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Abortion in Japan: Law, Spousal Consent, and Access
Abortion in Japan (人工妊娠中絶, jinkō ninshin chūzetsu) is lawful under the Maternal Health Act when a designated physician performs it on one of two statutory grounds, with the required consent, normally before 22 completed weeks of pregnancy (as of 2026-10; confirm current figures with the Ministry of Health, Labour and Welfare).12 Abortion for economic reasons is not covered by public health insurance, and a married patient generally needs the spouse's consent, subject to defined exceptions.13
Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (MHLW) site. This article is general information, not medical advice; for your specific case, consult a licensed physician designated under the Maternal Health Act (母体保護法指定医, botai hogo-hō shitei-i).
Overview
The rules apply to anyone in Japan seeking an induced abortion, of any nationality and any status of residence. The governing texts are national: the Penal Code, the Maternal Health Act (母体保護法, Botai Hogo-hō), and national administrative notices, and none of them contains a nationality or residence-status condition.124
The legal structure has two layers. The Penal Code still contains the crime of abortion, and the Maternal Health Act is what makes lawful abortion possible.5 Under that Act, induced abortion is lawful only when a designated physician performs it, on one of the two Article 14 grounds, with the required consent.1
Three constraints shape every decision:
- Time. The administrative standard for the period in which abortion is possible is "通常妊娠満22週未満," normally before 22 completed weeks of pregnancy (as of 2026-10; confirm current figures with the Ministry of Health, Labour and Welfare).2
- Consent. The patient's own consent is always required, and the spouse's consent is required too, except in cases set out in the statute and in MHLW interpretations.16
- Cost. Induced abortion for economic reasons is not covered by public health insurance, so the patient pays the full fee.37
Most procedures in Japan are surgical. A national survey covering 36,007 abortions from May to October 2023 at 2,096 responding facilities found aspiration alone in 62.5% of cases, curettage alone in 13.8%, the two combined in 22.4%, and the oral medication Mefeego Pack in 1.2% (as of 2024-05).8
The legal framework
The Penal Code prohibition and the Maternal Health Act exception
Chapter XXIX of the Penal Code, Articles 212 to 216, sets out the 堕胎罪 (dataizai, "crime of abortion").4 The articles cover:
- a pregnant woman who causes her own abortion by drugs or other means (Article 212);
- a person who causes an abortion with the woman's consent (Article 213);
- a person who causes an abortion while acting in a professional capacity (Article 214);
- abortion without the woman's consent, and abortion resulting in death or injury (Articles 215 and 216).
These provisions remain in force. In the words of a Waseda University Institute of Comparative Law report, "Although the crime of abortion continues to exist in the penal code, the Eugenic Protection Act was enacted in 1948, opening the way for legal abortion."5
The 優生保護法 (Yūsei Hogo-hō, "Eugenic Protection Act") carried that name from 1948 to 1996. In 1996 its eugenic provisions were removed and it was renamed the Maternal Health Act.5 The amending law was 平成8年法律第105号, and the Act keeps its original number, Act No. 156 of 1948.12
Article 14 of the Maternal Health Act is the provision that authorizes a designated physician to perform an induced abortion.1 The Act defines induced abortion as artificially discharging the fetus and its appendages from the mother's body in a period when the fetus cannot survive outside it.1
Lawful grounds under Article 14
Under Article 14(1), a designated physician may perform an induced abortion, with the required consent, on a person who falls under either of two items:16
- Continuing the pregnancy or giving birth is likely to significantly harm the mother's health for physical or economic reasons (身体的又は経済的理由により母体の健康を著しく害するおそれのあるもの).
- The pregnancy resulted from sexual intercourse by violence or intimidation, or while the person was unable to resist or refuse (暴行若しくは脅迫によつて又は抵抗若しくは拒絶することができない間に姦淫されて妊娠したもの).
MHLW's administrative notice interprets "economic reasons" as a case where continuing the pregnancy or giving birth would cause serious economic hardship to the household and, as a result, the mother's health is likely to be significantly harmed (as of 2026-10; confirm current figures with the Ministry of Health, Labour and Welfare).2 The notice adds that a person currently receiving public assistance (生活保護, seikatsu hogo, including medical assistance only), or who would come to need it because of the pregnancy or delivery, "normally" falls under this ground (as of 2026-10).2
For the second item, the same notice states that "violence or intimidation" is not limited to tangible physical violence (as of 2026-10).2 The item broadly matches the Penal Code's forcible sexual intercourse offenses, but the perpetrator does not need to have been convicted; the notice gives the example of a perpetrator who is not punished for lack of criminal capacity. Physicians are asked not to apply the item lightly to cases outside its scope.2
The 22-week limit
The statute itself names no week number. Article 2(2) defines induced abortion by reference to "a period when the unborn child cannot survive outside the mother's body."1
The week number comes from MHLW's notice on implementing the Act. It sets the standard for that period as 満22週未満 (man nijūni-shū miman), "normally before 22 completed weeks of pregnancy," which is up to 21 weeks and 6 days (as of 2026-10).2 The notice also says the number of gestational weeks is determined objectively, based on the designated physician's medical judgment.2
The line has been in place for decades. A Ministry of Health and Welfare administrative notice of 1990-03-20 set the period at up to 22 weeks.5
Designated physicians
Only a physician designated by the prefecture's medical association may perform an Article 14 abortion.1 The designation is called 母体保護法指定医師 (botai hogo-hō shitei ishi), commonly shortened to 指定医 (shitei-i).12
A physician without the designation may not perform an induced abortion under the Act, except as an emergency measure (緊急避難, kinkyū hinan) when the mother's life is in danger, such as sudden uterine bleeding or eclampsia (as of 2026-10).2 When you contact a clinic, ask whether its physician is a 母体保護法指定医.
Designations are not permanent. An MHLW notice of 2026-08-31 asks facilities to confirm the designated physician's validity period before ordering Mefeego, and asks prefectural medical associations to keep managing those periods (as of 2026-08-31).9
Designated physicians must report each month's sterilizations and abortions, with the reasons, to the prefectural governor by the 10th of the following month.1
Consent rules
Your own consent
Article 14(1) requires the consent of the person herself (本人, honnin) in every case.1 Clinics collect it on their own form, the 同意書 (dōisho, "consent form"), which many title 手術同意書 (shujutsu dōisho, "surgery consent form").10
Clinic forms differ in what they ask for. Hakusan Ladies Clinic in Bunkyō, Tokyo, requires the 手術同意書 to be handed in at reception and will not perform the procedure without it (as of 2026-07-24).10 An OB-GYN clinic in Gifu, misao-ladies.jp, states that "in principle" it requires the signature and seal (署名・捺印, shomei natsuin) of the patient and her legal husband (the page carries no date; retrieved 2026-10).11
For medication abortion, the Mefeego Pack patient guide says treatment begins only after the patient has received an explanation of the risks, efficacy, and required follow-up, and has agreed (as of 2026-08).12
Spousal consent for married patients
Article 14(1) requires the consent of "the relevant person and the spouse."1 The statute contains no nationality condition, so a foreign spouse is a spouse under the same rule.1
Article 3(1) of the Maternal Health Act defines 配偶者 (haigūsha, "spouse") to include a person who, without a registered marriage, is in a relationship like a marital relationship, and states that the same applies throughout the Act. A de facto partner (事実婚, jijitsukon, or 内縁, naien) is therefore a spouse for consent purposes.1
Clinic guidance is consistent with this definition. Hakusan Ladies Clinic lists "not married, and no de facto marriage either" as a case where the patient's consent alone is enough (as of 2026-07-24).10 The sources cited here do not describe how clinics verify whether a de facto relationship exists, so ask the clinic how it handles the question.
A spouse who lives far away or abroad is not automatically excused. MHLW's notice says "cannot express an intention" covers cases where the spouse is in fact unable to do so, but not cases where, as with a spouse working in a distant place, the spouse's whereabouts are known and the spouse can express an intention by some means (as of 2026-10).2 A reachable spouse overseas therefore still needs to consent; how a given clinic collects that consent is something to confirm with the clinic.
When spousal consent is not required
Article 14(2) lists three situations in which the patient's consent alone is enough: the spouse is not known, the spouse cannot express an intention, or the spouse "no longer exists after the pregnancy" (妊娠後に配偶者がなくなつたとき).1 MHLW interprets "not known" to cover both cases where the spouse's whereabouts are legally established as unknown, such as a spouse treated as an absentee under the Civil Code, and cases where they are unknown in fact (as of 2026-10).2
Two later MHLW interpretations, listed by the Children and Families Agency, address situations the statute's wording left unclear:6
| Date | Notice number | Interpretation |
|---|---|---|
| 2020-08-28 | 子母発0828第2号 | Article 14(1) item 2 (pregnancy from sexual violence) does not mean the consent of the perpetrator is required. |
| 2021-03-10 | 子母発0310第1号 | Where the pregnant woman is suffering domestic violence from her husband, or the marriage has otherwise effectively broken down, and obtaining the spouse's consent is difficult, the patient's consent alone is enough. |
The 2020 interpretation answered a formal inquiry from the Japan Medical Association dated 2020-08-24 (日医受第1700号), which asked whether item 2 could be read as not requiring the perpetrator's consent.13 Reporting at the time described medical institutions asking for the perpetrator's consent in pregnancies from sexual violence, which the law does not require; the notice revision of 2020-10-20 was the first in 24 years.14 A lawyer quoted in that reporting warned that secondary victimization would likely continue without an explicit prohibition.14
The flowchart below summarizes whose consent the statute and these interpretations require, drawing on Article 3(1), Article 14, and the MHLW interpretations.126 The 2020 interpretation states only that item 2 does not mean the perpetrator's consent is required; it does not address the consent of a spouse who is not the perpetrator.6
Unmarried patients with no spouse, including no de facto spouse, need only their own consent under Article 14.1 Clinic statements match: misao-ladies.jp says a boyfriend's or partner's consent form is "not legally required" when the patient has no legal spouse (retrieved 2026-10).11 Hakusan Ladies Clinic's own guidance lists patient-only consent for unmarried patients, for marriages effectively broken down by domestic violence, and for pregnancies from sexual violence, stating that "the perpetrator's consent is not necessary" (as of 2026-07-24).10
If domestic violence is part of the situation, see Domestic Violence Help in Japan: Shelters, Protection Orders, and Visa Status alongside the support lines listed under Support and counseling below.
Minors
Article 14 names only two consenting parties, the person herself and the spouse. It contains no parental or guardian consent requirement.1
Practice is a separate matter. Hakusan Ladies Clinic states that the law has no provision requiring a guardian's consent for minors, but that "to protect physical safety and ensure post-operative care, handling of minors differs by medical institution," and that a minor can first consult on her own (as of 2026-07-24).10 This is one clinic's published guidance, not a professional-body or MHLW position.
Methods
The method available depends on how far the pregnancy has progressed. The chart below maps the stages using the Mefeego Pack indication, the national survey's gestational bands, the 12-week (85-day) stillbirth-notification point, and the 22-week standard.212815
Medication abortion (Mefeego Pack)
メフィーゴパック (Mefīgo Pakku, "Mefeego Pack") combines a mifepristone 200 mg tablet with misoprostol 200 µg buccal tablets. It was approved on 2023-04-28.9
Its indication is induced abortion in a person with a confirmed intrauterine pregnancy of 63 days (9 weeks 0 days) or less (as of 2026-08; confirm current figures with the Ministry of Health, Labour and Welfare).12 Gestational days are confirmed by transvaginal ultrasound, and ectopic pregnancy is excluded (as of 2026-08).12
If the day of the first (mifepristone) dose is past 63 days, the drug cannot be given, even if the consultation took place earlier (as of 2026-08).12 Waiting for an appointment can use up the window.
Only designated physicians may use the drug, and only at registered medical institutions; it is distributed from the manufacturer to wholesalers to registered institutions only (as of 2026-08).1612 The August 2026 patient guide states that it is used at facilities with beds that can admit patients, meaning hospitals or 有床診療所 (yūshō shinryōjo, "clinics with inpatient beds") (as of 2026-08).12 Neither the patient guide nor the MHLW page mentions an expansion to 無床診療所 (mushō shinryōjo, "clinics without beds").1612
That expansion has been discussed but not adopted. In September 2024 the Pharmaceutical Affairs Council considered allowing use at clinics without beds; after objections from the Japan Medical Association and obstetric professional bodies the proposal was sent back, and in April 2025 the president of the Japan Association of Obstetricians and Gynecologists (JAOG) said nationwide outpatient use was "1 to 2 years" away (as of 2025-04-28).17
The most recent national notice, dated 2026-08-31, asks prefectures to promote JAOG-led training material on proper use, the manufacturer's digital tracking system (流通等管理システム), designation validity checks, and emergency-referral arrangements with a standard referral form (as of 2026-08-31).9 It does not change the facility condition.9
How the two doses work
The patient takes one mifepristone tablet at the facility, then returns 36 to 48 hours later (as of 2026-08).12 At the second visit the physician decides whether misoprostol is needed; if so, four tablets are held inside the cheeks for 30 minutes. Both doses require an in-person visit.12
After misoprostol, the rules on where to wait come from an MHLW notice of 2023-04-28, last amended 2024-11-29 (as of 2026-08):1612
- If your home is not near the facility, you must be admitted or wait at the facility until the gestational sac is expelled.
- Going home is allowed only if you wish to and your home is both within a 16 km radius of the facility and within the facility's secondary medical area or perinatal medical area.
- If you go home, you return about one week after misoprostol to confirm expulsion, and immediately if bleeding suggests expulsion.
Risks and who cannot use it
The patient guide names heavy uterine bleeding, including bleeding with fainting, and infections such as endometritis as risks; it also notes that deaths from sepsis and toxic shock syndrome have been reported overseas (as of 2026-08).12
The drug is not for people using anticoagulants or antiplatelet drugs, people with bleeding disorders, porphyria, or severe liver impairment, or people on certain CYP3A-inducing drugs, among others (as of 2026-08).12 An IUD or IUS must be removed first, and Rh(D)-negative patients may receive prophylaxis.12
How widely it is offered
Availability is limited. In the national survey of May to October 2023, 2.6% of responding facilities used Mefeego, which accounted for 435 cases, or 1.2% of all abortions and 1.5% of cases up to 9 weeks 0 days; no serious complications were reported among those cases (as of 2024-05).8
Later figures come from secondary reporting. A 2025 legal-news report cites 12 serious cases among about 6,800 packs distributed from 2023 to March 2025 (as of 2025-04-28); the underlying safety report is not cited here.17
Early surgical abortion (before 12 weeks)
Surgical abortion in Japan uses 掻爬法 (sōha-hō, "curettage"), 吸引法 (kyūin-hō, "aspiration"), or both combined.8
Practice has shifted toward aspiration. Compared with a 2012 survey (curettage 33%, aspiration 20%, combined 47%), curettage fell by 19 points and aspiration more than tripled by 2023, when aspiration alone accounted for 62.5% of cases (as of 2024-05).8 The overall serious-complication rate was 0.317% in 2023, against 0.355% in 2012 (as of 2024-05).8
Timing within the first trimester matters. The serious-complication rate was 0.250% up to 9 weeks 0 days and 0.561% from 9 weeks 1 day (as of 2024-05).8
Clinic descriptions show what the day involves. misao-ladies.jp performs MVA (手動真空吸引法, shudō shinkū kyūin-hō, "manual vacuum aspiration") under IV anesthesia while the patient is asleep, as a day procedure with no admission (undated page, retrieved 2026-10).11 Hakusan Ladies Clinic asks patients to fast from midnight because of IV anesthesia and performs a separate cervical-preparation step before surgery (as of 2026-07-24).10
Mid-term abortion (12 weeks to before 22 weeks)
中期中絶 (chūki chūzetsu, "mid-term abortion") covers 12 weeks to before 22 weeks. According to the National Center for Child Health and Development, induced abortion in this period ends in vaginal delivery, which places a mental and physical burden on the pregnant person.18
The drug used is gemeprost vaginal suppository (プレグランディン腟坐剤, Puregurandin chitsu zazai), indicated for "therapeutic abortion in mid-pregnancy" (as of 2019-12).19 It is restricted to designated physicians in an inpatient setting prepared for emergencies, and its listed risks include uterine rupture and cervical laceration.19
Hospitalization is measured in nights, not hours. misao-ladies.jp describes it as starting "from 1 night 2 days" because it is a delivery method, and offers epidural anesthesia as an option (undated page, retrieved 2026-10).11 The National Center for Child Health and Development provides epidural pain relief (無痛分娩, mutsū bunben) for these cases on request and notes that there is no set anesthetic method for them.18
Process
The sequence below shows the general path from a positive test to follow-up, with the extra administrative step that applies from 12 weeks.1101215
Confirming pregnancy and gestational age
The first step is an OB-GYN (産婦人科, sanfujinka) visit, where the physician confirms the pregnancy and how far it has progressed. For Mefeego, transvaginal ultrasound confirms the number of gestational days and that the pregnancy is inside the uterus (as of 2026-08; confirm current figures with the Pharmaceuticals and Medical Devices Agency).12
A pregnancy notification (妊娠届, ninshin todoke) at the ward office is not a prerequisite for an abortion. Children and Families Agency guidance addresses people who "had a miscarriage or induced abortion without filing a pregnancy notification" (as of 2025-04).20 The registration path for continuing a pregnancy is covered in Confirming Pregnancy and Registering at the Ward Office.
A physician's confirmation of fetal heartbeat matters for one benefit: it triggers eligibility for the 妊婦のための支援給付 payment described under Costs and insurance (as of 2025-04).20
Finding a clinic and booking
Only a facility with a designated physician can perform the procedure.1 Ask the clinic directly whether its physician holds the 母体保護法指定医 designation.
Not every facility offers every method. Hakusan Ladies Clinic does not offer Mefeego and refers patients on request, and misao-ladies.jp says it is "carefully considering" introducing it (as of 2026-07-24, and retrieved 2026-10 from an undated page, respectively).1011
Two tools help with language:
- 医療情報ネット (ナビイ, Navii), MHLW's medical-facility search, has English, Simplified and Traditional Chinese, and Korean interfaces, and foreign-language availability is a search criterion (as of 2026-10).21
- AMDA International Medical Information Center runs a multilingual line at 0120-339-266 (or 03-6233-9266), weekdays 10:00–16:00, in English, Chinese, Korean, Spanish, Portuguese, Thai, Filipino, Vietnamese, Indonesian, and Japanese (as of 2026-10).22
Finding an English-Speaking Provider covers the general search for English-language care.
Pre-procedure consultation and paperwork
A clinic's fee schedule shows the usual sequence: an initial consultation, pre-operative blood work, cervical preparation, then the procedure (as of 2026-07-24).10 The consent form must be completed before the procedure; see Consent rules above.10
Testing varies by method. In the 2023 national survey of abortions under 12 weeks, a blood count was always done in 78.8% of surgical cases and a blood-type test in 80.4%, against 11.2% and 11.5% of Mefeego cases (as of 2024-05).8
Your health insurance card does not change the bill. Induced abortion for economic reasons is outside public health insurance, so the patient pays the full amount.37
The procedure day and follow-up
For a surgical procedure, Hakusan Ladies Clinic's instructions give a sense of the day (as of 2026-07-24):10
- Fast from midnight (tea or water only) because of IV anesthesia.
- Bring the consent form, nightwear with a short-sleeved top, sanitary shorts, large night pads, and a bath towel.
- Have someone accompany you home; otherwise, go home by taxi.
- A next-day check is included in the fee.
For Mefeego, the pattern is two in-person visits 36 to 48 hours apart, then waiting at the facility or, if eligible, at home, with a check about one week later (as of 2026-08).12
Aftercare support differs from facility to facility. Nationally, more than 70% of facilities gave contraception information to every patient, about half gave recurrence-prevention guidance, about 10% gave grief care, and fewer than 10% gave a referral to a counseling window (as of 2024-05).8 If you want counseling, ask the facility or use the lines under Support and counseling.
Additional steps after a mid-term abortion
A 死産届 (shizan todoke, "stillbirth notification") is required for a miscarriage or stillbirth at "妊娠満12週以降（妊娠85日以上）," meaning 12 completed weeks, the 85th day of pregnancy or later, according to municipal guidance (as of 2026-04-01).15 The childbirth lump-sum benefit uses the same point, "妊娠85日（4か月）以降."23
Induced terminations fall within this category. Vital-statistics definitions treat 死産 (shizan, "stillbirth") as the delivery of a dead fetus from 12 weeks onward, and define 人工死産 (jinkō shizan, "artificial stillbirth") as a stillbirth caused by artificial intervention, including labor-inducing drugs, while the fetus was confirmed alive in the womb.24
The same municipal guidance sets the filing details (as of 2026-04-01):15
| Item | Detail |
|---|---|
| Deadline | Within 7 days |
| Where | The municipal office for the filer's location, or for the place where the stillbirth occurred |
Procedures and forms differ by municipality, so confirm with the office where you will file.
Costs and insurance
Four terms come up repeatedly when budgeting:
| Term | Reading | Meaning |
|---|---|---|
| 妊婦のための支援給付 | ninpu no tame no shien kyūfu | Support payment for pregnant women, paid by the municipality20 |
| 出産育児一時金 | shussan ikuji ichijikin | Childbirth and childcare lump-sum benefit, paid by the health insurer23 |
| 直接支払制度 | chokusetsu shiharai seido | Direct payment system: the insurer pays the lump sum straight to the facility23 |
| 産科医療補償制度 | sanka iryō hoshō seido | Obstetric Compensation System, which compensates severe cerebral palsy related to delivery25 |
Why public health insurance does not cover it
Public health insurance does not apply to "normal pregnancy and childbirth" or to "induced abortion for economic reasons," on the stated rationale that pregnancy is not regarded as an illness.3 Municipal National Health Insurance lists the same exclusion, 「経済上の理由による妊娠中絶」 (as of 2026-05-21; confirm current figures with your health insurer).7
There are narrow exceptions. Insurance may apply to an induced abortion performed to protect the mother when danger is imminent, and to abnormal deliveries such as those caused by hypertensive disorders of pregnancy.3 Other exclusions from coverage are covered in What Insurance Doesn't Cover.
Typical self-pay cost by method
No national price survey was found. The table lists individual facilities' published fees, each with its own date; they are examples from single fee pages, not national ranges. The misao-ladies.jp page carries no date, so its rows show the retrieval date (2026-10).101126
| Facility (area) | Method or stage | Price (tax included) | Covers | As of |
|---|---|---|---|---|
| Hakusan Ladies Clinic (Bunkyō, Tokyo) | Surgery before 9 weeks | ¥143,000 | Procedure, anesthesia, medicines, nursing, recovery room, next-day check | 2026-07-2410 |
| Hakusan Ladies Clinic | Surgery at 9 weeks or later | ¥176,000 | Same as above | 2026-07-2410 |
| Hakusan Ladies Clinic | Initial consultation / pre-op blood work / cervical preparation | ¥8,000 / ¥8,800 / ¥9,380 | Billed separately from the procedure | 2026-07-2410 |
| misao-ladies.jp (Gifu) | Early abortion, total | ¥110,000 | Initial visit, pre-op tests, surgery, post-op check | Retrieved 2026-1011 |
| misao-ladies.jp | Mid-term, 12–13 / 14–15 / 16–17 / 18–19 / 20–21 weeks | ¥620,300 / ¥630,300 / ¥640,300 / ¥650,300 / ¥660,300 | Before benefits; epidural +¥55,000; extra night ¥12,000 | Retrieved 2026-1011 |
| Kasugai Maternity Clinic (Kasugai, Aichi) | Mefeego Pack | ¥110,000 | Mefeego abortion fee | 2024-1226 |
The examples show what moves the price: gestational week, add-ons such as misao-ladies.jp's Saturday surcharge of ¥10,000 and certificate fee of ¥5,500, and epidural anesthesia for mid-term cases (retrieved 2026-10).1011 Ask each facility for its current fee schedule and what it includes.
妊婦のための支援給付 as a cost offset
Since 2025-04-01, municipalities have run a national support payment for pregnant people. The first payment is ¥50,000 per pregnant person after a physician confirms fetal heartbeat, and the second is ¥50,000 multiplied by the number of fetuses (as of 2025-04).2027
Induced abortion is eligible. Children and Families Agency guidance states that "because the payment focuses on pregnancy, miscarriage, stillbirth, and induced abortion are also covered"; a gestational sac without a confirmed heartbeat does not qualify, and neither does an ectopic pregnancy (as of 2025-04).20
How you apply depends on timing (as of 2025-04):20
- Before the procedure: no physician's certificate is needed.
- After the procedure, without a prior pregnancy notification: a physician's certificate (診断書, shindansho) of the heartbeat confirmation is required, and clinics set their own fee for it.
- Claim period: 2 years.
- Where: the municipality of your resident registration (住民票, jūminhyō) at the time of application.
One clinic shows the effect on the bill: misao-ladies.jp lists its ¥110,000 early-abortion total reduced by ¥100,000 of this benefit (retrieved 2026-10).11
The childbirth lump-sum benefit for terminations at 12 weeks or later
For the 出産育児一時金 (shussan ikuji ichijikin), "childbirth" includes live birth, stillbirth or miscarriage, and induced abortion from 85 days (4 months) of pregnancy.23 The benefit applies only to people enrolled in Japanese public health insurance, either National Health Insurance or employee health insurance.2325
The amount per fetus depends on gestation and on whether the Obstetric Compensation System applies (as of 2026-04-01).25
| Gestation at delivery | Obstetric Compensation System applies | Amount | As of |
|---|---|---|---|
| 22 weeks or later | Yes | ¥500,000 | 2026-04-0125 |
| 22 weeks or later | No | ¥488,000 | 2026-04-0125 |
| 12 weeks to under 22 weeks | Not applicable | ¥488,000 | 2026-04-0125 |
Every lawful abortion takes place before 22 weeks, so the applicable amount is ¥488,000, not ¥500,000 (as of 2026-04-01).2325 Under the 直接支払制度 (chokusetsu shiharai seido, "direct payment system"), the insurer pays the benefit directly to the facility, and you pay only the amount above it (as of 2026-04-01).2325
Combined, the two benefits cover most of one clinic's mid-term fee: misao-ladies.jp gives net mid-term costs of ¥32,300 to ¥72,300 after the ¥488,000 lump sum and the ¥100,000 support payment (undated page, retrieved 2026-10).11 Details of claiming the lump sum are in Childbirth Lump-Sum Benefit (Shussan Ikuji Ichijikin).
Confidentiality and privacy
Anyone involved in work related to performing a sterilization or induced abortion must not leak confidential information learned in that work, and the duty continues after leaving the work.1 Article 33 of the Maternal Health Act makes an unjustified leak a punishable offense.1
Some records are still created, depending on the stage and on which benefits you claim. The table shows who receives each one. Rows drawn from municipal or agency guidance carry their own date, starting with the stillbirth notification rule (as of 2026-04-01; confirm current figures with your municipal office).13231520
| Record | When it arises | Who receives it | As of |
|---|---|---|---|
| Physician's monthly report of procedures and reasons1 | Every lawful abortion | Prefectural governor | Stable |
| Insurance claim3 | Not for an early abortion on economic grounds, which is self-pay | No insurer involved | Stable |
| Lump-sum benefit claim23 | Termination at 12 weeks (85 days) or later, if insured | Your health insurer | Stable |
| 死産届 (stillbirth notification) | Termination at 12 weeks (85 days) or later | Municipal office | 2026-04-0115 |
| 妊婦のための支援給付 claim | If you apply for the payment | Municipality, which may contact the facility with your consent if an application raises doubts | 2025-0420 |
Support and counseling
Support is organized locally, so numbers, hours, and channels differ by prefecture and city. Three terms describe the main channels:
| Term | Reading | Meaning |
|---|---|---|
| にんしんSOS | ninshin SOS | Unplanned-pregnancy counseling line run by a prefecture or city28 |
| ワンストップ支援センター | wan sutoppu shien sentā | One-stop support center for victims of sexual crime and sexual violence29 |
| 配偶者暴力相談支援センター | haigūsha bōryoku sōdan shien sentā | Spousal violence counseling and support center30 |
The table lists national entry points and one local example. Each row carries its own date (as of 2026-10; confirm current figures with each operator, since hours change).282930313222
| Service | For | Contact | Hours and notes | As of |
|---|---|---|---|---|
| にんしんSOSヨコハマ (example of a local Ninshin SOS) | Unplanned pregnancy | Phone 045-662-5524; LINE | Phone daily 10:00–22:00; LINE daily 10:00–21:30; anonymous consultations accepted; men may also consult | 2026-06-0928 |
| #8891 | Sexual violence | Call #8891 (toll-free) | Connects to the nearest one-stop support center; most keep limited hours, some prefectures operate around the clock | 2026-1029 |
| #8008 (DV相談ナビ) | Spousal violence | Call #8008 (normal call charges) | Connects to the nearest prefectural spousal violence counseling and support center, within its hours | 2026-1030 |
| DV相談＋ (DV Sōdan Plus) | Spousal violence | 0120-279-889 | Phone 24 hours; web chat 12:00–22:00; chat in 10 languages | 2026-1031 |
| TELL Lifeline | English-language emotional support | 0800-300-8355 (toll-free) | Free; chat daily from 16:00 | 2026-1032 |
| AMDA International Medical Information Center | Multilingual medical navigation | 0120-339-266 | Weekdays 10:00–16:00; see Finding a clinic and booking | 2026-1022 |
To find the Ninshin SOS window for your own area, the MHLW-supported site あなたのみかた (Anata no Mikata) lists pregnancy consultation windows by location, including municipal sexual-health consultation centers that handle unexpected pregnancy (as of 2026-10).33
Municipal benefit offices can also be a route to support. The Children and Families Agency asks municipalities to use the support-payment application interview to connect people who have had an abortion with counseling (as of 2025-04).20 For a broader list of urgent help lines, see Crisis Resources in Japan.
Good to know
Time is the binding constraint
Every threshold in this process is set by gestational age. The Mefeego window closes at 63 days (9 weeks 0 days), judged on the day of the first dose (as of 2026-08; confirm current figures with the Pharmaceuticals and Medical Devices Agency).12 In the national survey, the serious-complication rate for surgery more than doubled from 9 weeks 1 day, at 0.561% against 0.250% (as of 2024-05).8
From 12 weeks (85 days), the procedure becomes an induced delivery with hospitalization and a stillbirth notification, and one clinic's prices start at ¥620,300 (undated page, retrieved 2026-10); insured patients can offset ¥488,000 with the lump sum (as of 2026-04-01).112515 The 22-week standard is the final limit (as of 2026-10).2
Children and Families Agency guidance says that even when a patient asks to delay surgery to qualify for the support payment, the timing should be decided with maternal safety as the priority while considering the patient's wishes (as of 2025-04).20
Clinic practice can be stricter than the law
Some medical institutions asked for the perpetrator's consent in pregnancies from sexual violence until MHLW stated on 2020-08-28 that it is not required.614 The 2021-03-10 interpretation extends patient-only consent to domestic violence and marriages that have effectively broken down.6
Those MHLW interpretations are the reference point if a clinic asks for more than the law requires. Minors face a similar gap: the law sets no parental-consent requirement, but handling differs by facility (as of 2026-07-24).10 Because practice varies, another designated facility may handle the same situation differently.
Importing abortion pills is not a workaround
Personal import of oral abortion drugs is restricted by MHLW designation; import is possible only where the regional health bureau (地方厚生局, chihō kōseikyoku) can confirm it is based on a physician's prescription (as of 2025-02-13).34 An Indian-made oral abortion product was added to the restriction in 2025 (as of 2025-02-13).34
The route for medical professionals is closed too. After Mefeego's approval, MHLW told regional bureaus that mifepristone products do not meet the criteria for an import confirmation certificate (輸入確認証, yunyū kakunin-shō) for personal use by medical professionals, because a strictly controlled domestic product exists; in principle none will be issued (as of 2023-05-15).35 For how personal-import certificates work in general, see The Yakkan Shomei Import Certificate.
The health risk is direct. Shizuoka Prefecture warns of heavy vaginal bleeding and serious bacterial infection, and calls using such drugs without a physician's instruction "very dangerous."34
Emergency contraception covers the earliest window
If unprotected intercourse happened within the last 72 hours, emergency contraception is a separate, earlier option. Since 2026-02-02, the emergency contraceptive ノルレボ (Norurebo, "Norlevo"), a pharmacist-guidance drug (要指導医薬品, yō-shidō iyakuhin), can be bought at pharmacies and drugstores, after an in-store explanation, and must be taken in front of the pharmacist (as of 2026-10).36
MHLW publishes the list of pharmacies that sell it, and calling ahead is advised.36 Options and access are covered in Contraception and Emergency Contraception in Japan.
Ending a wanted pregnancy for medical reasons
Article 14(1) item 1 covers physical as well as economic reasons, and the same 22-week standard applies (as of 2026-10).12 Health insurance may apply when an abortion is performed to protect the mother from imminent danger.3
The treating physician is the first contact for the medical decision. About 10% of facilities give grief care to every patient, and fewer than 10% refer every patient to a counseling window, so you can ask the facility directly for that support (as of 2024-05).8
See also
- STI Testing and Sexual Health Services in Japan
- Psychiatry, Psychology, and Counseling in Japan
- English-Speaking Mental Health Providers
- Medical Japanese: Intake and Symptom Description