely used even now. I am so concerned that the abortion pills approved this year may follow the same path. [4]
Here is a summary of the legal status quo. The penal code criminalizes and stigmatizes abortion. The MPL allows designated doctors to perform abortion only after obtaining consent from the pregnant woman and her spouse. In reality, 99.9% of abortions performed because of threatened maternal health for economic reasons. [5]
This chart shows the difference in abortion methods between Japan and WHO. Japanese doctors have been using D&C for early abortions since abortion was legalized in 1948. Although the use of aspiration methods has increased just recently, even the latest data show that D&C is used alone or in combination with aspiration in 60% of the early-term surgical abortion procedures. [6]
In April this year, the abortion pill, mifepristone and misoprostol, was finally approved in Japan for termination only up to 9 weeks. All the abortions are exclusively performed legally only by designated doctors, with no health insurance coverage. [6]
Here is a compilation of pictures of abortion methods used in Japan. Abortion by surgeries usually costs 700 – 1500 US dollars. Please refer to the brief explanation about “designated doctors” in the box. [7]
Here is a list of issues regarding the handling of oral abortion pills approved this year in Japan. Abortion pills are so safe and effective that the WHO has included them in their essential drug list as you know. However, in Japan, only designated doctors could prescribe them, hospitalization is required, and the price is very high, equivalent to a surgical procedure. [8]
This year, the UPR of the UN Human Rights Council took place for Japan, the Japanese government received many recommendations regarding SRHR. Several countries called on Japan to abolish the criminal offense of abortion and to implement comprehensive sexual education to guarantee human rights. However, Japan rejected most of the requests. They answered that Japan would respect "the unborn" as a human life and dismissed the guarantee of human rights for women, citing the ethics and morality of the people. This attitude of the government has been the same for almost half a century. [9]
This diagram illustrates the relationship between three interest groups in conventional Japanese society regarding abortion: medical doctors, the government and lawmakers, and women. The medical associations have provided organizational votes and donations to support ruling party legislators, and the government has adopted policies that favor the doctors, as the EPL and the MPL protect their interests. On the other hand, the government has bound women by criminalizing abortion and stigmatizing it. Meanwhile, doctors have monopolized and stigmatized abortion by maintaining outdated and ethically problematic abortion methods. Women have been forced to internalize shame and guilt and remain silent because of stigmatized abortion. [10]
To break this vicious cycle, we need to proclaim reproductive rights as a universal human right. Promoting this concept enable women to confront their shame and guilt and raise their voices. Empowered, self-respecting, and united at home and abroad, women can advocate that it is essential for the government and doctors to guarantee women's reproductive health and rights. We demand that doctors respect WHO guidelines and scientific evidence; similar pressure can be applied to them by WHO and FIGO. Meanwhile, empowered women could ask the government to abolish discriminatory abortion-related laws and introduce comprehensive sexual education. The UN and other countries can also put pressure on the Japanese government. [10]
Our basic principle is "justice" based on human rights. Even though the current situation differs from country to country, it is imperative to spread this transnational principle to all people and realize reproductive justice. [10]
Thank you for your attention.
Refer to the PPT for this presentation: here
[number] refers to the page of the PPT.
