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Asia Stream: Abortion in Asia -- Beyond Taboo

Abortion rights in Asia are not just about women's autonomy. From population control to sex selection, we break down abortion access and its complex consequences across the continent.

NEW YORK -- Welcome to Nikkei Asia's podcast: Asia Stream.

Every other week, Asia Stream tracks and analyzes the Indo-Pacific with a mix of expert interviews and original reporting by our correspondents from across the globe.

Listen on: Apple Podcasts | Spotify | YouTube

Abortion is the talk of the United States right now as the Supreme Court prepares to release a decision that could overturn Roe v. Wade, the case that enshrined abortion rights nationally. But what's happening in the places where abortion is a quieter conversation? What about the state of reproductive rights in Asia?

This episode, we survey the laws and attitudes regarding abortion in Asia. We place special attention on four countries: China, Indonesia, India and Japan. Our reporters Marrian Zhou, Ismi Damayanti and Kiran Sharma fill us in, while host Waj Khan and producers Alice French, Monica Hunter-Hart and Jack Stone Truitt guide the story. Asia Stream is hosted by Wajahat S. Khan, our digital editor and executive producer, and produced by Monica Hunter-Hart and Jack Stone Truitt.

Related to this episode:

Abortion in Asia: The limits of choice, by Ismi Damayanti, Kiran Sharma and Arisa Kamei

China's three-child policy aims to head off demographic crisis, by Iori Kawate

TRANSCRIPT:

(Theme music in)

WAJ KHAN, HOST: Hello, and welcome to Asia Stream, where we track, report and analyze the issues and interests of the world's largest region.

I am Waj Khan, Nikkei Asia's digital editor, here in New York City.

Today's episode: Abortion in Asia -- Beyond Taboo.

Abortion remains a complicated, divisive topic across the world. Any day now in the U.S., the Supreme Court is expected to overturn a decades-old law, premised on the landmark case of Roe v. Wade, which will deny American women the right to end their pregnancy. In the White House, the Biden administration is scrambling to give women in Republican-controlled states more options, if and when the law is overturned. In a hyperpolarized America, this may be the most contentious issue of all. A debate between the progressive "pro-choice" and the conservative "pro-life" camp, not really as black versus white as it is blue versus red, for in the United States' two-party system, it's easy to demarcate who lies where on the subject, with Democrats seeking to expand abortion rights and Republicans looking to restrict them.

But beyond America, there is a larger debate about the controversial medical procedure, which, by the way, is widely practiced, globally. According to the World Health Organization, 6 out of 10 pregnancies worldwide end in abortion. In Asia, at least 36 million women have abortions every year. Many of them don't live through the procedure. But in the world's largest region, the abortion debate isn't just a two-way argument like it is in the U.S. Rather, religion, population control, gender selection and cultural taboos all intertwine to form a staggering, complicated picture about what a woman can or cannot do with her body.

Put your thinking cap on. We've got quite the show.

You're listening to the sound of Asia, streaming in your ear.

From Nikkei Asia, this is Asia Stream.

(Theme music out)

KAORI YOSHIDA, ANNOUNCER: A reminder that Nikkei Asia is currently offering an exclusive discount for our podcast listeners. Get three months of our award-winning coverage for just $9. To redeem, just click the link in the episode description.

KHAN: Whatever your opinion about abortion, the numbers don't lie. About eight years ago, the WHO funded a study looking at abortion rates worldwide. Within Asia, the safest abortions were carried out in East Asia -- places like Japan, China, Taiwan and South Korea.

But the most unsafe places in Asia to get an abortion, gauged by the highest case fatality rate -- women dying in the procedure of abortion -- were in South Central Asia: India, Pakistan, Bangladesh, Afghanistan, the former Soviet "Stans," etc. Just over half of the abortions in that region were conducted safely. That's a staggering rate, as almost 1.9 billion people live in South and Central Asia, the most populated part of the world.

But why this topic, and why now? Well, with the expected reversal of Roe v. Wade, millions of Americans are up in arms about the future of women's rights in this country. But what happens in America doesn't just stay in America. The impact of American law has had and will probably trigger a larger, international debate. Here's a fact. Abortion is real. Unless you live alone on an island, hundreds if not thousands of abortions will have happened, legally or illegally, in the country you're in by the time you're done listening to our show today. And if you're from Asia, you'd probably acknowledge that this hush-hush topic doesn't get the airtime it deserves.

With that in mind, our coverage of abortion in Asia is inspired by Nikkei Asia's Big Story this week, which is also on the same topic. We hope you grab a copy from your favorite newsstand or check out our Big Story on asia.nikkei.com.

With that, let's turn to Asia Stream correspondent Monica Hunter-Hart, who will take a look at Asian abortion laws and perspectives through three case studies: China, Indonesia and India. Over to you, Monica.

HUNTER-HART: Thanks, Waj. Let's start with the largest country on Earth by population, where abortion has historically been used as a means of population control. I'm talking, of course, about China. Here to discuss is our Beijing-born New York reporter, Marrian Zhou. She's one of 11 journalists who reported out Nikkei Asia's new, big feature on abortion rights in Asia. So Marrian, unlike much of Asia, abortion laws in China are very lenient -- abortion is legal and quite accessible. Tell us why that is.

ZHOU: Well, because China had the one-child policy for a long time. That was implemented, you know, back in the 1980s. It was used to curb population growth. So, you know, parents with unauthorized pregnancies, they would face serious fines, you know, and sometimes forced abortion. So abortion has been long accepted as a tool to, you know, terminate unwanted pregnancy. And in Chinese society, you know, it's, it's not so much a taboo, unless you are not married as a woman, and you have a child, then, you know, people might judge you in a certain way, which is a stigma that I think a lot of feminists are trying to address right now.

HUNTER-HART: As background for listeners, currently Chinese parents are allowed to have up to three children. And that's because China has a demographic crisis. From 2010 to 2020, the number of people at or above 65 years old increased by 60%, and at the same time, the working population fell 4% from 2013 to 2020. The PRC [People's Republic of China] is worried about having enough young people to economically support the elderly population. With this in mind, last year, the Chinese authorities came out with a 10-year plan that included language saying they aim to reduce the abortion rate. The note was short and vague, though. Does this signal a significant sea change? Might the PRC restrict abortion access anytime soon?

ZHOU: So it took the Chinese government a very long time to change the one -- the one-child policy, or to roll back on it, right? So, you know, generally, when the law in China is inked, it's hard, it's very hard for them to roll back on it, you know, especially like something like abortion, which has long been accepted as available tool. So, you know, it's very unlikely that they would take it away just because of the population growth. There are other ways that, you know, they could encourage people to get married and have children than taking away abortion.

HUNTER-HART: Got it. Switching gears a little, some analysts compare the PRC's stance on abortion to eugenics, which is the practice of labeling some human traits as more desirable than others, then selectively breeding populations -- or in some cases sterilizing populations -- to quote-unquote "improve" the human species. That's a pretty strong claim. Eugenics remains one of the most controversial scientific topics of our time. What is meant by that?

ZHOU: If you're, if you're pregnant, and your baby is not healthy, I think it's pretty accepted in the Chinese society that abortion will be a better solution. The government would, would support -- even though they want more babies to be born -- but they would want healthy babies to be born. To them if you're born with, you know, health complications, that's more burden on the society, more burden on social services. It's not like, you know, every Chinese family is practicing this. It's just more accepted, you know, in government value.

HUNTER-HART: Thanks, Marrian. Let's move on now to one of the biggest factors that influences abortion laws across the world -- that is, of course, religion. I'm going to run through some major religions that are practiced in Asia, with a couple important stipulations. One, the level of religious strictness regarding abortion doesn't always translate to an equivalent legal strictness in the places where those religions are practiced, and two, there's of course great variation in the beliefs of individual practitioners. But here we go: On the most restrictive side, you have the Roman Catholic Church, which considers abortion to be a grave sin under any circumstances. That dogma of course affects the Asian Catholic-majority countries of the Philippines and Timor-Leste. Hindu texts say abortion is unacceptable -- in Asia, that primarily affects India and Nepal. In terms of Buddhism, many traditional sources say abortion is wrong. That's the view the Dalai Lama holds, though he's said that it to some extent depends on the circumstances. Buddhism is particularly common in Southeast Asia, including in Cambodia, Thailand, Myanmar and Laos, but goes all the way west to Sri Lanka and as far north as Bhutan. Islam, which is practiced widely from Malaysia to the Middle East, isn't particularly clear. Islamic scholars disagree about the extent to which abortion should be allowed, so it varies a great deal from place to place, though even the strictest laws almost always allow abortion to protect a pregnant woman's life. To delve just a little into the "God factor" affecting abortion in Asia, we took a look at the world's largest Muslim country -- Indonesia. And we spoke to Ismi Damayanti, our correspondent in Jakarta. Here's what she had to say:

ISMI DAMAYANTI, CORRESPONDENT: So currently the abortion is, is legally recognized in Indonesia only under two circumstances, as regulated by the law on health. First is for medical emergency, and then the second circumstances would be the pregnancy from rape -- the unwanted pregnancy from rape. Indonesian Muslim are mostly following some sort of a school of thought in Islam, which is this Shafi'i school, that that ceded the abortion would be required under circumstances. And this Islam references on abortion has been made formal through through the Indonesian Ulema Council, the cleric council, the most prominent organization, who is our vice president has this background, from this organization. It is that prominent. So. In addition, they make clear that the practice of ab -- abortion by choice, either for those who are unexpected of a married, married couple -- who apparently you would not expect, expect their pregnancy -- or or those from extramarital relationships are strictly forbidden.

HUNTER-HART: Ismi interviewed a young woman who had one of those illegal abortions when she was at university and unmarried. Her name has been changed for her protection; we're calling her Rara. Rara went covertly to a place in central Jakarta to get the procedure.

DAMAYANTI: It shows nothing showing that it's an operation, especially a medical operation place, you know.

HUNTER-HART: Rara went with the man who impregnated her, and because they didn't know of the clinic's exact location, they walked around looking purposefully confused until a person approached them and subtly asked Ismi about her period.

DAMAYANTI: Someone could appear, and, "Are you late?" Just asking you around like that. And yeah, that's the very person who would lead you to the actual place of the, of the, of the clinic.

HUNTER-HART: Such people are employees of these secret clinics and get paid a commission for each customer they bring in.

DAMAYANTI: According to her, it's quite a cold treatment. It's quite a cold behavior from the, from the doctors and, and the nurse. And that's what made her nervous about it the most.

HUNTER-HART: Here's Rara herself talking about the procedure.

(Rara's voice rises, then falls below translation)

RARA: When the abortion was carried out, I was very nervous because the doctor didn't tell me anything to do before the treatment started. I was only asked to change into a gown and sit on the chair with my legs opened facing upwards. That was surprising, because there was no anesthetic.

DAMAYANTI: She told me that she suffered a bleeding. That she wasn't even, you know, dared or willing to ask if it's all right or not, you know? If a week long of bleeding is normal. And she could not really tell anybody about that. That's how challenging her situation was. When the bleeding stop, she said, the period pain was similar something like when she had the abortion. It's something like she said so excruciating, and that's how she could really recall how traumatic, how traumatic the experience was.

HUNTER-HART: Those excruciating periods continued for about a year. If Rara's abortion was ever discovered, both she and the doctors that performed the procedure could be charged with criminal offenses. If the man who impregnated her were found to have persuaded her to get the abortion, he could be charged, too. The fine would be up to a billion rupiah, which is the equivalent of almost 68,000 U.S. dollars.

DAMAYANT: It was never an option to keeping, because the situation of the guy having a serious girlfriend on the other side and she said, says she was coming from a religious family that would not even tolerate such, such situation to ever getting discovered.

HUNTER-HART: Here's Rara again, describing her complex views on the procedure.

(Rara's voice rises, then falls below translation)

RARA: I do believe that abortion is wrong. I researched that this is a criminal act. But there was no other option, because the guy already had a girlfriend. They had dated since high school and had no plan to break up. I also didn't want to date him, I didn't have feelings like that. And if my parents had found out about my pregnancy, I might have been kicked out of the house and had to leave college. I understand that a fetus becomes a baby and then becomes a human. Abortion means killing it. But there was no other option.

HUNTER-HART: Rara does, however, think that women in difficult situations like hers should be able to get legal and safe abortions. Here's our reporter Ismi again.

DAMAYANTI: It's still a long way for for feminist movement, for, for really moving towards that women actually having the right to govern our body. Everyone felt like they have the right to judge and to, to let this female lady know what to do with their body. And yeah, sadly even the the National Commission for Violence Against Women noted that even for for carrying the abortion for and with unwanted pregnancy from rape, was still an issue to enforce. You know, it's it's sad to admit that it's still gonna be another fight to get women who suffer sexual harassment or abuse with the police would face like victimization, you know, something like: "Were you would you triggering it?" "Were you wearing something that would let this rapist, would actually want it to do such crime?" It's still common, you know, even on the, on this legal abortion for, for women who are suffering from rape.

HUNTER-HART: So far, we've looked at population control and religion as factors that influence the conditions around abortion in Asia. Let's take a look at one other major element: The preference for male children, which leads to something called sex-selective abortions. That's when a fetus is aborted because of its sex organs. This happens across the world, mostly to avoid raising girls. Boys are considered more able to provide for the family when they grow up. In Asia right now, sex-selective abortion is most prevalent in Vietnam, China and India, the country we're going to discuss next. Abortion has been legal in India since 1971, but it's only allowed under limited circumstances, including fetal abnormality, risks to the health of the mother, and failure of contraception, which as you can imagine, is a complicated thing to prove. Sex-selective abortions are against the law in India. Doctors aren't even allowed to tell you the sex of your fetus. But these laws are very hard to enforce. We spoke recently to our correspondent in New Delhi, Kiran Sharma, who told us more.

SHARMA: Yeah, the male preference is huge in India, because -- India mostly being a patriarchal society, you know -- there is a cultural preference for a male child, especially, you know, in the country's north. A boy is traditionally seen as, as an heir and breadwinner of the family, while a girl is treated as a financial burden who will be married off and sent to another house with huge dowry, for which the parents start, you know, saving from the day a girl is born in the family. So she's treated as a liability. So if you have a male child, then the respect for you goes up in the family, among your relatives and the society. And it is so unfortunate, because, you know, how you are treated depends on, you know, what you have delivered. And especially in the business families I know, because they have really been under pressure after they got married to deliver a male child because they would be told, "Who would take the business forward?" So, because a girl is not considered as someone who is efficient enough, and who is someone who will stay with the parents to carry forward the business of the family, or even the name of the family, because she's eventually going to get married and going to stay in someone else's place.

HUNTER-HART: The male preference exists even across class lines and other demographic differences, Kiran says. She spoke to an activist who conducted a survey at Delhi University, one of the most prestigious schools in the country, and the vast majority of 18- to 22-year-olds at this elite university said they'd prefer a boy.

SHARMA: Because now they think that the cost of living has gone up so high and they can't afford to have more than one child, so if there is going to be only one child, then it better be a boy. And having experienced myself over the years, because I live in the society, I am a woman, and I have two children, I have a son and a daughter. When I had conceived my daughter, second child, another journalist colleague of mine, who was a female, came to me and, you know, she asked me, "What was the need to go for another child, you already have a boy?" So this is the kind of, you know, mentality you see around yourself, because I have been among people who are educated, who are writing about women's rights, you know, and who are talking about welfare of women and they are coming to me and saying that, "Why, what's the need for another child, there is already a boy in the family." And that's why when I hear all these things, they don't shock me.

HUNTER-HART: The number of girls born compared to boys is increasing every year in India, but there's still a significant gap. According to government statistics, for every 1,000 boys born in the last five years, just 929 girls were born. So, according to Kiran's reporting, there currently isn't a major push among women's rights groups to further increase abortion access.

SHARMA: They think that those rights are already quite liberal. Because abortion is legal in India, in India for the past 50 years or so. And, you know, the more rights they see, in terms of abortion, there is a greater chance of, you know, sex-selective abortions increasing. So, they don't want to, you know, make much of an issue about it, and they are quite OK with the kind of rights India has on abortion.

HUNTER-HART: Across Asia, there's great variation in abortion laws and attitudes -- but we've just seen three themes emerge: the use of abortion for population control, its use for sex-selection, and restrictions based on religious influences. On a personal level, as a Western, American woman, it's been interesting to learn about perspectives that are so different from the way I'm used to abortion being framed as a black-and-white moral issue -- with "pro-life" advocates believing it's good and just to protect fetuses, and "pro-choice" advocates believing it's good and just to protect women's right to choose pregnancy. Some of the examples we just looked at are more grounded in questions of utility -- like, what size should a population be in order to sustain itself? Or, how is the sex of my child going to affect my family's economic well-being? Abortion's a deeply complex issue everywhere. These stories highlight just a bit of that complexity.

KHAN: That was Monica Hunter-Hart taking us inside of our comprehensive feature story -- it's called The Big Story for a reason -- but now we're going to take a step back and get a bird's-eye view as Nikkei Asia correspondent Jack Stone Truitt speaks with our Big Story editor, Alice French, about abortion throughout the rest of the continent.

JACK STONE TRUITT: Thanks, Waj. We just heard about three of the world's largest countries, but our feature story covered 11 countries across Asia, where laws and cultural dynamics around abortion vary greatly. Laws are liberalizing in Thailand, where the procedure was legalized up to 12 weeks last year. South Korea also decriminalized abortion last year, but regulations there are still being hashed out. And the country's large Christian community is pushing back. Christianity, specifically Catholicism, is the major force in the Philippines, which has some of the most restrictive abortion laws in the continent. So does Bangladesh, where illegal abortions lead more than 90,000 women to seek medical care from the unsafe procedures.

And of course we'd be remiss to neglect Nikkei's very own Japan, where the Tokyo Dispatch host and Big Story editor Alice French is joining me from. Alice, thanks for being here.

ALICE FRENCH: Thanks for having me.

TRUITT: So Japan was actually the earliest country in Asia to legalize abortion, which it did in 1948 as part of what was called the Eugenic Protection Act.

Now abortion is still legal -- in fact, reproductive health is a major part of its ranking of 19th on the U.N.'s gender equality index. But Japan is a very patriarchal society in many other ways. It scores quite poorly, for example, in terms of women in politics and in the labor force. So what are the cultural dynamics around abortion in Japan?

FRENCH: So as many of you know, Japan is currently in an aging population, almost 30% of the population are over 65. And Japan recorded its sixth consecutive year of record-low births last year. So there's a lot of pressure on the government to solve this aging-population problem. And as the population has been going down, the stigma surrounding abortion has been going up. On top of that, it's very expensive, you can be paying around $2,000 for the procedure, and all of the checks that surround it. And women also are still required to provide a male signature in order to get an abortion. Now, technically, the law only requires a male signature from married mothers. So it only requires a spouse's signature. But the punishment on doctors for performing for performing abortion without consent, is so harsh, it can be up to seven years in jail, that doctors often ask women to provide a male signature just in case in order to save their own backs. There have been some cases of rape victims and sexual assault victims being turned away because they couldn't provide consent from their abuser. And there has been a little bit of movement in recent years to get rid of this spousal consent stipulation. But the government are very unwilling to do so partly because of demographic pressure, and partly because of the social stigma and the shame surrounding abortion as a whole.

TRUITT: Abortion is once against dominating headlines here the U.S. where the Supreme Court could overturn the landmark abortion case Roe v. Wade due to a conservative shift in the judiciary. But the politics and framing of abortion varies so much from one place to another, let alone somewhere as diverse as Asia. How did those differences from one country to another stand out to you in this story?

FRENCH: When we started commissioning this story, our plan was really to show how the decision in the U.S. with regards to Roe v. Wade would be affecting Asian abortion in Asia. But as we started to report on it, we realized that actually, it's pretty much impossible to say what the impact of the U.S. decision will have over here. There are very few countries in Asia where abortion is even considered a women's rights or a human rights issue. It's too deeply entrenched in politics and demographics and religion to really be considered part of any sort of feminist movement or female empowerment movement. Having liberal abortion laws does not always equate to a lot of women's rights. And I think that's my main takeaway from the story. And that was quite surprising, because I think in the States and the West, in general, it's considered if there are liberal abortion laws, then there must be good women's rights. It's all about autonomy, it's about choice. And that's not necessarily the case in a lot of Asian countries.

TRUITT: So as far as Roe v. Wade's impact on Asian abortion laws goes -- it sounds like there's little reason to believe it will have much of an impact for now, is that right?

FRENCH: We have had a few activists expressing concern over the fact that if the U.S. which is generally seen as a sort of progressive, liberal country, if even in the U.S., abortion rights are going to be restricted, then one can only assume that that might galvanize anti-abortion rights people in Asia too. So there are some activists that are concerned about that. But the overwhelming the overwhelming opinion that we heard from activists and experts is that probably abortion in Asia is too far removed from women's rights to really be impacted by the Roe v. Wade decision, but we'll have to wait and see.

TRUITT: Alice French is our Big Story editor in Tokyo. Alice, thank you so much for joining us.

FRENCH: Thank you very much.

KHAN: That's it for Asia Stream this week.

(Theme music in)

KHAN: As always, I encourage you to head to Nikkei Asia at asia.nikkei.com for more in-depth coverage of the abortion debate and all things related to Asia. If you enjoyed this podcast, please share, subscribe and leave us a review -- and hopefully a five-star rating! And a last reminder that Nikkei Asia is currently offering an exclusive discount for our podcast listeners. Get three months of our award-winning coverage for just $9. To redeem, just click the link in the episode description. This episode was produced by Alice French, Monica Hunter-Hart and Jack Stone Truitt. I'm your host, Waj Khan.

We'll stream again in two weeks -- till then, try to be a stream player.

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