POPULATION-JAPAN: Birth Control Pill Coming Soon, At Last?

By Suvendrini Kakuchi Reprint | | Print |

Suvendrini Kakuchi

TOKYO, Dec 15 1997 (IPS) - Mariko Goto, 40, is happily married and has a seven-year-old daughter. In the past five years, Goto confesses to having gone through two abortions.

“The experience was awful,” she says. “But I had no choice because the condom, the only method of birth control my husband and I have used, failed.”

Goto, though, may no longer have to turn to such desperate measures to keep her family small. According to press reports, the Ministry of Health and Welfare is finally on the brink of allowing Japanese women to buy the low-hormone contraceptive pill, which has been available for more than three decades elsewhere in the world.

“It looks like this time the government is ready to lift the ban (on the pill),” says Keiko Suwa of the Japan Women’s Association, a group that works on reproductive health issues. “If so, it will mark a step forward in the struggle for Japanese women to be able to choose their own methods of birth control.”

Japan is the only developed country that has not approved the low- hormone pill as a contraceptive. The health and welfare ministry almost allowed it to be prescribed and sold locally five years ago, but was held back by fears that the medication would reduce the use of condoms, and lead to the quicker spread of AIDS.

Then last February, the Central Pharmaceutical Affairs Council said the pill was as a safe and effective contraceptive. The health and welfare ministry’s green light is expected at the earliest by yearend, when the last Diet session begins.

Local women activists give credit for this to the United Nations Population Fund (UNFPA), which they say supported them in their fight for approval for the pill. Says Suwa: “The United Nations has played an important role in our struggle.”

Japanese women had spoken out on the issue at the 1994 United Nations population conference in Cairo, and had attracted the attention of UNFPA chief Nafis Sadiq. ‘

‘We pointed out that as a result of the legislation, Japanese women are forced to rely on men for birth control and also result to abortion, which is freely available in Japan,” Suwa says. “Both are risky and harmful to the women’s health.”

In Japan, which has one of the lowest birthrates in the world, a family with three children is already considered big. The main method of birth control here is the condom, which in 1995 was used by at least 77.5 percent of the male population.

Abortions, meanwhile, are done at the official reported rate of about 360,000 annually, but officials admit that the real number could be three times higher. Japanese laws allow pregnancies to be terminated up to the fourth week, so long as the pregnancy is harmful to the mother’s health.

But many women’s groups say Japan’s high abortion rate could well be attributed to the dearth of safer birth control methods available. Studies by the Japan Family Planning Clinic show that only 35 percent of the total number of pregnancies in a year are usually planned or wanted. About 35 percent are unexpected, while 27 percent are aborted.

For decades, both the family planning clinic and the Japan Society of Obstetricians and Gynaecologists have been lobbying the health and welfare ministry to make the low-hormone pill one of the country’s birth control options.

Ironically, Japanese pharmaceutical firms have been manufacturing the pill for years, solely for export to Asian countries and the United States. What are prescribed and sold locally are the medium- and high-hormone pills, which are considered to be more dangerous. These pills are supposed to be used only to regulate menstruation, and not for birth control.

Demand for the low-hormone pill is expected to be large. According to the Ministry of Health and Welfare, the domestic market for the pill may amount roughly to 780 million U.S. dollars, based on the population of Japanese women in their child- bearing years.

Some ministry officials worry, though, that approval of the pill may be followed by a decline of morals among the youth. But Suwa dismisses this concern, arguing that “correct” sexual education for men and women would work against such a problem.

Besides, she adds: “Without the pill, Japanese society has not gotten any more different than its western counterparts.” Japanese youngsters these days are becoming sexually active at a younger age than teenagers of a decade ago, say researchers.

Meantime, officials remain concerned that the availability of the pill would dissuade men from using the condom and thereby risk a rise in HIV infections. And while women activists are one in saying the low-hormone pill is a safer birth control choice than what is currently available, some fear women will be hurt in the long run.

“With the approval of the pill, women will become solely responsible for birth control,” explains Keiko Tsuwa, a member of a citizens’ group on women’s health. “It will let men off the hook, and that is not fair.”