Women in Japan may be forced to obtain their partner’s consent before they are prescribed the morning-after pill, which is said to be due to be legalized later this year – nearly four decades after it was made available to women in the UK.

Under the 1948 Maternity Protection Act, approval for surgical abortion is already required in Japan – with very few exceptions – which political activists say tramples on women’s reproductive rights.

“Basically, we believe that even if an abortion is done via oral medications, the consent of the spouse is necessary,” Yasuhiro Hashimoto, a senior health ministry official, told a parliamentary committee earlier this month, according to Bloomberg.

Activists are calling on health officials to repeal the rule requiring women to obtain written consent from their partners before a doctor prescribes abortion drugs.

Abortion rights advocate Kumi Tsukahara said, “Husband consent becomes an issue when there is a conflict with the husband or when the husband forces the woman to give birth against her will.

“For women, forcing them to have a pregnancy they don’t want is violence and a form of torture.”

Politics can have tragic consequences. Last year, a 21-year-old woman was arrested after the body of her newborn was found in a park in central Japan. The woman, who was given a suspended prison sentence, told the court that she could not terminate her pregnancy because she could not obtain written consent from her partner.

Doctors insisted she was seeking her consent, although the Health Ministry later said it was one of the few cases where it was not required because the father was not available.

Japanese media have also reported cases of doctors refusing to authorize abortions for women who have been sexually assaulted, forcing Health Ministry officials to write to the Japan Medical Association to clarify that consent is not required in cases of rape.

Activists say Japan’s failure to approve a drug that has long been available in more than 70 other countries reflects the low priority the parliament and the country’s male-dominated medical community are giving women’s health.

It took Japan nine years to approve oral contraceptives in 1999, but only six months to approve Viagra for erectile dysfunction.

The Yomiuri Shimbun reported that in December last year, British pharmaceutical company Linepharma International applied for approval of a combination of two drugs for its morning-after pill, adding that approval is expected within a year of the application.

Japan, which performed 145,000 surgical abortions in 2020, is one of only 11 countries to require third-party approval for abortions, despite calls from the World Health Organization and the United Nations Committee on the Elimination of Discrimination against Women to end the practice.

“Spouse’s consent is not necessary for abortion and should be removed from the Maternity Protection Act,” said Chiaki Shirai, a professor in the School of Humanities and Social Sciences at Shizuoka University.

Safe abortion activists have warned that the abortion pill, which is not covered by the National Health Insurance, will be too expensive for many women.

According to Japanese media reports, a single dose can cost about 100,000 yen ($780) — roughly the same as a surgical abortion, and women taking it must do so under close medical supervision, including hospitalization.

“The reality is that for some women, abortion is not an option for financial reasons,” Shirai said. “Contraception, abortion, pregnancy and childbirth must be publicly funded.”

Mizuho Fukushima, a lawmaker from the opposition Social Democratic Party, has warned of the high cost of surgical abortion and consent requirements that force women to undergo unwanted pregnancies.

“Women are not the property of men,” Fukushima said in parliament this month. You should protect your rights, not men’s rights. Why does a woman need the consent of her partner? It’s her body.”