Ministry confirms safety of abortion method

Japan favors an abortion method less commonly employed in Western countries, but the method poses no major safety problems, according to a research panel.

The Health, Labor and Welfare Ministry's panel conducted the nation's first large-scale investigation of induced abortions beginning in September last year, in cooperation with Akihito Nakai, professor at Nippon Medical School Tama Nagayama Hospital. It was important to examine the safety of the method frequently used in Japan because it differs from the one recommended by the World Health Organisation.

The investigation surveyed all of the 4,154 institutions in Japan where obstetricians are certified to carry out abortions under the maternal health protection law, and looked at abortions conducted in 2012. Reports from 2,434 institutions, or 59 per cent, were received, covering about 110,000 procedures. That group covers about 50 per cent of all abortions carried out in Japan in 2012.

The survey found there were 391 cases among the 110,000 procedures, where patients developed complications, and one case in which a patient died. The frequency of such complications was no greater than in the United States or Britain.

There are three methods typically employed in first trimester abortions in Japan. The first is dilation and curettage, in which a special implement is inserted into the uterus through the dilated cervix to remove the foetus, accounting for 33 per cent of all abortions. The second method is menstrual extraction, in which the uterus is aspirated to remove the foetus, accounting for 20 per cent. The third, and most common method in Japan, is a combination of the other two methods, accounting for 47 per cent of procedures.

The WHO recommends menstrual extraction for early termination of pregnancies.

Abortions performed by the dilation and curettage method had a higher incidence than the menstrual extraction method of cases in which a second surgery was required due to insufficient removal of the foetus. However, there is noteworthy difference between the two methods in terms of the frequency of serious complications such as perforation of the uterine wall.