Family Choice, New Prenatal Diagnosis and Abortion
About 168,000 pregnant women had abortions in Japan in 2016. Half of these abortions were performed for economic or other reasons.
The breakdown is as follows: 63% of all respondents are between 20 and 34 years old, about 9% are under 20 years old, and about 23% are 35 years old or older.
Surprisingly common abortion
About 168,000 pregnant women had abortions in Japan in 2016. Half of these abortions were performed for economic or other reasons. Of these, 63% were between the ages of 20 and 34, 9% were under 20, and 23% were 35 or older.
Only licensed obstetricians and gynecologists can perform abortions, and the Eugenic Protection Act of 1948 legalized abortion only for unwanted pregnancies and for economic reasons, but not for abortions performed after 22 weeks of pregnancy, since the fetus can survive outside the mother. However, the fetus can survive outside the mother's body beyond 22 weeks of gestation and is therefore not legally allowed to be aborted.
The former Eugenic Protection Law allowed for reasons for abortion, such as hereditary diseases of the parents or the child, but this was removed by the Maternal Protection Law, which came into effect in 1996. abortion is not allowed for fetal abnormalities, even before 21 weeks.
However, many pregnant women think that if they have an amniotic fluid test and it reveals a disorder such as Down syndrome, they can have an abortion if it is before 21 weeks. A new type of prenatal diagnosis began in Japan in 2013, and the test is now available. This test is gaining more recognition each year, and the number of patients undergoing testing is increasing.
Let us consider the case of about 1 million births reported annually, of which 1% have abnormalities on NIPT. If all those who test positive have abortions, the number of abortions will be 10,000. Currently, 170,000 people have abortions due to unwanted pregnancies or for financial reasons. The Japanese Society of Obstetrics and Gynecology (JSGYN) has left out the 170,000 abortions, and it is obstetricians who are actually performing the abortions. Am I the only one who feels that it is irrational to oppose abortion for NIPT-positive patients just because there are more abortions?
About 95% of couples whose fetus is found to have a disease by the new prenatal diagnosis (maternal blood-fetal chromosome test or NIPT: non-invasive prenatal genetic test) choose to have an abortion, which has been widely criticized as "easy abortion" and "selection of life. Since the birth of a handicapped child increases the economic and emotional burden, abortion is legal and officially performed if either economic or physical reasons apply.
Couples who have easy abortions do not exist anywhere. They are making a choice after much worry and anguish. The grief and suffering of pregnant women in particular is immeasurable, and they feel no differently than a stillborn fetus that has been born due to illness. It also takes determination to conceive another child. I don't believe that we are "doing easy abortions" or "selecting life.
If it becomes a common belief that abortion is the only way to save a sick baby, it will hurt not only the people with disabilities who are alive today, but also their families. The reason is that people with disabilities themselves feel as if their own lives are being denied, as if they themselves should not have been born.
On the other hand, if a woman is found to have an 18-trisomy early in pregnancy, she often only survives in the abdomen and may be told to avoid a C-section in order to give priority to the mother. Some consider this to be the same as an abortion. There are many children who are staying in the hospital or at home. They may feel as if they are being denied life.
The Future of Prenatal Diagnosis
Prenatal diagnosis technology has advanced greatly, and the next generation of prenatal diagnosis has begun in Europe and the United States. As the new prenatal diagnosis is becoming less and less new in other countries, there is no reason for Japan to prevent the spread of this new type of prenatal diagnosis.
Couples who undergo the new prenatal diagnosis want their child to be born without any disease. They look forward to the time between births, imagining the postnatal period of the child in their stomachs.
This is the hope of every parent, whether they are ill or not. In taking the new prenatal diagnosis test, we would like couples to fully discuss what to do if a disease is found.
If a couple chooses to have a baby, they should discuss with each other how they can create a happy life for the newborn and their family during the preparation period leading up to the birth, and how they can create an environment before and after the birth that will make the newborn happy.