In response to an inquiry from an foreign researcher
I'll publish my email response here as well.
In Japan, abortion is in principle a crime under the Penal Code, but abortion under 22 weeks of pregnancy is permitted under certain conditions.
Those conditions are:
- The abortion must be performed by a doctor designated under the Maternal Protection Law ("a designated doctor").
- Consent must be obtained from the woman and her spouse.
- It is available when the health of the woman is seriously compromised for economic or physical reasons, or if the pregnancy is the result of sexual violence.
- Economic reasons (strictly limited to cases where the woman's health is severely compromised for economic reasons, i.e., extreme poverty level) are interpreted expansively and used for 99.9% of abortions.
The penal code stipulates:
Chapter XXIX Crimes of Abortion
(Abortion)
Article 212 When a pregnant woman causes her own abortion by drugs or any other means, imprisonment with work for not more than 1 year shall be imposed.
(Abortion with Consent; Causing Death or Injury)
Article 213 A person who, at the request of a woman or with her consent, causes her abortion, shall be punished by imprisonment with work for not more than 2 years. If the person thereby causes the death or injury of the woman, the person shall be punished by imprisonment with work for not less than 3 months but not more than 5 years.
(Abortion through Professional Conduct; Causing Death or Injury)
Article 214 When a physician, midwife, pharmacist or pharmaceuticals distributor, at the request of a woman or with her consent, causes her abortion, imprisonment with work for not less than 3 months but not more than 5 years shall be imposed. If such person thereby causes the death or injury of the woman, imprisonment with work for not less than 6 months but not more than 7 years shall be imposed.
(Abortion without Consent)
Article 215 (1) A person who, without the request of the woman or her consent, causes her abortion shall be punished by imprisonment with work for not less than 6 months but not more than 7 years.
(2) An attempt of the crime prescribed under the preceding paragraph shall be punished.
(Abortion without Consent Causing Death or Injury)
Article 216 A person who commits the crime prescribed under the preceding Article and thereby causes the death or injury of the woman shall be dealt with by the punishment prescribed for either the crimes of injury or the preceding Article, whichever is greater.
As for spousal consent for abortion required by "Maternal-body Protection Act":
- The intent is not to seek the consent of the perpetrator of forced sexual intercourse.
- The spousal consent for abortion is not legally required in cases such as broken marriages(including domestic violence), where consent was difficult to obtain.
- For unmarried women, consent is not required since the partner is not the spouse.
However, in order to avoid being sued later by their male partners, many doctors ask women to give "spousal consent," which is not legally required.
Emergency contraceptive pill is basically only available at certain pharmacies with a prescription from an obstetrician/gynecologist, but starting next week, November 28 (not in this summer), 150 pharmacies nationwide will begin "trial sales" without a prescription; those under 16 cannot use them and will be referred to an obstetrician/gynecologist if requested; minors between the ages of 16 and 18 must be accompanied by a parent. The fee is expected to be around 6,000-8,000 yen (€37-49). Other details have not yet been announced.
Mefeego Pack （a combi-pack product of one mifepristone and four misoprostol tablets) is available up till 9 week 0 day, on condition of hospitalization at a clinic or hospital with beds, or on condition of waiting in the hospital until the expulsion of the gestational sac.
Misoprostol, an ulcer treatment, is also available in Japan, but it is considered "contraindicated in pregnant women" and therefore cannot be given additionally for abortion.
In 1984 vaginal suppositories Preglandin (gemeprost) by Ono Pharmaceutical got available and still is only for termination of pregnancy after 12 week. Japanese "designated doctors" won't perform D&E. The Preglandin was tried for early abortion (less than 12 weeks) and succeeded, but Japanese designated doctors at the time, who considered early-term abortions to be sufficient for lucrative surgical procedures (D&C), convinced Ono to file an application for a drug only for the second trimester, concealing the clinical trial data for the first trimester.
Price for abortion: €600-1300 (up to 12 w); €3100*（from 12w up to 22w)
*After 12 weeks of pregnancy, a lump-sum maternity allowance is granted for "delivery" regardless of whether the fetus is alive or dead. Some facilities charge an additional fee.
Designated doctors are obstetricians and gynecologists who have been designated by prefectural medical boards as physicians who can legally perform abortions after completing a certain amount of surgical abortion training and undergoing an examination of the medical facilities where they work and their personal qualifications.
