Abortion in Japan – What you need to know
By Su KakizakiSeptember 23, 2015
Abortion is certainly a sensitive topic and sometimes a difficult one to discuss with friends and family. At the request of members seeking more information on this subject, we have put together the following article on abortion in Japan.
Abortion in Japan is legal and performed for patients with economic and social reasons, victims of sexual crime, or health reasons to terminate. Qualified OB/GYN practitioners in clinics and hospitals around the country perform the procedures. Japanese Health Insurance will not cover procedures related to abortions.
There are two types of abortion recognized in Japan – spontaneous and induced. Spontaneous abortion is defined as when the fetus expires in utero, and induced abortion is when an invasive event or technique terminates the pregnancy. Abortion is classified as a miscarriage if the fetus is under 22 weeks old. If the fetus is over 22 weeks old, it is classified as a stillbirth (exception for induced second trimester abortion see below) *.
An induced abortion in Japan is that which most frequently involves a choice between the mother and her caregiver. There are many reasons why a woman will decide to terminate a pregnancy. The choice can be a difficult one and in such cases it is recommended to discuss this with your trusted partner, friend, family member or doctor. As a general rule, a letter of consent must be signed by the individual and the father of the unborn child to authorize an abortion. If the partner cannot be located due to specific reasons such as missing or death, or if the pregnancy is the result of a sexual crime, the individual may proceed without the additional signature.
Abortions in Japan are primarily performed at designated OB/GYN clinics or hospitals. While you can find English-speaking facilities, most of the clinics or hospitals will not have English-speaking staff. In this case, if it all possible please find a bilingual friend or relative or a professional Japanese interpreter to go with you.
Pregnancy in Japan is divided into trimesters of 1st (16 weeks), 2nd (12 weeks), 3rd (12 weeks) with four weeks per month. Unlike in the west, the pregnancy period in Japan is counted as 10 months instead of 9 months. Each month is considered to be 28 days. Average total days of pregnancy is 280 days (40 weeks), hence 10 months.
First Trimester: 16 weeks (0-15 weeks) = 1-4 months
Second Trimester: 12 weeks (16-28 weeks) = 5-7 month
Third Trimester: 12 weeks (28-40 weeks) = 8-10 months
The Maternal Protection Act in Japan allows abortion for patients if the fetus is 21 weeks & 6 days or younger. If a fetus is 22 weeks or older, due to higher risks to the mother during surgery and ethical issues, abortion is not an option and must be carried to term. The procedure should be performed by doctors certified by this law at a designated facility.
If one chooses to have an abortion in Japan it is recommended to undergo the procedure during the early first trimester (up to 11 weeks & 6 days) as there are fewer risks to the mother. It is considered an outpatient procedure and there is usually very little need for extended medical care or hospital admission beyond the initial surgical procedure. Cost will vary depending on the weeks of pregnancy, size of the fetus, the doctor and the medical facility performing the operation, but a good ballpark figure for a first-trimester abortion is between ¥100,000-¥200,000.
An abortion taking place during the second trimester (12 weeks to 21 weeks & 6 days), however, will require hospital admission for a few days. It is usually more difficult to find a hospital willing to perform the procedure.
For a second trimester abortion in Japan, the hospital is required to provide a death certificate to the ward hall (classified as stillbirth) and go through the process of retrieving burial approval, cremation, and optional placement at a cemetery. Therefore facilities that may perform a first trimester abortion in Japan may not conduct second trimester abortions.
As the weeks pass and the fetus grows, the scale of the surgery will become more complicated and expensive, along with higher risks for the mother undergoing the procedure. Abortion fees when a fetus has reached weeks 12-14 will generally be about ¥300,000 – ¥350,000. For a procedure after week 15 and beyond costs rise to about ¥450,000 – ¥500,000. Please consider that additional hospital admission fees may also be charged.
Third trimester abortions (22 weeks and above) are rarely ever performed as they are limited to extreme cases where serious problems arise that threaten the life of the mother and must be aborted.
Abortion Pills, made to mimic labor to induce miscarriage or stillbirth, are not legal in Japan. Those available through online purchases are not approved and therefore not safe for use. Should one purchase these pills, all responsibilities will fall on the individual.
* Note: This article is for general informational purposes only and is not intended to provide professional advice. Please consult with a medical professional for the latest information and for all medical-related questions and information.
Critical Knowledge Points:
Abortion: 妊娠中絶 (nin-shin-chuu-zetsu)
Induced Abortion: 人工妊娠中絶 (jin-kou-nin-shin-chuu-zetsu)
Spontaneous Abortion: 自然妊娠中絶 (shi-zen-nin-shin-chuu-zetsu)
Emergency Contraceptives: 緊急避妊薬 (kin-kyu-hinin-yaku)
First Trimester (Abortion): 妊娠初期（中絶）(nin-shin-sho-ki) (chuu-zetsu)
Second Trimester (Abortion): 妊娠中期（中絶）(nin-shin-chuu-ki) (chuu-zetsu)
Third Trimester (Abortion): 妊娠後期（中絶）(nin-shin-kou-ki) (chuu-zetsu)
Maternal Protection Act: 母体保護法 (bo-tai-hogo-hou)
Also see our article on birth control pills in Japan and Emergency Contraception (Morning After Pill) in Japan for additional useful information.