his own; this trust is further weakened by the mutual awareness of doctor and patient that something shameful is being done; and the patient is not likely to go back quickly, even though a complication demands attention. Furthermore, health insurance does not cover expenses, so women have to pay cash before they leave the clinic or hospital, whereas practically everything else is covered by insurance; this again strains relations of trust.

We ask ourselves, then, how the picture would change if abortions were restricted again. Perhaps as follows. Married women would not entrust themselves to quacks and unskillful operators; they would go to the same doctors and the same places as at present, or not at all. These doctors, however, would have to charge more, to pay for fines, suspensions, bribery, etc. The higher price would gradually erode the present peak of abortion statistics. The danger would be greater among school girls, and ordinary unmarried young women. For them special provisions should be made, so that they can have the baby with some dignity, and that the baby be taken care of through adoption or at special orphanages. The old Japanese tradition of adoption would probably swing into life again, taking care of practically all the cases. Moreover, public pressure to observe chastity before marriage or to take the consequences would very likely increase. Again, this would be instrumental in eroding the mountain of abortion statistics.

We believe that more damage is now inflicted on women in Japan by legal abortion, when total figures are tallied, than when abortion was restricted by law and was a relatively rare experience. Dr. Moriyama's figures indicate that only 0.3%-0.2% of the mothers experienced abortion in the prewar years (see Appendix I, p. 11). Now it appears to be over 50%. Damage mounts to staggering heights even when operations are legal, because an unhealthy operation is repeated on so many persons. We believe that the health of Japanese women, as a whole, will be preserved better if abortions are again severely restricted by the law and in its application.

7. ABORTION IS NOT NECESSARY TO SOLVE JAPAN'S SO-CALLED OVERPOPULATION PROBLEM

In the immediate postwar years the arguments advanced in favor of birth control (and abortion) as a means of solving Japan's so-called overpopulation problem sounded convincing to many. Our papers carried the report about conclusions reached by Dr. E. A. Ackerman after a two-year study of Japan's natural resources in 1949; he is reported to have concluded that Japan's population should be held down to 80,000,000 by means of birth control activity on an unheard of scale; else Japan would perpetually depend upon America for life support, or be forced to struggle at sub-human levels of subsistence.

Developments since then have been quite different than was foreseen. There are now 103,000,000 people, increasing at the rate of about 1,000,000 per year, and the living standard is very high.

The food problem is solved partly by better production, partly by trade. In fact, we have a chronic problem now with rice surpluses. Seven million tons of old rice will be left when this year's crop is harvested. We don't like old rice, and women are against mixing the old with the new. Koreans complained when we exported old rice there, even though they were short. When the government tries to solve the problem by lowering price supports, angry farmers descend on Tokyo to protest. This was certainly not foreseen in 1948.

There was much talk about chronic labor surpluses in the postwar days. Now the picture is entirely different. The White Paper on Labor issued in July, 1970 stresses the extreme gravity of the labor shortage and warns that Japan's continued economic growth may be seriously affected. And the situation is deteriorating. Until now the new labor supply was not decreased much by the lower birth rate which began in the 1950's. But now the peak has been passed in the number of youngsters who were born in the postwar baby boom, who have been entering the labor force.

In April, 1969 there were 5.7 job opportunities available per single high school graduate; in 1970 there were 6.5 times as many jobs as available graduates. As a result of the labor shortages, 20 to 40 percent of Japan's enterprises have been forced either to curtail operations, send out orders to outside firms, hold down sales, or to drastically increase overtime work. See report in Japan Times, July 26, 1970.) This is the very opposite of what was foreseen in 1948.

27-292-74- -14

It has also been stated that the Japanese people are too densely crowded on their islands, hence birth control is needed as an assurance that future persons will have enough living space. In fact, with 103 million people living in an area of 369,661 square kilometers, the population density is 279 persons per square kilometer; whereas the United States has an average of 25, and the world 27. Moreover, five-sixths of Japan's area is too steep for farming, hence also difficult for settlement. As it turns out, however, it appears that we Japanese are not overly concerned with the problem of crowding.

In fact, emigrants leaving Japan in order to seek wider living spaces are few. During 1955-65 there were more immigrants than emigrants in eight out of the eleven years.

Within Japan, the movement of the population is not away from the crowded cities but quite the opposite. Greater Tokyo, has already 26 million people, and 400,000 more are coming from the countryside annually. Everywhere, people are migrating away from the scarcely populated areas, towards the densely inhabited districts. Mr. Toshio KURODA of the Institute of Population Problems told participants of the XIth Pacific Science Congress (Tokyo, Aug. 1966) that Japan is polarizing in the following manner: The land area of Japan seems to have shown a polarizing trend, namely being polarized to two extreme patterns of area of increasing population and that of decreasing population. The decreasing pattern is found in local towns and villages. Eighty-three percent of total towns and villages shifted to the pattern of decreasing population during the latest censal years (1960-65). (Paper No. 8: Migration).

Great social problems are developing in towns and villages which are losing population. Up to 85% of the middle and high school graduates migrate to the cities. The countryside is becoming ever more conservative because of the preponderance of older people; there are not enough workers to clean streets, keep up river dikes, collect garbage. School teachers, doctors, professionals, leave for greener pastures. Some places have become completely depopulated by "population implosions."

Population in towns of 10,000-19,999 decreased from a total of 16.5 million to 13.9 million during 1960-65; in towns of 20,000-29,999 the decrease was from 7.0 million to 6.6 million; the next two categories also decreased; but in cities of 100,000-499,999 there was an increase from 19.3 to 22.9 million; and in those from 500,000 up there was an increase from 18.5 million to 22.8. (JAPAN STATISTICAL YEARBOOK). The great Todaido Megapolis stretching along the axis of the bullet train and down into North Kyushu contained over half of the national population in 1965 (53.3%) and is growing at the expense of the rest of Japan; it has been projected to contain 59.5% in 1975, and 65% in 1990. There is no real reason why people cannot also populate the countryside densely which is now emptying out, if ever there should be need.

The problems created by such concentration of population are huge indeed. But if the people are going to places where people already are, the advantages apparently outweight the disadvantages. They will have to cope with the problems of pollution, noise and crowded facilities as they arise. Our people have been living close together for many generations in Japan, and may have developed certain techniques, manners, etiquette, and ways of organization which make life quite bearable and even pleasant. Even under the most crowded conditions, the people manage somehow. For example, there were 64 million visitors to the World Fair at Osaka during 1970. On a number of days there were over 600,000 people on the 1.27 square miles of fairgrounds. Once 830,000 attended @ 4.7 sq. yds. per person. The concentration of Japan's population around harbors, river valleys, and the main lines of communication cuts down drastically the cost of manufacturing production, in contrast to conditions of America, where long hauls and expensive communications and transportation facilities add so much to the cost of production. This is a precious advantage for Japan when engaged in competitive international trade.

Comparative full use of facilities renders it possible for the Japanese to enjoy many social advantages at relatively low cost. The fast train carries 300,000 passengers on good days, and is in the black. One can tune into several television channels almost anywhere in Japan, up to 10 in good places, besides the UltraHigh-Frequency wavelengths. Excursion buses to parks and hot springs do a fluorishing business. Food is fresh, fruit delicious, carefully cultivated to be on the table the year around. We believe that an additional number of people can enjoy the same, and even help to enhance the standard of living further. But this will require vision and determination to make life in the cities pleasant and humane, will require peaceful living together in Japan, plus international peace and a consolidated international economy.

When the Governor of Kagoshima Prefecture announced recently that he wants
families to have three children rather than two, some newspapers raised eye-
brows asking: "What! Again?" That is, are we in for another round of "Increase
and multiply?" Probably not. But we believe that Japan's intensive pre-occupation
with population control is on the wane. Prime Minister Ikeda said already in
1963: "I wish that people would realize that when population is increasing the
nation is also prospering. I believe there are other ways of solving the over-
population problem (than preventing the unborn from entering the world.)
(Asahi, January 1, 1963.)

Prime Minister Sato asked the Cabinet three years ago to take steps to curb
the large number of abortions in the nation. Again, on March 23, 1970, Prime
Minister Sato declared at a public hearing of the Diet, televised throughout
Japan, that it will be necessary to restrict abortion in order to provide a sufficient
labor force, and to insure Japan's survival; but more necessary still because we
must respect human life: "Whether a life has already been born, or whether it
still exists as a fetus, our way of thinking about that life must be one of profound
respect." (See Appendix X.)

SUMMARY AND CONCLUSIONS

Twenty two years of experience with a liberal abortion law in Japan has given
us many reasons for regret. There is more and more criticism of the practice in
newspapers and on television as time goes on. There is a strong move within the
Liberal Democratic Party to curb abortion practice; gynecologists who make a
living from induced abortion are opposed, but even they seem to see the hand-
writing on the wall. A major effort to impose restrictions on legal abortion will
be made in the Diet shortly.

During these 22 years we have learned that our people adopted abortion very
rapidly and on a mass scale almost as soon as they were deprived of the solid
inhibiting supports of a strict abortion law. We also learned many other things:
abortion became a substitute for conception control for very many; failures in
conception control were surprisingly frequent when the escape hatch of legal
abortion was opened; some doctors are ready to operate on almost anybody be-
cause profits are high; several million women now claim that legal induced
abortion has made them physically unwell; finally, we have become more confi-
dent that Japan's population can keep right on growing without creating insuper-
able problems.

Much as we need guard rails, signal lights, speed laws, food and drug laws, and
tax regulations, so also we need precise laws about abortion which will not be
eroded off the map by human passion, or by liberal interpretations in court; we
need such laws to save us from ourselves; we need them to stop the terrible dis-
crimination against our most defenseless fellow human beings.

Note: Ministry of Welfare, Bureau of Statistics, "Eugenic Protection Statistical Report 1969", June 1970, p. 23.

Note: Ministry of Welfare, Bureau of Statistics, Eugenic Protection Statistical Report 1969, June 1970, p. 24.

HOW COMPLETE ARE OFFICIAL REPORTS OF INDUCED ABORTIONS?

Designated physicians file reports on the 10th of each month for the Governor,

on forms which indicate the following:

Name of physicians; date; place.

1. The serial number of the patient.

2. Her age.

3. Her location: the prefecture; whether she is from the countryside, a town, or a city.

4. Age of the pregnancy.

5. Date of operation.

6. Under which paragraph of Article 14 does the case fall?

7. Reason for the operation.

8. Does social insurance apply or not?

9. Does government livelihood or medical support apply or not?

Another sheet is provided for total statistics of the month, giving the paragraph of the law which applies, the age, whether from city or country.

The doctor who files higher statistics, will be assessed higher income tax, of course. Who can check on whether each case is reported? Word has leaked out from one location that the doctors have agreed to report one out of three operations.

Statistics fluctuate wildly from prefecture to prefecture:

Tokyo

Kyoto

Saitama

Number of Registered Abortions per 100 Births by Prefecture, 1962

36. S

136. 1

25.4

144.6

53.0

127.3

Kagawa

Hiroshima

Okayama

All Japan__.

61.0

Do the differences reflect degrees of completeness in reporting, or degrees of differences in operations performed, or both? Who knows except individual doctors insofar as their own reporting is concerned?

Parallel reports are filed by the designated doctors on eugenic operations for sterilizations. We have been able to check them against the latest public opinion survey. The 1969 survey of the Prime Minister's Office, Bureau of Public Information, indicated that 7.8% of the women and 1.7% of the men had received the operation, 9.5% together. Since there are over 30,000,000 married persons in the age category of the survey (31,156,540 married persons age 20-49 in 1965) we

should expect a report on at least 2,960,000 operations. The doctors reported only 616,572 operations during 1949-69, which is 20.8% of those expected. (Statistics on operations are in the "Report on Statistics of the Eugenic Protection Law, 1969" Ministry of Welfare, 1970.) Apparently, only one of five operations was reported. If compensation be made for women who received the operation but have since passed the age of 50, the rate is still lower. The nature of the statistics from the public opinion survey, however, does not allow us to draw precise statistical conclusions.

PUBLIC OPINION SURVEYS ON THE PERCENTAGE OF WIVES WHO HAVE HAD ABORPTION EXPERIENCE

1969, Office of the Prime Minister, Bureau of Public Information

Survey among a sampling of 3,000 married women, age 20-49. 2,597 respondents. Experienced abortion:

1 time_..

2 times.

3 times..

4 times...

5 or more times.

Forgot

No indication_-_-.

Did not experience__

No indication__.

Percent

21.9

11.9

4. 8

1.1

.9

.3

1.0

57.0

1. 1

1968, Aichi Prefecture Association of Women for the Protection of Human Rights Sampling survey conducted in and around Nagoya, among 1,500 married women, age 16 and above, representing roughly 1,500,000 women. Question. Have you ever experienced abortion? 62% Yes. 38% No.

1963, Aichi Prefecture Committee on Eugenic Protection Law

Gynecologists handed questionnaire to visiting patients, to patients of other departments, and to other women; 1.727 (74%) responded. They indicated experience with abortion as follows: 67% had experienced abortion (including 72% of the gynecologists' patients, 63% of patients of other medical departments, and 62% of the others). Of those with four children, over 80% had experienced abortion.

1962, study of Professor Yutaka Moriyama, Tokyo University Hospital

To the question why the first birth was so late, he received the following replies: 30.2% were practicing conception control, 26.5% had experienced abortion, 7.6% had experienced a miscarriage, 35.7% had been infertile.

(Reported in Aichi Prefecture family planning convention proceedings, Feb. 17, 1966.) He made a comparison of birth and abortion practice between those whose first baby was born in the pre-war years, and those in the postwar, with these results: