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FOCUS September 2020 Volume 101

Young Women and Girls in "Pregnancy Conflicts"

Kiyomi Matsushita

What do people, many of whom likely unfamiliar with the words, imagine when they hear “pregnancy conflicts?” Perhaps they think of conflicts of “having or not having” or “raising or not raising” a child.

Piccolare was established in Tokyo as a non-governmental organization with a mission: to stand by and extend support to all women and girls who are in trouble or unsure of what to do with their pregnancy. The word “piccolare” was created by combining the words piko (navel, center or core in Hawaiian) and coccolare (to cuddle, to treat with great care in Italian). The name of the organization reflects its mission.

To the young women and girls, the “conflicts” they bring to Piccolare are matters of life or death such as “I will lose my job, if they find out about my pregnancy,” “I will lose the place where I stay,”“I want to go to the hospital, but I cannot afford to,” or “Is there any hospital that would accept me?”

In this society, there are “pregnancy conflicts” arising from fear of losing employment or places to live or being deprived of the life they have been barely maintaining. The pregnant women and girls who have these problems are mostly young, between ten to twenty years old.

A nineteen-year-old pregnant woman, calling herself “Stray Pregnant Woman” who worked six to seven days a week as a day worker and stayed at an internet café at night, spoke of her fear of being refused by hospitals. A twenty-two-year old pregnant woman contacted Piccolare during winter while trying to keep warm by staying close to a vending machine in a park. She suffered violence from a man she turned to for help. An eighteen-year-old feared that she might end up not being able to contact anyone because she could no longer pay the phone fee for her smartphone.

Women and girls who worry about their pregnancy and yet unable to consult anyone and bear the “conflicts” within them are not few. And they are not in distant and unknown places but are somewhere nearby.

Death from Abuse and Teenage Pregnancies

Government reports show that, among cases of death of infants due to abuse, the proportion of teenage mothers is significantly high. The proportion of these teenage mothers in the total number of births is stable at around 1.3 percent, while the rate of pregnancy among youth involved in cases of infant death due to abuse is at 17 percent (excluding death in collective suicides).1 Many deaths of infants due to abuse happen on the day they were born, with fourteen cases out of fifty-two reported cases.2 Of the fourteen cases, eleven infants were abused by their own mothers, seven of whom were twenty-four years old or younger. And in all cases, the mothers gave birth not in a medical facility but in the toilet or bathroom at home.

Approximately 90 percent have not been issued the Mother and Child Health Handbook, or received pre-natal health checkups.3 The deaths can be seen as the result of women and girls giving birth alone, unable to reach out to anyone.

Imagining Giving Birth Alone

Giving birth at the risk of one’s own life must have been a frightening experience.

The 2017 government report states that “The feeling of not wanting anyone to know about this [pregnancy] was stronger than the feeling of wanting to help the baby.” These words express the degree of their desperation.

If someone found out their pregnancy, they might completely lose their livelihood.

Are These Women and Girls the Abusers?

Why did they have to give birth at home on their own? Why did not anybody notice their pregnancy? Why did they have to continue their pregnancy?

Perhaps they would not have ended up as abusers if the methods of contraception were affordable and available, if they did not have to pay for the cost of giving birth, if the society had in place mechanisms that would prevent the isolation of the pregnant women and girls.

I hope that we will be more aware that it is this society that is the real abuser that caused the deaths of the children.

Pregnancies: Responsibility of the Women and Girls Alone?

Pregnant because of enjo kosai (being paid for dates), a twenty-year old woman began suffering morning sickness and was unable to earn a living. She started staying at her acquaintances’ homes, one after the other. By the time she approached Piccolare, the only thing she had eaten or drank for five days was orange juice. She was about to leave the place she was staying in for a few days. When we picked her up from the place, her lips were cracked and she could barely sit up.

Piccolare is often consulted by “drifting” pregnant young women and girls who have no place to stay and move from home to home of friends or acquaintances who are not their partners, as well as by teenage girls who may fall into such situation. Without the pregnancy, they could have continued earning income and having a place to stay.

Behind most of these “drifting” women and girls are problems that they cannot solve by themselves such as poverty, abuse, domestic violence, other forms of violence, precarious employment, mental illness and various forms of social exclusion.
Many of the women and girls who managed to come to Piccolare had been unable to ask anyone for help. When people are continuously exposed to poverty, abuse, domestic violence and other forms of violence, they become uncertain on whether they are allowed to ask for help or not. That is why they have been managing on their own, despite numerous difficulties.
But since pregnancy is not a matter they can face on their own, they were forced to ask for help.

We greet each woman or girl with
    Thank you for coming to consult us. From here on, let us think together with you about what to do next.

We listen to what they want to do and accompany them to local public offices and medical institutions to secure the necessary social welfare support  and services while negotiating with them so that they can avoid suffering any disadvantages. We accompany them to local public offices and medical institutions to secure the necessary social welfare resources. When they are finally able to see a path to move forward, many of them would say, “I thought I was going to be scolded, but I was surprised that I was thanked and praised.” They thought they would be berated because they believed it was their fault that they became pregnant.

The initial contact with the “Stray Pregnant Woman” was through an e-mail message. When I read the words “Stray Pregnant Woman,” I could not forget how devastated I was thinking about the desperation and isolation she must have felt. In her e-mail she wrote that she saw on the internet that “stray pregnant women” were refused by hospitals, and this was all their fault. Even though she could not get pregnant on her own, she wrote that it was all her fault. Responsibility is rarely sought from the other party in the pregnancy, and instead placed on the pregnant women alone. These women and girls find themselves in such unreasonable situation.

Is pregnancy the responsibility of women and girls alone? Why do pregnant women and girls have to take responsibility for the pregnancies? And why are the abusers in infant deaths all mothers who gave birth to them?

You cannot get pregnant by yourself. Why is this simple truth forgotten in this society?

Irrationality of Stigmatization of Contraceptives and Abortion

There are other irrationalities involving “pregnancy conflicts.”

In Japan, access to contraception and abortion is extremely poor. A campaign to improve access to emergency contraceptive pills collected 67,000 signatures, which were submitted to the government with a letter requesting the improvement of access. I hope immediate action is taken on this matter.

Under the Maternal Health Act, abortion is allowed only for health or economic reasons and in cases of rape. In these cases, induced abortion is allowed to be performed by a designated doctor.4

This irrationality isolates the pregnant women and girls who suffer from inner conflicts, leads to the way the society looks at them and shuts them out.

Changing the Way the Pregnant Women and Girls are Viewed

In May 2020, Piccolare cooperated with another non-governmental organization, PIECES, to open a place called PISARA for young pregnant women and girls who have no place to go and are “drifting.”

A pregnant girl who did not get along with her mother and ran away repeatedly from home spent two restful days at the place. We sent her back to her home, telling her that she could come back to PISARA any time when things got difficult. But she stayed home, gave birth safely, is now raising her child and working towards becoming independent.

Just being able to know that you have a safe place to go any time you want, may empower you to live through the days.
If so, when society’s positive view of these women and girls inspires safety, they may find it easier to live, even when their circumstances are severe. For this purpose, it is necessary to make the problems of these women and girls known and visible to the public. Piccolare is currently preparing a “White Paper on Pregnancy Conflicts – from the consultation desk of Pregnancy SOS Tokyo” to be published in December 2020.

Kiyomi Matsushita is a Social Worker and a staffmember for Consultation Support and Board Member of Piccolare.

For further information, please contact: Kiyomi Matsushita, Piccolare, 2-6-14, Senkawa, Toshima-ku, Tokyo 171-0041 Japan; ph 050-3134-4479; e-mail:;


1    See 14th Report on the Deaths by Child Abuse, Special Committee on Child Abuse (in Japanese), August 2018,
2    See 15th Report on the Deaths by Child Abuse, Special Committee on Child Abuse (in Japanese), August 2019,
3    14th Report on the Deaths by Child Abuse, Special Committee on Child Abuse, op. cit.
4    See Article 14(1), Chapter III, Maternal Health Protection, Maternal Health Act,