Pregnancy is a big event which can lead to many (sometimes conflicting) feelings, such as happiness, guilt, anger, anxiety, and others. If the pregnancy was unplanned, or if there are health concerns or problems with the pregnancy, making a decision about the future can be very difficult. It’s important to understand all the options that are available to you, and to know what’s involved with each choice on an emotional and physical level.
There are no simple or easy answers, and you might be worried that people may judge you. You may feel vulnerable, or under pressure to make a certain choice. It’s important to have someone who will support and accept you, listen to you and reassure you that you have time to come to the decision that is right for you. You may want to discuss your options with your partner, a friend, a family member, someone else you trust, or a counselor. The TELL Lifeline (03 – 5774 – 0992) is here to listen and give you resources, and to support you non-judgmentally, no matter what option you decide is right for you.
What are your pregnancy options?
Abortion: Have an abortion (termination of pregnancy).
Adoption: Carry the pregnancy to term and place the baby for adoption.
Fostering: Carry to term and seek foster placement for the baby until you can assume responsibility.
Parenting: Carry to term and parent.
Home pregnancy tests (ninshin kensa youhin in Japanese) are available at Japanese pharmacies. They come with easy-to-understand picture instructions, so you don’t need to read Japanese to use one. The cost for a pregnancy test starts at around ¥800.
Ending a pregnancy in Japan
If your pregnancy is unplanned, or if there are health concerns about the pregnancy, you may have a lot of questions, or you may feel scared or uncertain. Women often have different needs and questions about ending a pregnancy, depending upon their stage of pregnancy, possible health concerns, and their personal feelings and values. If you are considering an abortion, it may help you to have answers to some of the following questions:
- What is an abortion?
- How are abortions performed?
- What costs are involved?
- What are the possible risks of having an abortion?
Elective abortion is usually a simple procedure in which a doctor or other medical provider ends a pregnancy through a medical intervention. The exact procedure and the cost involved will vary depending on the number of weeks of pregnancy (how far along the pregnancy is), making it important to know how many weeks pregnant you are. In the early stages of pregnancy (approximately 7 to 10 weeks), the cervix will be opened slightly, allowing a small syringe to be inserted in the uterus and the pregnancy to be removed. The procedure is usually done under a light anesthesia, so there is minimal discomfort. After 12 weeks of pregnancy, hospital admission is required and facilities will vary in up to how many weeks they can accommodate. The “abortion pill” (misoprostol) is not available in Japan.
Abortions in Japan are available according to the conditions of the Maternal Protection Law, and up to 21 weeks and 6 days of pregnancy (in other words, within 21 weeks and 6 days after the start of the last menstrual period). After 22 weeks, abortions cannot be conducted in Japan unless it is medically necessary. Abortions must be carried out by a medical practitioner and mostly in small local hospitals or clinics; there are no specialized abortion clinics in Japan.
Three visits to the hospital are typically required: the first, for the general consultation and medical examination; the second, for the procedure itself; and the third, for a follow-up check up. A consent form is required before the procedure, which asks for the husband’s or partner’s signature, but you can sign for yourself if the partner is unknown. If you are under the age of 18 years old, a parent’s or guardian’s signature is required.
As not all doctors in Japan speak English, you may wish to arrange for an interpreter during your visits. The procedure is not covered by Japanese Health Insurance, and the costs vary by clinic/hospital. The average cost is around 100,000 yen to 200,000 yen up to 10 to 12 weeks, and you will often be required to pay cash.
Generally, first trimester abortions are extremely safe and have a very low risk of complications. Most women return to their usual activities within the few days following the procedure. The earlier in a pregnancy a woman has an abortion, the safer and less expensive it will be.
As with any big event or difficult decision, it can be a big help to have some support, for example from friends or family. The TELL Lifeline also offers callers the chance to talk about their options and feelings in a non-judgmental way.
The following links can give you more information and resources:
- Information about getting an abortion in Japan:
- AMDA provides medical information and can recommend medical services and clinics by telephone in Japanese, and 7 other languages. For more information about language availability, see the AMDA website: AMDA
- Himawari can help you find a clinic, pharmacy and medical interpretation in Japan: Himawari
Rh factor and termination of pregnancy
There are four blood types: A, B, O and AB. Within these four groups, each person is either positive or negative for the “Rh factor,” a protein found on the red blood cells. As blood types are genetic and inherited from parents, the prevalence of different blood types varies from country to country. In Japan, studies indicate that fewer than 1% of people are Rh-negative, while in Europe, Australia and the US, often 10-15% of people are Rh-negative.
The Rh factor is only a concern when a pregnant woman is Rh-negative, and her developing fetus has inherited a positive Rh factor from the father. In this case, the woman’s immune system will become sensitized during the pregnancy, and if she later becomes pregnant again, her immune system will make antibodies against the Rh factor. These antibodies will attack the baby’s red blood cells, causing a host of problems. Even if a pregnancy only lasts a short time, the woman’s immune system can become sensitized, putting possible future pregnancies at risk. Fortunately, treatment of these antibodies is available to prevent problems in the future if you are Rh-negative.
How can problems be prevented?
A simple blood test can tell you if you are Rh-negative and therefore if you should have antibody treatment. Because the chance of Rh-related problems is very low in Japan, doctors in Japan may not always think to check your Rh factor. If your doctor doesn’t mention it, be sure to ask your doctor about it.
If you are Rh-negative, an injection of Rh immunoglobulin (RhIg, known as “Rhogam”) can prevent sensitization. This treatment must be given before an abortion or within 72 hours following the procedure. You can also request an antibody screen (a kind of blood test) to see if you have developed antibodies to the Rh factor.
More information about the Rh factor:
Adoption & fostering
Some women who feel that they cannot become parents at this point choose to carry their pregnancy to term and then have the baby fostered or adopted. While Japan is still behind other countries like Australia the United States, and South Korea in finding foster homes for children, the Japanese government developed foster care placement guidelines in 2011, and has been strengthening the foster care system so that more children can grow up in a family environment. The Child Welfare Act was also revised in June 2016, to promote raising more children in home environments through special adoption and foster care. Among other things, the law now requires that municipalities establish “Comprehensive Support Centers for Families with Children that provide seamless support from pregnancy to the child-rearing period.” The Happy Yurikago Project is a good starting point for finding out more about these services in Japan.
- Happy Yurikago Project
- International Social Service in Japan (website in English and Japanese; staff also speak Tagalog and Thai)
- Christian adoption organization with information in English and Japanese
- 全国児童養護施設一覧 (website in Japanese only)
- Motherly Network (website in Japanese only)
- Baby Pocket (website in Japanese only)
If you decide to continue your pregnancy and become a parent, you may have a lot of questions about what to expect. Some aspects of pregnancy and having a child (such as pain management during delivery or infant immunization schedules) may be managed differently in Japan than in your home country, so it’s important to find out what resources and options are available, and to find care that works for you. You may feel a variety of emotions about the future and here, too, it’s important to have support from a partner, friends, family, others you trust, or a counselor. The following links may help you find some useful information.
- Information on what to expect during prenatal visits and after birth for foreigners in Japan: Having a baby in Japan
- Information on pregnancy and childbirth in Japan in English: Japan Healthcare Info
- Information about giving birth in Japan: Japan Today
- Parenting groups in Japan: Best Living Japan
Whatever decision you make about your pregnancy, a wide range of emotions is possible. Please be reassured that your feelings are normal. As with any big decision or life event, it is important to be able to talk to someone you trust about your thoughts and feelings. Talking openly with a supportive partner, friend, or family member can help. TELL Lifeline (03 – 5774 – 0992) is also here to listen and support you every day from 9 AM until 11 PM. TELL