Monday, 12 July 2010

Abortion in Japan


All this talk of abortion has made me think about differences between the debate here in NZ (where I live) and Japan (where I lived for a while). The purpose of this post is to share a few observations of a society which is more relaxed about abortion than most other places, where abortion was legalised earlier than almost anywhere else and where the decision to continue a pregnancy is generally recognised as the business only of the individual (woman) concerned.

Abortion has for a long time been the de facto method of birth control in Japan. I saw a statistic that some 60% of university-educated Japanese women in their 40s had had at least one abortion.
With the liberalized law enacted in 1948, abortion became the primary mode of fertility control in Japan. Abortion played a significant role during the early years of the overall fertility decline, with contraception subsequently playing a greater role. According to health authorities, the number of induced abortions in Japan continued to increase after the 1948 law was enacted. A peak was reached in 1955, when more than 1,170,000 abortions were reported against about 1,731,000 officially registered live births. Thereafter, the number of induced abortions gradually decreased. As of 1983, slightly over 567,000 cases—about half of the number of abortions that were performed in 1955—were reported.

The vast majority of abortions in Japan have been performed under the maternal health protection indication, which is in effect a combination of medical and socio-economic reasons. Nearly all abortions have occurred within the first trimester. In contrast to the general declining trend in the total incidence of abortion, the number of abortions obtained by women with low parity and by teenagers has been increasing since the late 1970s. As reported by one study in 1990, pregnancies among adolescents in Japan occur at a rate of about 22 per 1,000, and most of them end in abortion.
When I was living in Japan there was talk about how the local doctors who perform abortions had been trying to block wider access to the oral contraceptive and emergency contraceptive pills. For a long time these were not available and the main debate around abortion was in relation to this, that a predominantly male health sector was limiting access to less full on medical options to unwanted pregnancy. The oral contraceptive pill only became available ten years ago but is still not that widely used. On a personal level I noticed that I had to be much more vigilant in terms of contraception than I had been in NZ and this seemed to be because people were less terrified by the prospect of an unwanted pregnancy.

Women choose abortions for a range of economic, personal and social reasons and the Japanese attitude is that the woman concerned is the best placed to make a decision about whether to continue a pregnancy. The factors that will influence the decision are just as relevant in 2010 as they have been in the past and the decision to have an abortion is a woman's own.

What strikes me as different about the abortion debate in NZ is the centrality of the foetus, the "potential person". In Japan the idea that a foetus has a right to life has not been widespread and the practice of abortion not a taboo on religious grounds. Traditionally it was not at conception or the quickening that the foetus became a "person" but rather this occurred when the religious rites of passage were peformed after birth. From what I understand there have been periods when abortion has been illegal in Japan but again this was nothing to do with the right to life of the foetus but rather was because the government wanted to boost population numbers during times of war. Society recognises that responsibility to the living (the parents, family, community) is the key consideration, rather than the rights of the foetus.

In terms of the legal situation, which is described below, there is still room for improvement. However, it is the public debate around abortion which has always interested me as removing the religious angle makes the discussion quite a different one. There are still issues around agency and liberation but these align themselves in a different way.
Under the Law, an abortion could be performed only in a medical facility by a physician designated by the local medical association. The consent of the woman and her spouse was required unless the spouse was unascertainable, unable to express his will or had died after conception of the foetus. If the woman who was to undergo the abortion was insane or mentally retarded, consent had to be given by the woman’s guardian.

Owing to the provision in the law of socio-economic grounds for abortion above, abortions became available virtually on request since the pregnant woman needed only to find a physician who was willing to perform the operation. The time limit for the performance of abortions was not specifically set by the Law. Rather, the Law designated viability as the limit for all abortions. Subsequently, notices issued by the Ministry of Health and Welfare moved the point of viability from an initial eight months to 23 weeks. Although these notices, technically, do not have binding legal effect, they indicate the Government’s understanding of the Law and are almost universally followed.
Spontaneous or deliberate termination have the same moral status in Japan and there is a religious ritual called Mizuko Jizo which provides a way for women to acknowledge these, if they want to. Parents who are unable to have a child because of miscarriage, abortion or stillbirth will often visit a temple to visit the Mizuko Jizo (pictured above) and will write a letter to the child that cannot be born now but will be born at a later time.
Many women or couples in Japan who have terminated a pregnancy, suffered a miscarriage, or had a stillborn baby choose to honour the soul of this child through a practice called mizuko jizo. Mizuko means ‘child of the water’ and is used to refer to the soul of a child who has been returned to the gods, and Jizo is the name of the Buddhist god who protects and guides that soul on its journey to another world.

Abortion is regarded as the parents willingly making a decision to return a child to the gods, sending a child to a temporary place until such time that it is right for the child to come into this world, either into the same family or another one. The child is returned because the parents, at that time, would be unable to provide enough love, money, or attention to this child, without it being to the detriment of their present family. Practicing mizuko jizo allows the parents to provide a certain amount of attention to the child, who is regarded as a member of their family.

4 comments:

Meg said...

Thank you for this post, I found it thoughtful, interesting and enlightening. Have been so impressed by the collective hand of the Hand Mirror over this issue!

Bel said...

Ditto Meg's comment!

Here's an interesting article about Japan and the contraceptive pill:
href=http://www.cbsnews.com/stories/2004/08/20/health/main637523.shtml
Yes, it's from 2004 and by CBS but still some good background info...

Julie said...

This is a really interesting post Katy, thanks so much for contributing it.

I think for me the phrase that stuck out was:

"Society recognises that responsibility to the living (the parents, family, community) is the key consideration, rather than the rights of the foetus."

I also very much like the Mizuko Jizo idea. It strikes a chord with my own feelings about a miscarriage that I had prior to having my son. It helped, once Wriggly had arrived, to think that he was the one I was meant to have as my child. Irrational and unprovable? Probably, but it helped. It sounds to me very healthy to give people a chance to publicly acknowledge their loss, rather than the "harden up" (or find someone to blame) attitude we so often seem to see here.

Thanks again, this is a v timely thoughtful post.

katy said...

Thanks for the comments and for the link about the contraceptive pill in Japan. It was a little tricky to write this piece because there are still many areas for Japan to improve around these kinds of issues and the issue of the oral contraceptive pill is a good example of this. However, I always really liked the public attitude towards abortion and I wanted to provide a bit of info about that.

The thing I liked about the Mizuko Jizo statues is that you see them everywhere. The experiences of miscarriage and abortion are actually pretty common among adult humans and I appreciated that there was this reminder that was constant but guilt-free and that gave people a way to work through any grief associated with this.