The development of reproductive policy in Japan has followed an unusual path compared to other industrialized nations. Specifically, women gained access to legal abortion in 1948, yet the low-dose contraceptive pill only became available in 1999. This paper argues that controversy over reproductive policy in Japan stems from the male-centered, patriarchal character of the political administration. Women's low representation in the national government is directly related to the slow development of policies protecting women's reproductive rights, because legislative acts of specific concern to women tend to be introduced through private members' initiatives.

Prior to the Meiji Restoration in 1868, abortion and infanticide were relatively common; however, abortion was designated a crime when it was added to the penal code in 1880. In 1940, people with disabilities became subject to forced sterilization under the provisions of the National Eugenic Act. In 1941, the government increased restrictions on abortion and birth control and issued the Program on Population Policy to increase the size of the “healthy” Japanese population.

In 1946, the adoption of a new constitution established legal equality between men and women. Two years later, the National Eugenic Act was amended to the Eugenic Protection Act, which granted women the legal right to abortion in certain circumstances, such as genetic problems. The following year, women were granted the right to have an abortion for economic reasons. Although abortion still appeared in the Japanese penal code in 1948, it had essentially been decriminalized.

Women's groups and medical doctors successfully defeated the ruling conservative political party's multiple attempts to impose new restrictions on abortion in the 1970s. Another factor that protected women's reproductive rights was the government's decision to sign the “Treaty to Abolish All Discrimination Against Women” in 1980 in order to maintain Japan's status as an “advanced country.” When the demand for reproductive rights grew among disability rights groups in the late 1970s and early 1980s, some feminist groups collaborated with them in a joint attempt to have abortion removed from the penal code as a crime. In 1996, clauses restricting the rights of people with disabilities were removed when the Mother's Body Protection Act amended the Eugenic Protection Act.

After the United States approved the use of the contraceptive pill in 1960, the Central Board of Medicine considered distributing it in Japan. The Board's deliberations were interrupted due to political concerns about the pill's effect on sexual morality. In 1966, certain middle-to-high-dose contraceptive pills were approved for use in the treatment of painful menses. Ironically, the male potency drug, Viagra, was legalized in just six months, whereas deliberations over the low-dose contraceptive pill lasted nine years. This notable situation stimulated public discussion about the sexual double standard in Japan, enabling women to finally secure government approval for the low-dose contraceptive pill in 1999.