Terminating a pregnancy can often be a controversial issue, but it is a decision made by about 350,000 women in Japan every year, and a small percentage of them are Western women who have the added difficulty of being in a foreign country. Abortion is legal in Japan. It is not covered by insurance, and it cannot be done after the second trimester. Certain aspects of the experience make it less unpleasant than it might be in their respective home countries. The attitude towards abortion in Japan is that it is considered a ‘necessary sadness’ and a natural process. Counselling is not provided, nor is it assumed that you will suffer any kind of moral dilemma. Please be aware of this when you visit a doctor, and don’t be surprised by their matter-of-fact approach.
For young women, parental consent for a termination is not required; however, for all women, written consent from ‘the father’ is required. If this is not possible, then a male friend will suffice. As health insurance does not cover abortions, you will need to pay about ¥120,000. An anesthetic is not always used during the procedure, so check beforehand. If you are in the first three months of pregnancy, the cervix will be dilated and the womb scraped or suctioned. Your visit may take just a few hours. If your pregnancy is more advanced, labour will be induced and you will need to stay overnight. Your doctor will explain the methods in detail.
Both the Tokyo English Life Line (TELL; 03-5774-0992, daily from 9:00 to 23:00) and AMDA: International Medical Information Center (03-5285-8088, Monday to Friday, 9:00 to 17:00) can be contacted for referrals to doctors that perform abortions. If desired, ask for a doctor that can provide after-procedure counselling.
Home pregnancy testing kits are available from any drug store and are pretty easy to spot. They come in pink boxes showing pictures that represent urinating on a stick and seeing the stick change colour. Some have instructions in English, but the pictorial instructions are generally easy to understand.
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: to apologise to the child and to ask for forgiveness from their child for being unable to bring them up.
Online medical abortion service that helps women get a safe abortion with pills.
A video on general information on abortions and procedures.
Japan-specific information. JHI can also help you locate an abortion clinic and an abortion counsellor.
Some history on abortion and its policies in Japan.
The following is a personal story from a previous member of the JET Programme:
This is one of those topics no one likes to talk about. The "what ifs" becoming reality. You find yourself pregnant and for various reasons have come to the conclusion that you want or need to terminate. I caught my pregnancy at exactly 4.5 weeks, right after my missed period. I thought my period was a little late but it didn’t feel like a regular period, and I had all the signs and symptoms of pregnancy. You can get a home pregnancy test, but honestly I wanted 100% proof that I was indeed knocked up.
I went to my gynecology clinic in town. I was lucky enough to live in an urban town. If you live in a much smaller place, you may for any gyno exams (especially for pregnancy tests) want to go to a different town. I went in and told the receptionist very quietly what I wanted. I handed my insurance card over and played the waiting game. I had a friend with me to help translate as my Japanese was okay, but hers was much better and I wanted NO misunderstandings. What they will have you do is pee in a cup. Then write your name on the cup and put it in the special little cubby thing they have for samples that is in the bathroom. Shortly after, they called me to the doctor where they go over the results. They test your urine for presence of the pregnancy hormone. I was positive. Just as I thought. Great now what? They then quickly ushered me to the fancy exam chair to get an inter-vaginal ultrasound to double check how far along you are. It is this little long and rounded plastic instrument that they cover in lube and stick up there. Then they quickly locate the growing embryo and try to determine how old it is. The hard part was they the nurses and the doctor were super happy for me and excited, which made me feel like shit. I walked in the clinic already knowing that if I was pregnant, I wanted to terminate. This was not making it easier. Be prepared for some backlash. I asked about termination rather abruptly. I think that is why it was so shocking to them. I did get some guilt tripping, and the doctor kept saying “Does your partner agree? Did you tell him? Does he support your decision?” The feminist in me was like MY BODY!! MY DESICON!!! Their ideas are very different than ours coming from a western society, which I’ll explain a little later. However, don’t just misconstrue some of those statements as purely a guilt trip. My doctor kept asking about if my partner supports me, my decision, not just because of the shared responsibility. He wanted to make sure that in my heart that I was supported in my turbulent time. So do try to think of some of it as that as well.
In Japan the idea of abortion is considered a necessary sadness. That the potential child may come back later and right now is not good, so it will have to wait for the next opportunity to be born. Also, you and your partner will need to sign a slip giving permission. It is considered a shared decision, so one cannot act alone. Lastly, there is NO medical abortion in Japan presently. Surgical abortion in Japan is used up to eight or nine weeks and can be done in the clinic. However from about 10 to 12 weeks you will have to be admitted to a regular hospital for the procedure. They can do local anesthetic, but it is strongly recommended and insisted upon that you go under general anesthetic.
I needed it get as soon as possible and only had one day that next week to do it. The longer you wait the harder it is. So three days later at 5 weeks I went in to get it done. It is a multi step process. First you will come in for a blood test, and they may do some other work to make sure you are healthy. They will also go over some details for the surgery. It sounds much scarier than it really is. You also receive your paper work that both you and your partner will have to sign. The document I had needed both mine and my partner’s hanko. DO NOT FORGET THIS! If you cannot get your partner to sign or do not know who, you can get a very good male friend to sign instead. They will also describe to you what they will do the day or two before the surgery. After the blood test (or even the same day) they will stick a small seaweed stick called laminaria into your cervix. It will slowly expand, dilating your cervix. Before you get this done, take three ibuprofen tablets about an hour or so before you go in. This will help with some of the pain. The pain will feel like mild period cramps, but your body may react differently. DON’T STRESS OUT. That will just make everything worse. It is super quick 1, 2, 3, and it’s done. The nurses and I were laughing at my “ow “face and gently petted my back as I walked out and sat in the waiting room. Then for a day or two you can go about your day with the stick up there. Just make sure to take it easy and watch for any signs that it may fall out. Keep an eye on the toilet incase it slips out. You may have to go get it done again if this is the case. It felt like a regular period pain by the time I had to have my surgery.
The day of, I went in just before the clinic opened. I went to the surgery room, where they kept it nice and warm for me. I had a female anesthesiologist there with two other helper nurses. I stripped everything off except my tank top, put a hospital gown on and went on the table. They had my lay down, stuck the IV in my hand, told me to relax (yeah relax haha no), and before I knew it I was out. The IV hurt going in but the medicine actually kind of stung. My hand and wrist hurt for two weeks afterwards so do be aware of this. Make sure they put the IV in the non-dominate hand/wrist. In my case it only took 5-10 minutes for the whole procedure, I had the weirdest dream and I woke up to the nurses taking care of me, talking to me, and being very kind. I was in a recovery room for about two or three hours. I was lucky to have the female CIR with me the entire surgery day. It will take some time for the drugs to wear off and it is nice to have someone there not just for moral support, but to also help take care of any needs you might have during the recovery time. The nurses even brought me a small sandwich and a bottle of water with a straw after they pulled out my IV. I was woozy but okay. After about three hours I got up and waddled out. I met my partner at a shop nearby and we walked home. You may not be able to do this however, so DO take care of yourself. For about three days after it may not hurt right away, nor bleed right away, but it certainly will to some extent those two or three days after. Take it easy. In my case I had to go to work the next day.
Reflection back, the thing I remember the most is how much better physically I felt and that mentally and emotionally the weight just lifted off my shoulders. The relief was immense and that surreal feeling of, “Did that just happen? What happened?” You may react differently. A PA is always there to help in anyway if you need it. That is what they are there for.
Something else you will notice that is different about abortions in Japan is that they really don’t offer much in the way of emotional support. I was lucky in that I had a great medical staff. But this is not the norm I’ve been told. That is why it is so important to confide in a PA if you need to for anything at all. Even if you felt confident about doing this procedure, the pregnancy hormones before your procedure and after (post partum) WILL most definitely affect your emotions. It sure made me cry a few times before and after, despite me not having any moral or emotional regarding my decision. Please have someone you can trust. It makes everything easier. Don’t let anyone else tell you how you should feel or make your feelings invalid not matter what they may be. Even if you feel guilty for not feeling guilty, or you feel all of the emotions at once. Your feelings are valid and your feelings are YOURS. No one has any right to police the way you feel or guilt you. No matter how hard or how “easy” the decision might be.
I’ve provided some information below about pregnancy termination. Most of it is either government or trusted organizations that help with health care. There is a lot of misinformation and cruel biased sites that mimic credible resources. Before researching, please make sure that your sources are government sponsored sites (like the CDC or NIH) or research reports by universities or as non-biased as possible. You can usually tell by the use of loaded words and connotations associated with those words. So do be mindful of what you click to save yourself some stress to an already stressful situation. I wish you all the best. I have been there and while I may not know exactly how you personally feel, I have been there. I understand and know that you are never alone.