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The History of Abortion and the Need for Prenatal Testing

The History of Abortion and the Need for Prenatal Testing

While there has always been a certain demand for prenatal testing, it has historically accounted for only a small percentage of overall testing, much lower than in Western countries. Why, despite the demand, have so few people utilized these tests?

Table of Contents

Conflicts Surrounding the Eugenic Protection Law

One reason for the low rate of prenatal testing is the historical conflict surrounding the Eugenic Protection Law.

The Eugenic Protection Law pertains to sterilization and induced abortion to protect maternal health. Essentially, it allowed for sterilization and abortion if the mother's health was at risk. The law was renamed the "Maternal Protection Law" in later revisions.

When enacted in 1948, the law was more broadly interpreted, encouraging sterilization and abortion for disabled individuals. This was based on eugenic beliefs that children of disabled parents were more likely to be disabled, as well as concerns about economic strain from population growth. Economic reasons for abortion were also recognized, and the procedures became simpler.

As a result, abortions increased, peaking at over one million annually. However, by the early 1970s, opposition groups, including religious organizations, petitioned the government to abolish economic reasons for abortion.

The petition was rejected due to protests from women who did not want to be forced to give birth against their will. The debate continued, with disabled individuals opposing economic abortions and women advocating for their right to choose.

Changes began when disabled women, who understood both perspectives, started speaking out. By the 1980s, there was a shift away from eugenic thinking, emphasizing that selective abortions were not a woman's right.

In 1996, eugenic aspects were removed from the law, and it was renamed the "Maternal Protection Law."

This historical context has contributed to the low rate of prenatal testing in Japan, as such tests are often viewed with skepticism.

Increased Demand Due to the Development of NIPT

Although prenatal testing is less common in Japan compared to other countries, its use is increasing due to the advent of NIPT (Non-Invasive Prenatal Testing).

Traditional tests like amniocentesis and chorionic villus sampling were not widely used due to their high cost and the physical burden on both mother and child. However, NIPT requires only a blood sample from the mother, making it simpler and more appealing.

NIPT is not a definitive diagnosis; positive results need confirmation through amniocentesis or chorionic villus sampling. However, it allows for initial screening of fetal conditions, prompting further testing if necessary.

With increasing maternal age in Japan, the prevalence of conditions like Down syndrome has risen. NIPT offers a less invasive option for initial screening, likely leading to more parents opting for prenatal testing.

The Rise of Unlicensed NIPT Clinics

As NIPT becomes more popular in Japan, the number of unlicensed clinics offering the test has increased. Not all hospitals provide NIPT, leading to a rise in these unlicensed facilities.

NIPT involves only a blood test, so it can be conducted even by non-specialized clinics. As demand increases, unlicensed clinics are emerging to meet it.

Are Unlicensed Clinics Bad?

The term "unlicensed clinic" may suggest fraud or unethical practices, but this is not necessarily the case. Blood samples are collected under medical supervision and tested by specialized companies, providing reliable results.

Unlicensed clinics offer advantages like no age restrictions for testing, no need for referrals, and quick test initiation. However, they also have drawbacks, such as the absence of clinical geneticists for specialized advice if a positive result is found.

For these reasons, the Japan Society of Obstetrics and Gynecology does not recommend testing at unlicensed clinics. While not inherently bad, the lack of genetic counseling can lead to regret for some parents. Thus, testing at licensed clinics is advised whenever possible.

Choosing Not to Undergo Prenatal Testing

Some parents opt not to undergo prenatal testing, believing that they will raise their child regardless of the results. Others fear the responsibility of making a life-and-death decision if the test is positive.

In Japan, over 95% of couples choose abortion if a genetic disorder is detected. Even friends and family may encourage abortion, considering the challenges of raising a child with disabilities.

However, abortion means ending a life, a difficult decision for many. Some parents prefer not to undergo testing to avoid facing this choice.

Some doctors also oppose prenatal testing, believing that selecting against disabilities is unethical. They advocate valuing all life and encourage thorough deliberation before deciding on abortion.

Prenatal testing can help many parents, but it can also increase anxiety.

Future Demand

As NIPT and other prenatal tests become more accessible and less burdensome, more people are likely to use them. However, ethical considerations regarding the selection of life must not be ignored. Genetic counseling and careful deliberation will be essential in making informed decisions.

References