Abortion in Japan is allowed under a term limit of 22 weeks for endangerment to the health of the pregnant woman, economic hardship, or rape. [1] Chapter XXIX of the Penal Code of Japan makes abortion de jure illegal in the country, but exceptions to the law are broad enough that it is widely accepted and practiced. Exceptions to the prohibition of abortion are regulated by the Maternal Health Protection Law that allows approved doctors to practice abortion on a woman if the pregnancy was the result of rape or if the continuation of the pregnancy endangers the maternal health because of physical or economic reasons. Anyone trying to practice abortion without the consent of the woman will be prosecuted, including the doctors. If a woman is married, consent from her spouse is also needed to approve abortions for socioeconomic reasons, although the rule doesn't apply if she is in a broken marriage, suffering abuse, or other domestic issues. Despite the partner's consent not being necessary for unmarried women and women who were impregnated by abusive partners or through rape, many doctors and medical institutions seek a signature from the man believed to have made the woman pregnant for fear of getting into legal trouble, rights advocates say. [2] [3]
In April 2023, medical abortion was approved in Japan for pregnancies up to 9 weeks of gestation. [4] The Japanese health ministry approved an abortifacent from British pharmaceutical company Linepharma. [5] Women who have a medical abortion are required to stay in the hospital for the abortion to be confirmed by the prescribing physician. Any other person who is not a certified gynecologist or obstetrician who aborts a fetus using abortifacients that is not approved by the Japanese Health Ministry will be penalized. [6]
Abortions are not covered under Japanese insurance. [4] Surgical abortions can cost between 100,000 yen and 200,000 yen; the total cost of the abortion pill and a medical consultation would be around 100,000 yen, according to the NHK. [7]
Since the approval of the Mefeego pill pack in April 2023, the government conducted a survey that concluded there were no severe side effects and complications as a result of the newly approved medication. In August 2024, the Ministry of Health announced it is now considering the expansion of medical abortion to outpatient clinics that can coordinate inpatient facilities in the case of emergencies. [8]
In 1842, the Shogunate in Japan banned induced abortion in Edo, but the law did not affect the rest of the country until 1869, when abortion was banned nationwide. [9] [10] However, the crime was rarely punished unless the conception was a result of adultery or the woman died as a result of the abortion procedure. [9]
According to the scholar Tiana Norgern, the abortion policy under the Meiji government was similar to that of the Edo period, and was fueled by the belief that a large population would yield more military and political influence on the international stage. [9] In 1868, the emperor banned midwives from performing abortions, and in 1880, Japan's first penal code declared abortion a crime. [9] The punishments for abortion grew more severe in 1907 when the penal code revised: women could be incarcerated for up to a year for having an abortion; practitioners could be jailed for up to seven. [9] The Criminal Abortion Law of 1907 is still technically in effect today, but other legislation has overridden its effects. [9]
In 1923, doctors were granted legal permission to perform emergency abortions to save the mother's life; abortions performed under different, less life-threatening circumstances were still prosecuted. [9] In 1931, the Alliance for Reform of the Anti-Abortion Law (Datai Hō Kaisei Kiseikai) was formed by Abe Isoo and argued that "it is a woman's right not to bear a child she does not want, and abortion is an exercise of this right". [9] This organization believed that abortion should be made legal in circumstances in which there was a high chance of genetic disorder; in which a woman was poor, on public assistance, or divorced; in which it endangered the woman's health; and in which the pregnancy was a result of rape. [9] In 1934, the Fifth All-Japan Women's Suffrage Congress wrote up resolutions calling for the legalization of abortion as well as contraception. [9] This did not result in any immediate reaction from the government at the time, but after the war, these resolutions were consulted when drafting legislation legalizing abortion.[ citation needed ]
Fearing a decline in birth rates in the following decades, the nationalist Konoe cabinet decided to implement a series of pro-natalist measures. On 22 January 1941, the Outline for the Establishment of Population Policy (人口政策確立要綱, Jinkō Seisaku Kakuritsu Yōkō) was approved, which included among its policies the prohibition of abortion. [11] [12]
In 1940, the National Eugenic Law stopped short of explicitly calling abortion legal by outlining a set of procedures a doctor had to follow in order to perform an abortion; these procedures included getting second opinions and submitting reports, though these could be ignored when it was an emergency. [9] This was a daunting and complicated process that many physicians did not want to deal with, and some sources attribute the fall in abortion rate between 1941 and 1944 from 18,000 to 1,800 to this legislation. [9]
After World War II, Japan found itself in a population crisis. In 1946, 10 million people were declared at risk of starvation, and between the years 1945 and 1950, the population increased by 11 million. [9] In 1948, in the wake of the Miyuki Ishikawa case, Japan legalized abortion under special circumstances. [13] The Eugenic Protection Law of 1948 made Japan one of the first countries to legalize induced abortion. In 1949, a revision passed which provided abortion in the case of extreme physical or economic distress to the mother. [14] A further stipulation was added in 1952 requiring that the mother meet an economic threshold of poor living conditions to obtain an abortion. [15] The whole law was revised as the Maternal Health Protection Law in 1996. [16]
Overall, in 2019, the total number of abortions officially reported was 156,430, [17] representing a 56% decrease from the number reported for 2000. The overall abortion rate changed from 22.3 to 15.3 abortions per 1,000 women aged 15–39 years. Going further back, there were 598,084 abortions in 1980 and 1,063,256 in 1960. [17] In 2019, 49 abortions were reported for girls aged 13 and under, and a further 3,904 for girls aged 14–17. Some 39,805 abortions were performed on women aged 20–24. [17]
In 2020, according to the health ministry, there were 145,340 abortions, down 7.3% from the previous year. [3]
According to researchers, in more than 99 percent of cases, the reason reported for performing an abortion was to protect the woman's health; this percentage remained constant during 1975–1995. [18] The same researchers also suggest that while official figures may be lower than the true rate of abortion due to under-reporting by doctors in order to lower tax bills and protect patient identities, trends may be "reasonably accurate". [18]
A scenario study was conducted to assess the extent to which the unintended pregnancy rate in Japan, for the period when oral contraceptives (OC) had not yet been legalized for family planning purposes and couples relied mainly on condoms, might change if more women were to use OC. Data provided by the 1994 Japanese National Survey on Family Planning were used to construct scenarios for national contraceptive use. Annual failure rates of contraceptive methods and nonuse were applied to the contraceptive use scenarios, to obtain estimates of the annual number of contraceptive failure-related pregnancies. Subsequently, contraceptive practice situations assuming higher OC use rates were defined, and the associated change in the number of contraceptive failure-related pregnancies was estimated for each situation. It emerged that OC use rates of 15% decreased the expected number of unintended pregnancies by 13–17%, whereas use rates of 25% resulted in decreases of 22–29% and use rates of 50% in decreases of 45–58%. The findings were reasonably robust to variation in the assumptions that were made. In conclusion, each theoretical percentage increase in the OC use rate in Japan was found to lead to a roughly equivalent percentage decrease in the number of unintended pregnancies. [19]
Oral contraceptives were legalized in 1999. Emergency contraceptive pills were approved by the Ministry of Health, Labour and Welfare of Japan in 2011. [20]
Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy.
Abortion in the Netherlands was fully legalized on 1 November 1984, allowing elective abortion up to the 24th week of the pregnancy. Abortion for "serious medical reasons" can be performed after 24 weeks. There used to be a mandatory five-day waiting period for abortions done after one's menstrual period is 17 days overdue. However, on 21 June 2022, Dutch parliament approved a law to scrap the mandatory five-day reflection period before undergoing an abortion, saying women with a joint consultation with the doctor, should be able to determine the time before making a decision. The law went into effect in January 2023.
Chile's abortion laws have undergone significant changes in recent years. Prior to 2017, Chile had one of the strictest abortion laws globally, prohibiting the practice altogether. However, since then, abortion has become legal in certain circumstances.
Controversy over the beginning of pregnancy occurs in different contexts, particularly as it is discussed within the debate of abortion in the United States. Because an abortion is defined as ending an established pregnancy, rather than as destroying a fertilized egg, depending on when pregnancy is considered to begin, some methods of birth control as well as some methods of infertility treatment might be classified as causing abortions.
Abortion in Italy became legal in May 1978, when Italian women were allowed to terminate a pregnancy on request during the first 12 weeks. A proposal to repeal the law was considered in a 1981 referendum, but was rejected by nearly 68% of voters; another referendum aimed at eliminating the restrictions was rejected by 88.4%.
Abortion has been legal in India under various circumstances with the introduction of the Medical Termination of Pregnancy (MTP) Act, 1971. The Medical Termination of Pregnancy Regulations, 2003 were issued under the Act to enable women to access safe and legal abortion services.
Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unintended pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only became available in the 20th century. Planning, making available, and using human birth control is called family planning. Some cultures limit or discourage access to birth control because they consider it to be morally, religiously, or politically undesirable.
Unintended pregnancies are pregnancies that are mistimed or unwanted at the time of conception, also known as unplanned pregnancies.
Abortion in Namibia is restricted under the Abortion and Sterilisation Act of South Africa (1975), which Namibia inherited at the time of Independence from South Africa in March 1990. The act only allows for the termination of a pregnancy in cases of serious threat to the maternal or fetal health or when the pregnancy is a result of rape or incest. This law has not been updated since, and attempts to liberalise it have been met with fierce opposition from religious and women's groups.
Abortion in Spain is legal upon request up to 14 weeks of pregnancy, and at later stages in cases of risk to the life or health of the woman or serious fetal defects.
Birth control in the United States is available in many forms. Some of the forms available at drugstores and some retail stores are male condoms, female condoms, sponges, spermicides, over-the-counter progestin-only contraceptive pills, and over-the-counter emergency contraception. Forms available at pharmacies with a doctor's prescription or at doctor's offices are oral contraceptive pills, patches, vaginal rings, diaphragms, shots/injections, cervical caps, implantable rods, and intrauterine devices (IUDs). Sterilization procedures, including tubal ligations and vasectomies, are also performed.
Abortion in Kazakhstan is legal as an elective procedure up to 12 weeks, and special circumstances afterwards. The relevant legislation is based on the laws inherited from the country's Soviet past, when abortion was legally permitted as a contraceptive.
Abortion in Guatemala is illegal, except when needed to save the woman's life. Abortion was illegal without exception prior to 1973. Congressional Decree 17-73 altered the penal code to allow abortion in cases in which the pregnant woman's life is endangered in September 1973. The procedure must be done by a physician and approved by a second doctor.
Birth control in Japan has been available since at least the 17th century, and its evolution has been informed by political, social, and economic contexts. Prior to World War I common forms of birth control included abortion, infanticide, and condoms. Birth control as an oral contraceptive, while known in intellectual circles, was not widely circulated until the interwar period when the debate over birth control gained public support and momentum. However, it was the militarists, whose goal of achieving a strong population in order to establish Japan as an international power prevailed, as Japan prepared to enter World War II. The end of World War II, and Japan's subsequent demilitarization brought an emphasis on population reduction by the US-led occupation SCAP who were fearful of a rise in communism or militarism which would create a threat to democracy and the "free-world."
Abortion in South Korea was decriminalized, effective 1 January 2021, by a 2019 order of the Constitutional Court of Korea. It is currently legal throughout pregnancy, as no new law has been enacted. Thus there are no gestational limits or other restrictions.
There are many types of contraceptive methods available in France. All contraceptives are obtained by medical prescription after a visit to a family planning specialist, a gynecologist or a midwife. An exception to this is emergency contraception, which does not require a prescription and can be obtained directly in a pharmacy.
In Yemen, abortions are only “permitted to save the life of a pregnant woman”, making it one of the strictest abortion laws in the Middle East and the world. Abortion is not widely accepted in Yemeni society. However, because of the recent conflict in Yemen, rape, honor killings, and unsafe abortions have increased in Yemen. According to a study conducted by Canadian Studies in Population, the number of unsafe and illegal abortions are high in Yemen, which can lead to fatal health risks for women.
Nepal legalised abortion in March 2002, under the 11th Amendment to the Civil Code. The legal services were successfully implemented on December 25, 2003. The high maternal mortality rates in Nepal led to the government legalising it. More than 500,000 women sought abortion between 2004 and 2014. In 2014, 323,100 women in Nepal had the abortion; among this, only 42% of abortions were legal and 19% were treated for abortion complications. Similar study had found the rate of unintended pregnancy as 50%.
Abortion in Ghana is banned except when there is a valid exemption. The abortion should also be conducted only at a government hospital; registered private hospital, clinics registered under the Private Hospitals and Maternity Homes Act, 1958 and a place approved by the Minister of Health by a Legislative Instrument. Illegal abortions are criminal offenses subject to at most five years in prison for the pregnant woman who induced said abortion, as well as for any doctor or other person who assisted this pregnant woman in accessing, or carrying out, an abortion. Attempts to cause abortions are also criminal, as are the purveyance, supply, or procurement of chemicals and instruments whose intent is to induce abortions.
In Madagascar, abortion is illegal in all circumstances. The abortion law punishes receiving or assisting in an abortion with imprisonment or fines. It is one of the only countries with a total abortion ban. Abortion has been illegal since the French colonial era, influenced by attitudes favoring increased births. In 2017, the government rejected a proposal to legalize therapeutic abortion. A bill allowing abortion in the case of rape was proposed by Member of Parliament Masy Goulamaly in November 2021 but was withdrawn by the parliament.
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