Women in Japan could be forced to seek their partner’s consent before being prescribed the morning-after pill, which will reportedly be approved late this year – almost four decades after it was made available to women in the UK.
Under Japan’s 1948 Maternal Protection Law, consent is already required for surgical abortions – with very few exceptions – a policy that campaigners say tramples over women’s reproductive rights.
“In principle we believe that spousal consent is necessary, even if an abortion is induced by an oral medication,” Yasuhiro Hashimoto, a senior health ministry official, told a parliamentary committee earlier this month, according to Bloomberg.
Campaigners are calling on health authorities to ditch the rule requiring women to gain written consent from their partners before a doctor can prescribe a course of abortion drugs.
Kumi Tsukahara, an abortion rights advocate, said: “‘Spousal consent’ becomes an issue is when there is a disagreement with the spouse or the spouse is forcing the woman to give birth against her will.
“For women, being forced into a pregnancy they do not want is violence and a form of torture.”
The policy can have tragic consequences. Last year, a 21-year-old woman was arrested after the body of her newborn baby was found in a park in central Japan. The woman, who was given a suspended prison sentence, told the court she was unable to end her pregnancy because she could not gain written consent from her partner.
Doctors had insisted that she obtain consent, even though the health ministry later said hers was one of the few cases in which it was not required because the father could not be contacted.
Japanese media have also reported cases in which doctors refused to approve an abortion for women who had been sexually assaulted, forcing health ministry officials to write to the Japan Medical Association to clarify that consent is not required in rape cases.
Campaigners say Japan’s failure to approve a drug that has long been available in more than 70 other countries reflects the low priority the country’s male-dominated parliament and medical community give to women’s health.
Japan took nine years to approve oral contraceptives, in 1999, but only six months to approve the erectile dysfunction drug Viagra.
In December last year, the British pharmaceutical firm Linepharma International applied for approval of a combination of two drugs for the morning-after pill, the Yomiuri Shimbun reported, adding that approval was expected within a year of the application.
Japan, where 145,000 surgical abortions were carried out in 2020, is one of only 11 countries that require third-party consent for abortions, despite calls to end the practice by the World Health Organization and the UN Committee on the Elimination of Discrimination against Women.
“Spousal consent is unnecessary for abortion, and should be removed from the Maternal Protection Law,” said Chiaki Shirai, a professor in the faculty of humanities and social sciences at Shizuoka University.
Campaigners for safe abortion have warned that the abortion pill, which will not be covered by national health insurance, will be prohibitively expensive for many women.
Japanese media reports say the cost of a single dose could be around ¥100,000 ($780) – around the same as a surgical abortion, and that women who take it must do so under strict medical supervision, possibly including hospitalisation.
“The reality is that for some women, abortion is not possible for financial reasons,” Shirai said. “Contraception, abortion, pregnancy, and childbirth should all be publicly funded.”
Mizuho Fukushima, an MP with the opposition Social Democratic party, has warned that the high cost of surgical abortions and the consent requirement are forcing women to go through with unwanted pregnancies.
“Women are not the property of men,” Fukushima said in parliament this month. “Their rights, not those of the man, should be protected. Why should a woman need her partner’s approval? It’s her body.”