When Will Japan Lift Ban on the Pill?

Box 21

Lack of access to a full range of family planning methods is a problem in some developed countries as well as in developing ones. Japan, for example, continues to ban oral contraceptives. It also bans the medicated copper intra-uterine device, proven in other countries to be safer than the non-medicated IUD approved for use in Japan.

Japanese physicians are allowed to dispense the pill only from their offices or clinics, and only for health purposes other than family planning. Critics charge that the policy increases the incidence

of abortion. Japan is the only developed nation that still bans the pill. The only oral contraceptives approved for doctors to dispense to patients are medium- to high-hormone versions proven to be more dangerous than the advanced low-dose versions. An estimated 200,000 Japanese women currently use the higher-dose pills.

"As far as reproductive health is concerned, Japan is a country of contradictions," said Dr. Kunio Kitamura, director of the Japan Family Planning Association’s Reproductive Health Centre Clinic. The JFPA, the Family Planning Federation of Japan (FPFJ) and the Japan Society of Obstetricians and Gynaecologists have been lobbying the health ministry for decades to make the safest version of the pill available to women—and to provide women and couples with up-to-date, accurate information about healthy contraceptive choices.

The health ministry’s previous plan to remove the ban was reversed in 1992, when it said increased use of the pill would reduce the use of condoms, resulting in an increase in HIV infections. The gynaecologists’ association, JFPA and FPFJ, however, point to various studies that show no correlation between the HIV infection rate and the availability of the pill.

Condoms account for three quarters of contraceptive use (and 46 per cent of couples’ use) in Japan, the highest levels in the world, according to United Nations’ estimates for 1994 (World Population Monitoring, 1996).

Studies indicate that only 35 per cent of pregnancies in Japan are wanted; 35 per cent are unexpected, 3 per cent are unwanted but carried to term, and 27 per cent are aborted. Researchers estimate the ratio of unmarried women’s abortions to pregnancies carried to term is considerably higher. Studies show that unwanted pregnancies are generally the result of condom failure, or more commonly, of the failure to use any contraception.

In February 1997, six NGOs, including JFPA, the Japan Society of Obstetricians and Gynaecologists and the Japan Society for STDs, completed a set of guidelines on the pill to provide doctors with information prior to its licensing. It is hoped that this action may serve to expedite the lifting of the ban.