The politics of reproduction co-produced by abortion and medically assisted reproduction: a comparative case study of Italy and Japan

Abstract

My dissertation investigates how abortion and medically assisted reproduction (MAR) co-shape the politics of reproduction. Abortion and MAR serve opposite reproductive outcomes: whereas abortion is performed to terminate unwanted pregnancy, MAR is utilized to achieve pregnancy in the case of involuntary childlessness. Yet both are part of reproduction, i.e. processes of having or not having children.

First, I look at the macro-level interaction between abortion and MAR, especially cross-agenda references between regulations in the two policy areas. Because both abortion and MAR involve the same legal and ethical issues including the beginning of life, the status of the unborn, as well as the state responsibility for human life, regulatory debates in each policy area may pave the way for politicization of the other. Analysis of regulations in both fields can also illuminate who is allowed to attain the (non)procreative outcome they desire under these policies.

Second, I investigate the meso-level interrelations between abortion and MAR, focusing on how training and qualification of physicians and other healthcare professionals are organized in abortion care and fertility treatment. The study pays special attention to how medical professionals are taught to navigate the tension between patient autonomy and medical authority in both abortion and MAR. This includes the choice between medial and surgical abortions as well as selection between available MAR options.

Third, I scrutinize the intersection of abortion and MAR at the micro level, taking multifetal pregnancy reduction (MFPR) as a showcase. MFPR is a procedure to abort one or more foetuses in multiple pregnancy, which occurs more often following MAR. By investigating how MAR patients experience the procedure, the study explores the converging point of abortion and MAR at the individual level.

The study looks comparatively at the Italian and Japanese cases, following a most-similar systems design. The two countries share societal features that are relevant to reproduction, including strong familialism i.e. a great emphasis on family as a welfare provider in the welfare state organization as well as a lowest-low fertility rate with a rapidly aging population. Both countries maintain abortion in the penal code with a special law which exempts the criminality of abortion under certain cicrumstances. In both Italy and Japan, de facto access to legal abortion is more restricted than de jure access. Both countries are currently in the process of increasing the access to MAR, while certain groups such as same-sex couples remain excluded.