Situation of sexual and reproductive health and rights in Japan in comparison with the world

Since the 1994 Cairo Conference, global efforts have focused on improving sexual and reproductive health and rights. This review examined the progress and challenges of the SRHR in Japan, comparing it with the global situation. SRHR indicators and situations were assessed using the United Nations Sustainable Development Goals' monitoring indicators and relevant reports. For the past two decades, Japan has consistently maintained the lowest maternal and neonatal mortality rates, as well as adolescent birth rates, globally. However, contraception-related indicators remain suboptimal and inadequately monitored at the national level. Although the percentage of unwanted pregnancies has decreased over time, unintended and unwanted pregnancies remain prevalent in Japan. Notably, adolescents (aged <20 years) and youth (aged 20–24 years) accounted for over 33% of the total 126 734 induced abortions in 2023. The number of induced abortions among adolescents has consistently exceeded the number of live births in the same age group since the mid-1970s. In conclusion, key areas for further improvement in Japan include reducing unintended and unwanted pregnancies, improving contraception access and monitoring systems, and ensuring women's right to self-determination. As outlined by the Programme of Action of the Cairo Conference, appropriate information and means should be provided to support women and men, including adolescents and youths appropriately, in making informed decisions about their fertility. In collaboration with various health professionals and other sectors, obstetricians and gynecologists are expected to be more actively committed to improving SRHR in Japan and the world.