Birth Control/Abortion: East Asia

Steffani Pankonin

Abortion and Birth Control in East Asian Countries

Across the globe, the issue of abortion and forms of birth control can be very controversial. In some countries it can be common and legal whereas in other countries it can be illegal and considered wrong for religious reasons. East Asia is home to some of the biggest populations per square mile in the world. The population is rapidly increasing that many countries are now afraid that it will not be able to support the population. With the population on such a great rise, abortion has also increased over the years. The relationship between birthrates and abortion as a form of birth control is a big part of the cultural norm today, but the countries of China, North Korea, South Korea, Taiwan, and Japan all have different regulations on abortion. Meanwhile, all of these countries also have different views on other forms of birth control including oral contraceptives, sterilization, and condom use. While China, North and South Korea, Taiwan, and Japan all have different preference on their forms of birth control that is what makes them unique.

East Asia can vary from country to country on regulations for abortion and types of birth controls that they use in the region. The country of China specifically is estimated alone to have over 13 million abortions performed each year (CNN.com, 2009) with 95.2% of the population using some form of birth control regularly (Ye D.-Q, 2009), which includes abortion as a form of birth control. Abortion in China is legal because of the One-Child Policy that helps in controlling the rising population throughout the country.  This policy makes China different from North/ South Korea, Taiwan, and Japan because these countries do not have this policy. The One-Child Policy specifically limits couples to having only one child born. This policy tends to be the number one reason for an abortion, but other reasons can be used in situations due to rape, fetal impairment, and incest which can also hold true for other countries in East Asia as well.

Abortion in China is legal at any time during the pregnancy for any reason, but because of the government strict policy to reduce the rising population, abortion is widely used as a birth control method. The One-Child Policy was introduced in 1979 as a law that restricts married couples to only having one child (Sun, 1987). This policy is strictly enforced at the provincial level through fines that are imposed based on the income of the family and other factors (Page, 2011). It is also uncommon for women to become pregnant with a second child due to the fines and because of this some Chinese women choose to have tubal ligation after having their first child. Due to China’s One-Child Policy if a woman is pregnant with their second child, they will more than likely be forced to have an abortion predominantly in urban areas.  On the contrary, in rural areas it is permissible to have a second child if the first born is a girl and a "second-birth permit" is granted by the government, which can cost approximately 4,000 Yuan ($600 US) (Junhong, 2001).

As part of the Chinese family traditions many women have abortions because of the desire for boy rather than a girl. One commonality to China as well as the countries of Hong Kong, Singapore, South Korea, and Taiwan where they have a Confucian cultural heritage states, “An imperative on continuing a family’s lineage through the male heir as a metaphysical key to greater universal harmony and virtue” (Eberstadt, 2011). They believe there must be a male child in order for the family to continue which leads to many girls being unwanted. Meaning their families will be happier and reflect luck if they conceive a baby boy. This then inclines that many female infants are often killed or aborted illegally. Yet, while abortion is easily accessed in these countries, prenatal gender determination and sex-selective abortion are illegal today due to the sex-ratio being significantly different.

On the other hand, women in Japan are encouraged to accept the baby they are pregnant with. Abortion in Japan was not legalized until 1984 and was only legalized due to postwar devastation and starvation as part of the concern for population control (Borovoy, 2011). What makes Japan different from China, but more like a developed country, is the fact that the mother is to make the decision about the fate of her fetus, because she is the sole caregiver and knows what’s best. She may choose to abort the fetus but has to do so her first two trimesters as Japan’s law states that any abortion within the first two trimesters is legal. In Japan, more than half of all premarital pregnancies to women aged fifteen to twenty-nine, between the years 2000 and 2004, were aborted; 38 percent of pregnancies to this age group ended up as marital births and only 4 percent led to non-marital births (Borovoy, 2011). Japan lets the mother decide what she wants to do with her fetus, while still putting limitations on abortion, in hopes that she will take into consideration family welfare, the social good, and the environment in which a child would be raised within the first two trimesters.

Besides the cultural and social norms for abortion there are also numerous reasons why women in East Asia choose to receive abortions. In all of the countries, unprotected intercourse (53.6%) and contraception failure (43.9%) were also popular reasons given for the current induced abortion for every married woman (Shenghui, 2011). Specific universal reasons for abortions include saving the mother’s life, to preserve the physical or mental health of the mother, or social reasons consisting of where the mother cannot afford to have the child. In countries like Japan abortion is completely legal during the first two trimesters for reasons consisting of saving the life, preserving health and mental wellness, social reasons, or rape. But, an abortion is never legal in Japan if the baby has a known defect. In North Korea abortion is always legal, while in South Korea abortion is legal with significant restrictions such as spousal authorization. In Taiwan you may also need spousal authorization or parental authorization to receive an abortion.

Both medical and surgical abortions are popular in developing countries. Medical abortion, or abortion using a pill, is a way to end a pregnancy with medication early on during pregnancy. It is an abortion method that uses two medications to end a pregnancy over a span of time (Johnston, n.d.). Surgical abortion is when a doctor removes a pregnancy from the uterus. The doctor numbs the cervix with a local anesthetic similar to Novocain, then dilates--or stretches-- the cervix a little bit to put in a small tube, and then removes the pregnancy with suction (Johnston, n.d.). Often it is common in East Asia that doctors will inject women in their third trimester with a substance called Rivalor, which causes direct heart failure to the fetus. The baby will die within the next few days, and then it is delivered dead (Mosher, 1987). Since abortions in China are always legal, cost usually isn’t a factor for them. Often, they can cost around 600 Yuan or $88 (CNN.com, 2009). In Japan it can often be a financial difficulty to have an abortion while in South Korea the rising cost of abortions can have an influence as well. In the end, the preference of medical or surgical abortions is completely up to the woman and what she thinks is best for her.

Although the topic of abortion can be common in East Asia, there are also other forms of birth control that have become popular over time. Today more and more women have been using male condoms as a form of birth control, which has resulted in a decreasing prevalence of induced abortions of accidental pregnancies. According to Family Planning in China, “The most common contraceptive methods used in China are intrauterine devices (IUD), tube legation, and vasectomy. The IUD is an efficient, safe, low-cost, and reversible contraceptive method with about 40% of women choosing the IUD as the contraceptive method of choice after having raised their first child. 40% of women also use tube ligation as a fertility control method after having raised their second child, and only 11 % of Chinese men used vasectomy as a fertility control method.” More and more women in relationships today are also choosing oral contraceptive as the preferred method of birth control. This is gaining in popularity rapidly because the government now hands out contraceptives for free to all women of child bearing age (Smith, 2011). Asia is has one of the biggest users of tube legation, or female sterilization, around the world with the most occurring in China alone. This incident can tend to fluctuate a little depending on the numbers of unsterilized couples in the relevant age groups, which changes from year to year. While the idea of sterilization is a cultural norm from the past it is gradually becoming the last choice as a form of birth control in China today due to the rising popularity in and the education received about oral contraceptives.

In Japan, more than half of the married women there prefer male condoms as their method of birth control. Only 2.2 percent of women take the pill, 16.7 percent preferring their male partner to ejaculate externally and 3.6 percent opt for the rhythm method (Kato, 2009). Rhythm method referring to the women learning to recognize the days she is fertile, and not having sex before and during those days. Many Japanese women choose to use condoms and other techniques opposed to the pill because in the past it had been discouraged by abortion doctors. The pill is a fairly new contraceptive in Japan and many of the women tend to be concerned with side effects it may bring. Another reason for condoms over oral contraceptives is because of the costs for the pill. The cost can be around ¥3,000 a month, which is not covered by health insurance (Kato, 2009). While the concerns, the cost, and the idea of the pill still being a new drug in Japan has an impact now, the country expects the popularity to grow over time.

In North and South Korea, the top female contraceptive methods were IUD(53.6%), injection(11.6%) and tubal-ligation(6.4%) while male contraceptive practices such as condoms and vasectomy were rarely used (Soo-youn, n.d.). Although birth control pills are very cheap here and you can ask for them over the counter at the pharmacy, many women do not like them today due to side effects. Having to buy birth control pills in public is also another reason why pills aren’t as popular. Many Korean women consider buying items like condoms and birth control pills as embarrassing Like Japan, Korean women are likely to use the “pull out” and rhythm methods as well. Many of the women in North and South Korea were never or rarely educated about sex and reproductively, which leads them to have many unsafe abortions, poor contraceptive use and related complications. While North Korea doesn’t have a problem with abortion and it is easily accessed, abortion in South Korea is not as common as the other countries. Because abortion is not as common, it makes the forms of IUD and tubal- ligation popular for this reason.

Throughout East Asia, from country to country the regulations or no regulations on abortion can change significantly depending on the place women live. While abortion tends to be the most popular form of birth control, old and new methods of birth control including oral contraceptives, intrauterine devices (IUD), tube legation, vasectomy, and condoms can also be used. Birth control in other countries can also include forms of natural planning including male external ejaculation and the rhythm method. While sex-ratio in East Asia’s population is changing, the relationship between contraceptive use and abortion may take a variety of forms, frequently involving a simultaneous increase in both. With so many different contraceptive methods to choose from no single method is appropriate for all couples. When choosing a contraceptive method, factors such as, reversibility, effectiveness, cost, and especially cultural preferences should be greatly considered.

Work Cited

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