(Bloomberg) -- Japan’s anticipated approval of medical abortion pills may come with a hurdle, requiring women to get approval from their partners before doctors will give them the drugs that have been available for decades in many parts of the world.

The country is considering an application from pharmaceutical company Linepharma International for the tandem medications to terminate pregnancies -- mifepristone and misoprostol, currently in use in more than 70 countries.

“In principle we believe that spousal consent is necessary, even if an abortion is induced by an oral medication,” Yasuhiro Hashimoto, director of the health ministry’s Child and Family Policy Bureau, said at a parliamentary committee this week, indicating that the medication could not be sought by a woman alone.

Only surgical abortions are currently permitted in Japan, with the Maternal Health Act requiring providers to get the consent of the patient’s spouse or partner, with few exceptions.

Led by the conservative Liberal Democratic Party for most of the post-World War II era, Japan has trailed many of its peers on women’s reproductive care. While oral contraceptives were approved in 1999 after a nine-year process, it took a government led by the same LDP only about six months to approve Pfizer Inc.’s erectile dysfunction drug Viagra. Morning-after pills are available by prescription only.

“It is weird to require an approval from a spouse when taking a pill,” Mizuho Fukushima, a lawmaker from the opposition Social Democratic Party, said at the parliamentary hearing. She expressed concerns that medical abortions will be priced higher than other countries. She added, “is Japan still living in the middle ages?”

About 140,000 surgical abortions were carried out in Japan in 2020, according to the health ministry. Abortions aren’t covered by insurance and cost between 90,000 yen and 150,000 yen ($700 to $1,200) in the first 11 weeks, estimates a local advocacy group, Safe Abortion Japan Project.

In the US, the Food and Drug Administration approved mifepristone as a method of abortion over two decades ago. As of 2020 it accounted for more than half of all abortions in the country, according to the Guttmacher Institute, which researches reproductive rights.

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