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Japan Severely Lags on Reproductive Rights 

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Japan Severely Lags on Reproductive Rights 

While reproductive rights are a highly politicized topic in the United States, there is minimal discourse in Japan on the subject.

Japan Severely Lags on Reproductive Rights 
Credit: Depositphotos

Following the overturn of Roe v. Wade last year, the United States has been met with international condemnation for stripping women of the constitutional right to abortions. But why is nobody criticizing Japan?

Japan is an Organization for Economic Cooperation and Development (OECD) country with the world’s third largest economy, and boasts a top-class universal healthcare system. But women in Japan who seek the exercise of their reproductive rights find themselves blocked at every turn. 

Albeit legal since 1948, abortions are highly inaccessible in Japan. Japan is one of 11 countries that requires spousal consent for abortions. Although this mandate solely applies to married women, doctors often use this as a blanket rule, exemplified by the sentencing of a 21-year-old student who abandoned her newborn son. She had been unable to get her partner’s consent for an abortion even though they were not married and his permission was not technically necessary under the law.

Moreover, while the World Health Organization-recommended mifepristone and misoprostol pill for ending pregnancies has been available in the United States since 2000, the medication still awaits approval in Japan. Thus, the main abortion method is surgical, specifically dilation and curettage: an outdated in-clinic procedure with increased rates of complications. And since insurance does not cover abortion in Japan, the procedure often costs a whopping $1,500, almost three times as much as the U.S. average ($580)

These punitive obstacles have resulted in increasing cases of infanticide among desperate mothers, driving the creation of a  “baby hatch” in 2007, where over 160 unwanted babies have been dropped off since. However, the hospital is in a remote location, underscoring a suspicion that the number of unwanted pregnancies that end in infant deaths is much larger nationwide. 

Although the abortion pill remains illegal, oral contraceptives were approved in 1999 after decades-long deliberations, 40 years behind the West. However, birth control pills are seldom the choice of contraception in Japan, given that the medication requires a prescription and is not covered by insurance; nor is the morning-after pill, which costs $150. Such inaccessibility to appropriate contraception leads to unintended pregnancies. In contrast, multiple university campuses in the U.S. have vending machines that provide affordable, over-the-counter emergency contraception. 

Against this background, a 2019 Lancet study on worldwide contraceptive prevalence rates was unsurprising. The main contraceptive method in Japan — among the 51.4 percent of women who used some form of contraception — was the male condom (31.9 percent), while birth control pills (11.4 percent) were significantly less popular. According to the 64.3 percent of women in the U.S. who used some method of contraception, the pill (21.8 percent) was among the most common, while condoms (15.2 percent) were relied upon by far fewer women.

Japan is truly an anomaly in the developed world, long depriving women of the basic right to reproductive health care. Why are such backward policies still in place?

The answer lies in the inherently paternalistic nature of Japanese society. Japan has one of the world’s worst gender gaps, ranking 116th among 156 countries by the World Economic Forum. In a country where power is vested in male policymakers, the “protection” of women justifies access constraints to reproductive health care. 

For instance, responding to rising public demands to make the morning-after pill available without prescription, the Japan Society of Obstetrics and Gynecology (JSOG)’s male president argued: “I’d like to think that we as a society are mature enough to handle the over-the-counter purchase of Plan B, but in reality, we’re not quite there yet.” Citing concerns that the pill may be illegally abused or excessively used by women, the JSOG is yet to approve eased regulations for this basic necessity.

The overturn of Roe v. Wade showed that a developed country can have regressive policies on reproductive rights, but Japan’s case exposes a different facet of the problem. While reproductive rights are a highly politicized topic in the U.S., there is minimal discourse in Japan, largely due to the country’s sex education (or the lack thereof). Since sex remains a taboo subject, the curriculum has no real information regarding contraception, leaving Japanese youth unaware of their reproductive rights. Put simply, while the battle for reproductive rights is being waged in the U.S., the battle is yet to begin at all in Japan.

Japan’s appraised “successes” with universal healthcare and life expectancy may have overshadowed its severe lack of reproductive rights, but this should not shield Japan from criticism for these backward policies. Lackluster commitments made at Japan’s recent Universal Periodic Review — the review of each country’s human rights progress at the U.N. Human Rights Council — regarding the abortion pill approval, as well as discussions to establish another “baby hatch” in Tokyo rather than addressing the systemic causes of infant mortality, exemplify how little progress Japan has made.

Having recently assumed the G-7 presidency, Japan has international eyes upon it and can no longer afford to uphold its misogynistic policies. Until Japan adopts global standards by granting basic reproductive rights, the lives of its girls and women will remain at stake — and that should never be the case.