Japan maintains the lowest maternal and neonatal mortality rates globally but faces persistent challenges with contraception access, monitoring, and unintended pregnancies, particularly among adolescents and youth.
Japan has consistently maintained the lowest maternal and neonatal mortality rates, as well as adolescent birth rates, globally for the past two decades.
Contraception-related indicators in Japan remain suboptimal and inadequately monitored at the national level.
Unintended and unwanted pregnancies remain prevalent in Japan, despite a decrease in the percentage of unwanted pregnancies over time.
Adolescents (aged <20 years) and youth (aged 20–24 years) accounted for over 33% of the total 126,734 induced abortions in Japan in 2023.
The number of induced abortions among adolescents in Japan has consistently exceeded the number of live births in the same age group since the mid-1970s.
Key areas identified for improvement in Japan's SRHR include reducing unintended and unwanted pregnancies, improving contraception access and monitoring systems, and ensuring women's right to self-determination.
This research reviewed the state of sexual and reproductive health and rights (SRHR) in Japan, comparing it to global trends since the landmark 1994 Cairo Conference, which set international goals for reproductive health. The study found that Japan performs exceptionally well on some key measures — it has had the world's lowest rates of mothers dying in childbirth, newborn deaths, and teenage births for at least the past 20 years. However, Japan lags in areas related to contraception, with poor access and inadequate national tracking of contraceptive use. One of the most striking findings is that more Japanese teenagers have abortions than give birth — and this has been true every year since the mid-1970s. In 2023, young people under age 25 accounted for more than one-third of all 126,734 abortions in Japan. While the rate of unwanted pregnancies has declined over time, unintended pregnancies remain a significant issue, especially among young people. This research suggests that Japan needs to improve how it provides contraceptive information and services, particularly for adolescents and young adults, and better track reproductive health outcomes at a national level. The authors emphasize that women's right to make their own decisions about reproduction should be better supported, in line with international frameworks. Doctors specializing in obstetrics and gynecology are called upon to take a more active role in addressing these gaps, working alongside other health professionals and sectors of society.
Obara H, Haruyama R, Okawa S. (2025). Situation of sexual and reproductive health and rights in Japan in comparison with the world.. The journal of obstetrics and gynaecology research. https://doi.org/10.1111/jog.16273