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Students, activists petitioning to make emergency contraception easily accessible in Japan

Kazuko Fukuda (Mainichi/Satoko Nakagawa)
NorLevo, the emergency contraception pill that was approved for use in Japan in 2011, is pictured here in a photo taken Dec. 6, 2017. In many countries in Europe, North America, Asia and Africa, emergency birth control can be obtained without seeing a doctor. (Mainichi/ Kaori Owada)

TOKYO -- The morning-after pill, also known as emergency birth control or emergency contraception, cannot be obtained in Japan without a doctor's prescription. Today, women -- and men -- in Japan are raising their voices against this state of affairs.

When a woman takes one emergency contraception pill within 72 hours after sexual intercourse, ovulation is suppressed. In Japan, the hormonal medication levonorgestrel, under the product name NorLevo, was approved in 2011. According to gynecologist and Japan Family Planning Association (JFPA) Chairman Kunio Kitamura, the pregnancy rate after taking the emergency contraception pill after one instance of sexual intercourse is 0.7 percent. (The general pregnancy rate for healthy men and women in their 20s after one instance of sexual intercourse is 20 to 25 percent.)

Side effects of emergency contraception are rare, as are lasting impacts on the body, and even if a woman were to discover she were pregnant after having taken levonorgestrel, the fetus would not be affected. The woman, however, is at risk of pregnancy if she has sex after taking emergency contraception.

As emergency contraception becomes less effective the more time lapses after intercourse, it is important to take the pill as quickly as possible. It is easily available at drugstores in many countries, but cannot be bought in Japan without a doctor's prescription. In cases of rape, for example, time is of the essence. But gynecology clinics could be closed or too far away, making it difficult for women to get their hands on emergency contraception. Moreover, levonorgestrel pills come with a hefty price tag of 10,000 yen each.

Two years ago, Japan's Ministry of Health, Labor and Welfare deliberated converting emergency contraception from a prescribed medication to an over-the-counter drug, but the plan was shelved due to opposition from groups such as the Japan Society of Obstetrics and Gynecology (JSOG).

A Change.org petition demanding that emergency birth control be made available on an over-the-counter basis has been started by Kazuko Fukuda, a 23-year-old senior at International Christian University in the western Tokyo suburb of Mitaka, and Asuka Someya, who chairs the nonprofit sex education organization Pilcon. As of 6 p.m. on Jan. 14, around 16,500 people had signed the online petition, which will be submitted to the health minister, and the respective chairmen of the Japan Society of Obstetrics and Gynecology and the Japan Pharmaceutical Association.

Fukuda studied abroad in Sweden, and was astonished by the breadth and depth of sex education and birth control methods she was introduced to there. She resolved to change Japan from being a country where there is so little in the way of education and agency regarding sex. Last spring, after she returned from Sweden, she began the #nandenaino -- literally #whydowenothavethis -- project, which aims to spread information about sex and contraception.

In Sweden, youth clinics are set up in each community, where young people can go free of charge to consult with professionals about physical and emotional issues. These clinics teach specific ways to prevent pregnancy as well. Emergency contraception is provided for free or for the equivalent of several hundred yen, and a wide range of birth control options are made available, including hormone stickers that can be affixed to the abdomen, and female condoms.

"It's considered a basic and natural right in Sweden for young people to acquire accurate information at these youth clinics," Fukuda says. "But in Japan, sex education is not only insufficient, any interest in sex is liable to be seen as 'immoral' or 'problematic behavior.' I was made keenly aware of how little Japanese youth are protected."

Japan Family Planning Association Chairman Kitamura agrees that emergency contraception should be made an over-the-counter medication. "It's definitely a method that should be reserved for emergency situations, but considering the risks of unwanted pregnancies or abortions, it's imperative that emergency birth control be made easily available as soon as possible," he says. Kitamura adds that whenever he prescribes emergency contraception, he always recommends that the patient consider going on low-dose birth control pills taken daily. Those pills, too, require a prescription, and cost about 3,000 yen for a month's worth. They are extremely effective in preventing pregnancy, but due to a lack of information, among other reasons, the number of women in Japan taking the pill has grown very little.

"Improving access to emergency contraception, including making it easier for women to shift to using regularly taken low-dose birth control pills, needs to be discussed," Kitamura says.

(Japanese original by Satoko Nakagawa, General Digital News Center)

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