If these Buddhist priests sense an incongruity between their teaching on the sanctity of life and their practice of providing guilt-relieving ceremonies for parents who have had abortions, they don’t talk about it. Mizuko kuyo has generated some controversy in Japan, but the contention isn’t over the morality of abortion but the morality of possible extortion by Buddhist temples. Many skeptics ask whether these temples are profiting off women’s guilt, particularly since many temples claim that if the parents don’t perform mizuko kuyo, the spirits of the aborted babies will wreak revenge on them (called tatari in Japanese). Yet even that belief of tatari acknowledges that these unborn children have a soul and feelings of anger, hatred, and jealousy.

Shokai Kanai, a semi-retired priest at the Nichiren Buddhist Kannon Temple of Nevada, has helped perform mizuko kuyo for many Japanese-American parents but uses strong words for abortion: “It’s very, very selfish. Abortion is killing a life—yes, a human life.” Now 75, Kanai was almost never born in 1942: His mother, then 29, had a difficult pregnancy and the doctors told her to choose between two options: Either she dies, or the baby dies. She chose to deliver Kanai and died a few days after his birth.

Today Kanai supports the legalization of abortion, though he calls abortion an “unnatural death”—and that’s why he does mizuko kuyo: The spirits of the aborted children, cut too early from life, might develop animosity toward their parents. Mizuko kuyo “eases this hatred and grudge,” Kanai said. It also helps the parents establish some sort of emotional intimacy with the deceased child through the bodily ritual of repentance, apology, and appreciation: “We have to save these suffering women who regret later on. If no regret, then no memorial service, you understand?”

“I’M SITTING IN MY ROOM with the drapes closed. I can’t eat. I can’t sleep. I can’t go out. What should I do?”

That’s a common question Cynthia Ruble and her team at Life Hope Network (LHN), a 14-volunteer group that counsels women with post-abortion issues and unplanned pregnancies, hear often. The voice is usually barely a whisper, sucked of energy and hope. Most of the post-abortion clients are unable to perform the normal functions of life: They cry constantly, suffer nightmares and flashbacks, and contemplate suicide. Some are teenagers, but some are in their 60s, still unable to forget or forgive themselves for what they did 20 or 30 years ago.

Ruble, an American missionary in Nagoya, Japan, founded LHN in 2005 when she realized there was no equivalent of a crisis pregnancy center in the entire country. She partnered with LIFE International, a Christian nonprofit in Michigan that helps start pro-life ministries throughout the world, and tailored LIFE’s post-abortion counseling curriculum to fit her Japanese clients’ needs. Three years later, she opened up a support line for women dealing with post-abortion trauma, and the phone has been ringing daily ever since.

Today LHN is still the sole post-abortion counseling center in Japan. Many of its clients turn to LHN as a last resort: They can’t go to their families for help, since many harbor deep resentment against the boyfriend, husband, or mother who pressured them into having an abortion; they can’t go to their friends, since abortion isn’t appropriate to discuss; and they don’t go to their Buddhist or Shinto priests for counseling. Most have sought mizuko kuyos or professional counselors—“but they find no comfort in it,” said Ruble: “They are really suffering, and nobody is telling them that abortion is a sin, that their reaction is moral, that it’s not odd, that it’s normal.”

Recently a group of nurses who staff the government-run prenatal support hotline in Tokyo visited Ruble in Nagoya, asking for training: These nurses have been receiving numerous phone calls from women dealing with post-abortion trauma, but they have no idea what to say to them. Ruble told them the one thing she knows: What these grieving women need and desire is forgiveness, and only the gospel can give them true, complete, liberating forgiveness.

And that’s what mizuko kuyo ultimately attempts and lacks: It addresses an innate recognition among the Japanese people that abortion is a moral problem—that it’s murder, an act against natural law, an injustice that demands retribution—and the whole ritual is a public expression of that awareness in bodily and verbal language. But mizuko kuyo also makes the practice of abortion more tolerable, removing it from the legal and political arena and placing it strictly in the realm of a religious institution that most Japanese people follow loosely. It’s an attempt toward retribution, but lacks restitution, said Ruble: “There is no Japanese solution to resolve guilt. There is no concept of forgiveness by God. So these women feel like they have to suffer until they die.”

This story has been updated to show the correct approximate cost in U.S. dollars for a mizuko-jizo statue.