Osaka, Japan—

A year after the historic approval of medical abortion pills, wider access to abortion in Japan remains largely elusive.

Last April, lawmakers approved the use of the two-step abortion pill MeFeego Pack up to nine weeks into pregnancy. Previously, women in the East Asian country could only receive abortions at private clinics with designated surgeons, often costing up to $370.

In addition to financial pressures, women are often required to provide proof of their spouse’s consent to an abortion, making it nearly impossible for them to make the decision on their own. Reports suggest that even for single women, doctors still seek permission from their male partners before agreeing to perform such surgeries.

Kumi Tsukahara, an independent researcher on reproductive health and rights, said that despite the approval of the abortion pill, only 3% of all clinics in Japan offering abortions offered abortions a year after the pill was approved, “and none of these clinics have maternal bodies.” Doctors designated under the Protection Act (MBPL),” Tsukahara told VOA News.

Under the MBPL, the controversial requirement to obtain spousal consent before doctors prescribe oral abortion pills remains in place – the same condition for obtaining a license for surgical abortion.

“Unfortunately, there are no signs of change on either front,” the expert said.

Compared with countries with better access to abortion, Japan’s approved abortion pills cannot be taken multiple times – sometimes requiring multiple attempts – and pregnant women still need to resort to surgical abortions, which poses serious risks to their health.

Since such procedures are only allowed in private clinics and deemed profitable by designated doctors, they often charge the same or higher prices for abortion pills as for surgical abortions. Neither measure is covered by Japan’s national health system.

“High prices and low affordability depend on individual doctors, inaccurate information provided by doctors, inability to use medications to guide people through routine surgeries, unjust situations and failure of the state to respond, and women are deprived of a sense of being empowered. They rights,” Tsukahara explained.

Those sentiments were echoed by abortion rights activist Kazuko Fukuda, who has launched a grassroots movement in Japan to promote women’s right to terminate pregnancies.

“Abortion rights [in Japan] There is no improvement,” Fukuda told VOA News. “Of course, this [approval of oral abortion] It’s better than nothing, but conservative politicians opposed the drug before it was approved. … Women must stay in a hospital with a bed until the abortion is completed, but designated private clinics often do not have beds. “

Japan bans women from taking abortion pills at home. They must take the medication in hospital and in front of a doctor because authorities fear they might resell it. If breached, the women could be jailed for up to a year.

Male-dominated political arena

Fukuda added that abortion remains a big political taboo and that real rights improvements would go a long way.

“It is still common for women to be arrested for giving birth alone and abandoned – we heard just a few days ago that… the government should decriminalize abortion. [Things don’t work] Because doctors are still afraid of being sued, they need the boyfriend’s signature to prescribe abortion pills. “

Last year, Japan began a study to make the morning-after pill available over the counter without a prescription. However, the study has limited availability in many cities. Girls under the age of 15 are not allowed to purchase drugs, and girls between 16 and 18 years old must be accompanied by their parents to purchase drugs.

Both experts interviewed by VOA said information and availability of these contraceptive pills did not appear to be high in online searches, a common method used by target groups to find contraceptives.

In a World Bank report in March this year, Japan ranked last among developed countries in terms of women’s rights.

Currently, the proportion of female members in Japan’s lower house of parliament is less than 10%, and the proportion of female members in the upper house is 27%. In local politics, only 15% of women are at the forefront. According to a report by the Organization for Economic Cooperation and Development (OECD), Japan’s gender wage gap reaches 40%.

Women’s issues such as abortion or contraception are often not considered priorities for female politicians.

“In male-dominated politics, a lot of women have to be more conservative and look stronger to be accepted, so it’s really hard for women to be liberal or supportive on this kind of thing [abortion and contraception in the parliament],” Fukuda said.

Women blamed for low fertility

The social stigma associated with abortion remains high as Japan blames women for low fertility rates. The country had a record low number of births last year.

‘Japanese government blames ‘lower numbers’ on [fertility rate] In the case of “barren women,” women feel social guilt for trying to choose not to have children. Of course, such question framing is itself highly biased and misogynistic,” said researcher Tsukahara.

Fukuda said government support for pronatalist policies was limited to women who did not want children.

“Anything against [wanting babies] Not supported at all.Many people think that “contraception” is taboo, and even take [morning after] Taking birth control pills can cause women to be judged for being promiscuous. It’s not easy for women to talk about. “