The recent Supreme Court draft leak opinion concerning Roe v. Wade has led not only to a widespread outcry but widespread activism as well. Educators, activists, and everyday citizens have united together to protest the decision which would overturn nearly fifty years of established precedent.

Through their combined efforts, nationwide protests went underway and organizations were able to increase their outreach, bringing information as well as hope to those who need it the most during this incredibly uncertain time. In particular, discussions regarding medication abortion access have gone up considerably, as the nation not only braces itself for the end of the Roe v. Wade era but actively explores what unique, individualized healthcare options are available in today’s modern and technologically advanced, post-COVID world. 

The United States is not alone in fighting for reproductive justice

The United States is not the only nation preparing for change. Another country has also made headlines for its prospective abortion legislation. Japan’s government has announced its intentions of allowing women to obtain medication abortion pills, but with one huge caveat. Pills cannot be obtained without explicit written spousal consent (Cheung, 2022). 

Currently, only medical abortions are legally practiced in Japan (Katanuma & Wei, 2022). Under the 1948 Maternal Health Act, these abortion procedures strictly require that doctors and patients demonstrate spousal/partner consent (Cheung, 2022; Katanuma & Wei, 2022)

Japan’s reproductive legislation has been the subject of global controversy following the medication abortion pill announcement. In comparison to other nations, the country was quite delayed in approving and providing common reproductive health care services, including oral contraceptives, which were not approved until 1999 following an extended nine years of deliberation.

reproductive justice

By contrast, the popular erectile dysfunction pill, Viagra, was approved in an estimated six months. It is also interesting to note that the majority of the Japanese parliament is made of male members (Cheung, 2022). 

 It is clear that there is still a long way to go when it comes to equitable, accessible reproductive care in Japan. Although medical abortions are legal, the procedures are not covered by insurance and can cost anywhere from $700 to $1200 for terminations within the first eleven weeks of pregnancy  (Katanuma & Wei, 2022).

Spousal consent can prove to be a formidable barrier to accessing care. Individuals who want to terminate their pregnancy may feel uncomfortable seeking approval from their husband/partner. And if a person does decide to open up that conversation, but their partner wishes not to support their decision, then their options are considerably fewer. 

Failing to follow the Maternal Health Act’s spousal consent requirement can result in sanctions, including one-year jail sentencing. It might be easy for those who are outside of the situation to ask, “Why can’t Japanese citizens purchase abortion pills online?”

Doing so is considered illegal and can also result in punitive actions (Katanuma & Wei, 2022). Additionally, with the extent to which technology has become enmeshed in daily life, it is extremely difficult to obtain abortion pills without leaving a trace of the transaction that can then be used against the patient. Abortion activists do have a few recommendations for keeping data as private as possible and for potentially mitigating the risk of seeking an abortion.

These precautions include paying for abortion services with cash or through prepaid gift cards, installing VPNs, using encrypted text messaging apps, momentarily turning off cell phone locations, and using web browsers like Duck Duck Go and Firefox (Pitney, 2022). Unfortunately, the risks still remain. 

In the States, reproductive justice has been renamed injustice

 In the United States, even just the suspicion that someone has obtained an abortion can lead to an arrest and imprisonment. Miscarriages and stillbirths have now come into question. That in itself illustrates the true extent to which individuals’ bodies, privacy, and autonomy are under threat (Levinson-King, 2021). 

reproductive justice

History has shown us that making abortions illegal or harder to obtain, does very little to stop people from attempting to access the care they need and want. Abortions still occur, even in places where the procedure is against the law. Restrictive legislation only makes it harder and more dangerous for those trying to access healthcare.

One poignant, heartbreaking example is the story of Rosie Jimenez, the first known individual to pass away after an illegal abortion following the implementation of the Hyde Amendment, which ended Medicaid funding for safe medical abortions (Laureano, 2022).

It is not far-fetched at all to wonder if as the world moves closer and closer to doing away with reproductive rights and access to care altogether, that fatal incidences like what happened to Rosie will not only continue but skyrocket. When the right to abortion is diminished, unrecognized, restricted, and up for debate, what shall happen to survivors of incest and sexual assault who are looking for these services? 

While the Maternal Health Act identifies exemptions in the case of sexual assault, there have been reports of doctors refusing to perform the procedure. This only helps to perpetuate an unsupportive culture of victim-blaming where survivors are left with very little recourse (Cheung, 2022).

Indeed, in the U.S. some believe that survivors of sexual assault should be forced to go through with their pregnancies, including Republican Nebraska governor, Pete Ricketts (CNN, 2022).

reproductive justice

Republican state representative, Jean Schmidt from Ohio, boldly mused that while rape incidences were a “shame,” they also presented “opportunities” for victims to decide whether or not they would like to be so-called “productive human being(s).” (Edwards, 2022). 

 In addition to the spousal consent barrier, is an added financial one. Medication abortion pills will not be covered by insurance, meaning even if they become legal on paper albeit, with the required spousal consent, low-income households will be unable to obtain this service. If individuals and their families cannot obtain medication for abortions, undoubtedly the costlier medical abortion procedures are just as unavailable. Who actually benefits from the Maternal Health Act? Certainly not the pregnant individuals and their families. 

Meanwhile, in America, the fight for reproductive justice continues, even in the face of painfully restrictive laws and ambiguous situations that seem to threaten everything that feminists and reproductive activists have fought so long and so hard for.

It matters a great deal what happens not only in our own homeland and government but what happens all around the world. Their fight is our fight. Their win is our win. Until people of all bodies and gender identities can safely access the care they need, until their right to self-determination is acknowledged and recognized, the battle continues. 


Cheung, K. (2022). Medication abortion will soon be legal in Japan—As long as your male partner says it’s OK. Jezebel.

Edwards, J. (2022). Ohio lawmaker calls pregnancies from rape an ‘opportunity’ for victims. The Washington Post. 

GOP Governor says that rape victims should have to carry child to term. CNN Politics.

Katanuma, M. & Wei, De L. (2022). Abortion Pills May Require a Partner’s Signoff in Japan. Bloomberg.

Laureano, B. (2022, March 5). Abortion in the US: Realities, laws & healing. [Webinar]. ANTE UP. 

Levinson-King, R. (2021). US women are being jailed for having miscarriages. BBC.

Pitney, Christine. (2022, May 15). Self-Managed Abortion Buddy Training. [Webinar]. Plan C Pills.