JAPAN : SOLIDARITY REQUEST  – Abortion pills due to be introduced in April 2022

With the news that the abortion pills may be introduced in Japan this April, the expectations of Japanese women have been raised. However, there is now a strong concern that the accessibility of the abortion pills will be compromised as doctors try to protect their interests. Women in Japan pay for everything out of their own pockets related to pregnancy, including birth control, emergency contraceptives and abortions. Fees are not regulated by the government, so doctors can set them as they please. Modern contraceptives, including birth control pills, have not been widely used (3%) in Japan as a result, as they are too expensive for many women. According to a report published in December 2021 by Kumi Tsukahara and others, it is not uncommon for contraceptives on prescription to be priced at more than 10,000 yen (US$90), and a first trimester abortion at between 100,000–200,000 yen (US$900–1,800). A different survey found that US$5,400 is being charged for a second trimester abortion in some clinics. Obstetricians and gynaecologists are strongly opposed to over-the-counter sales in return.

The only alternative that would control the price would be for the pills to be covered on the state health insurance as other essential health care services are.

The pharmaceutical company Linepharma submitted an application in late December 2021 to the Japanese government for approval of their combi-pack abortion pill up till 63 days of pregnancy (see their press release). The price of the pills will be set independently of the company.

In mid-December, several Diet members and advocate Kumi Tsukahara held a meeting at the House of Councillors building and invited officials from the Ministry of Justice and the Ministry of Health, Labour, and Welfare to exchange views over the abortion pill. A Ministry of Justice official argued that “the protected legal interest in the Japanese criminal law on abortion is the life and body of the fetus”. Several women present protested. It has been 140 years since the first criminal abortion law was established in Japan. One young woman gave a speech about how Japanese women are suffering from the lack of readily available contraception and abortion. The listeners applauded her. The group later submitted a request to the Ministries of Justice and of Health, Labor, and Welfare to make radical changes in the medical and legal aspects of abortion. They argued that both abortion care and the abortion law in Japan are far behind the rest of the world and women’s rights are being severely violated.

A morning programme on Japanese national television reported that the Japanese Society of Obstetricians and Gynaecologists (JSOG) had said they would make the price of a single packet of abortion pills equivalent to the “conventional” Japanese abortion procedure. In Japan, this is still D&C, done in tertiary hospitals. A JSOG doctor recently announced that for the time being, only designated doctors at medical institutions with inpatient facilities would prescribe the abortion pills. This has caused a lot of indignation.

The abortion rights movement in Japan has also been campaigning for the abolition of the “spousal consent requirement” that is still required for Japanese women to get an abortion. Only 11 countries, including Japan, require spousal consent for abortion. The Eugenic Protection Law 1948 (now known as the Maternal Body Protection Law) stipulated that, based on the medical standards at the time, only “designated physicians” who had been trained in obstetrics and gynaecology could perform the “dangerous abortion procedure of scraping the uterus with a surgical instrument” (D&C). D&C was introduced in Japan in 1906 and still accounts for the majority of abortions. But the World Health Organization has not recommended the use of D&C for many years, and both aspiration abortion and MA pills have, for many years now, been shown to be safe enough to be provided by midwives on an outpatient basis, and through telemedicine, MA pills can be used safely at home. In July 2021, the Ministry of Health, Labor, and Welfare asked one of the ob-gyn associations to inform their members about the aspiration method, but did not ask them to confirm whether D&C would be replaced by this method.

The fact is, Kumi Tsukahara reports, there is no end to the number of women who are unable to have abortions due to lack of money and who see no recourse except to give birth alone in toilets.

In order to change public opinion in Japan, their group is calling for solidarity from around the world. PLEASE SIGN THEIR NEW PETITION, prepared by Kazane Kajitani. We shared it in late December in the Campaign newsletter. But here is more information about it. It calls for reducing the burden on women regarding abortion. In order to respect the health and rights of all women living in Japan, the petition proposes the following five points:

  • Promptly approve the abortion pill as an option for women who have an unwanted pregnancy.
  • Provide abortion pills at a reasonable price and make them available to all who need them, regardless of their financial situation.
  • Eliminate abortion crimes under the Penal Code and the spousal consent requirement under the Maternal Body Protection Act, which unfairly hurts women and prevents them from accessing abortion.
  • Lift the ban on online medical consultations and home use of abortion pills to ensure that no woman is denied access to abortion because of where she lives and to protect her privacy.
  • Increase the cadres of health professionals who can provide abortion pills to improve access and lower the price of abortion.

In order to make Japan a place where all women can live in peace and control their lives and bodies without physical and mental burdens, they ask for your support.