Reproduction in the Current World: Focusing on Prenatal Testing and Abortion

In this session, we will discuss current issues and challenges by examining prenatal testing and abortion from women’s, men’s, disabilities, and health care providers’ perspective.
Prenatal examinations in Japan are characterized by large number of ultrasound examinations performed during antenatal checkups and the small number of screening examinations using maternal blood. Ultrasonography is performed as a medical checkup with a purpose of managing the mother and monitoring the growth of the fetus. Obstetricians and gynecologists, familiar with prenatal examinations, consider ultrasound examinations separate from the more precise tests such as the nuchal translucency test. In reality, however, fetal "abnormalities" may be detected during the prenatal checkup, with amniocentesis and other diagnostic procedures in such cases.
Japan has been cautious about maternal blood screening tests due to the discriminatory nature of prenatal testing against people with disabilities. Still with the introduction of NIPT in 2013, testing began to be performed by non-obstetricians and spread rapidly.
In recent years, some clinics have begun to specialize in fetal diagnosis. Prenatal testing, undoubtedly, will become increasingly liberalized; however, this trend also poses a significant problem. What are the consequences of discussions that focus only on NIPT? There are at least three aspects to consider: (1) the way the pregnancy medical examinations have been conducted so far, (2) the physician-led obstetric care that has been provided, and (3) the legal question of abortion. We would like to discuss the above issues thoroughly, comparing and contrasting them with cases from other countries.