COVID19 Sheds Light on to Women’s Struggle with Contraception in Japan

By Elif Erdogan
translated to Japanese by danıel read

Kazuko Fukuda, the leader of the #Nandenaino Project speaks to VoiceUp Japan to share the situation of increased consultations from teenagers regarding pregnancy in Japan under COVID19 pandemic. We realize that inaccessibility to contraception is more than avoiding unwanted pregnancies, but it is political.

“Don’t blame it on corona, it’s on you” were the words of many users of social media as a reaction to the doubled number of teenage pregnancy consultations. “Since schools are closed, the time spent in the house has increased. So, I believe that parents cannot give attention to their children and that results in increased consultation by teenagers about pregnancies.” says Hitomi Kumada from the NGO Baby Bridge in her interview with ANN News.  However, can we really simplify the problem to “increased time at home without the parents”? Can we really put the blame on the girls? 

Figure 1 Youtube comments of the news that covers the increased pregnancy consultation of teenagers

Morning-After Pill in Japan

Emergency contraception such as IUD and morning-after pill are known to be a method of eradicating unwanted pregnancies in the shortest time possible. These emergency contraception methods work best if they are used in the shortest time. Therefore, these methods could prevent the number of pregnant teenagers, however the inaccessibility of the emergency contraception is just making the name “emergency” ironic. Organizations like PilCon and #Nandenaino Project showed that the morning-after pill in Japan is more expensive than many other countries costing people around $100, and it requires prescription and cannot be bought through pharmacy. It means you can obtain it only from the hospital or a clinic, therefore if the clinic is closed for holiday or night acquiring the morning-after pill only gets more difficult. Nearly 90 countries allow their pharmacies to sell morning-after pill without prescription, but not in Japan. 

Figure 2 Infographic made by #Nandenaino Project that compares the prices in other countries and in Japan. The infographic shows that in other countries the prices vary from 1000JPY to 5000 JPY, however in Japan it varies from 10,0000JPY to 30,000JPY

The survey conducted by the #Nandenaino Project (Why don’t we have it?) showed the reason why people gave up on using morning after-pill in pandemic even when they faced fear of getting unintended pregnancy (in total 38 people):

  • 55.3% said the price was too expensive to purchase
  • 36.8% said because of the coronavirus it wasn’t desirable to go to the hospital
  • 31.6% said they had a resistance to visit the gynecologist. 

The Situation under Quarantine

Figure 3 Kazuko Fukuda, the founder of the #Nandenaino Project

In our interview with Kazuko Fukuda, the founder of the #Nandenaino Project, she outlines how COVID19 situation affects women and contraception, referring to her survey conducted this year. “What I found through the survey is that some women have less power to say no in COVID19 time. One woman said they feel bad that they don’t accept the sex when the boyfriend asks her because she stays at his place. Or one person says because she stays at his house longer than before and he does more housework she feels bad to say no to him.  Or, because of corona the husband/partner feels more stress they feel like sex releases stress she feels like she has to accept it.

It gets harder to set the boundary and say no. And some say there is no place to escape or go so it gets hard to keep saying no. They are more vulnerable than before. says Fukuda. 

From this picture, we can see that along with the inaccessibility of the morning-after pill and being shut down in the house at this pandemic with a partner, it is harder to demand basic contraception. With its financial inaccessibility and the hardship of going to the hospital before, women found themselves in a situation where it is difficult to acquire the morning-after pill.

Results of Inaccessibility of the Morning-After Pill

The results of inaccessibility to the morning-after pill is more detrimental than many people may think. Abortion in Japan costs nearly $2000 and abortion pill is not available too. Therefore, if people decide to go under abortion they face with physical, mental and economic burden along with probability of infertility due to old-fashioned surgery. But for those who decides not to go under abortion it is a different story. Fukuda takes our attention by showing that there are news of women abandoning their child after birth and getting arrested. “1/3 of the students who got pregnant in high school leaves the school, which makes it hard to get a job if they only graduate from junior high school, especially when they become a single mother. Also, there are some women who cannot reach public support so that they deliver a baby in school bathrooms or manga cafes, and the baby dies. These women are the one getting arrested and blamed by society, but they are the victim of the lack of supportive environment. They should have access to sex education, contraception, and people to talk. Also we should not forget men are never in this conversation.” explains Fukuda.  If the number of consultations by teenagers increased twice more, that means that there will be more women who would be facing poverty and this hardship in their lives. Not being able to access emergency contraception can be crucial in this point.  

Why Don’t We Have It?

This conversation raises the question why the government would make the morning-after pill so inaccessible compared to other countries although the results are detrimental for women’s lives. For Fukuda there are several reasons: “Some people believe having better access to emergency contraception can encourage unprotected sex. Also, I believe there is still slut-shaming on women taking contraception in general as sex is still morally accepted only when they are for having kids.” According to her, the main power against the accessibility of the morning-after pill is the gynecology association. The men dominant political situation and society leads to the lack of financial support for the morning-after pill. To that, Japanese National Health Insurance cannot be used for the morning-after pill since it not a treatment of an illness, thus making the morning-after pill financially inaccessible. 

Figure 4 Kazuko Fukuda along with Pilcon founder, Asuka Someya (at right) and gynecologist Sakiko Enmi (at left) as the co-chair of Citizen’s Initiative for Pharmaceutical Access to Emergency Contraception (CIPATEC) talking in the national diet in 2019.

What Do We Want?

Right now, in Japan there has been several actions regarding making morning-after pill and other contraception methods more available. Fukuda says that she is trying to reach the policy makers in order to change the situation. She started the “Citizen’s Initiative for Pharmaceutical Access To Emergency Contraception (CIPATEC)”,with two other activists and, they have submitted 67,000 online petition to demand emergency contraception at pharmacy to the Ministry of Health, Labor and Welfare emphasizes on the urgency of morning-after pill under COVID19. “We don’t have many opportunities in Japan to provide young women with sex education including contraception. If morning-after pills become too easy to access, I’m concerned that they will start abusing it and think they could just use it again” was the response to the petition by the Vice President of Japan Association of Obstetricians and Gynecologists Tsugio Maeda. 

The words of Doctor Maeda sparked anger among people. “Most women feel a crazy amount of fear and don’t want to do it again (when the contraception fails). How can he say that? There might be some women like that, but it doesn’t explain the inaccessible situation.” Fukuda comments on Dr. Maeda’s words. In this regard, Dr. Maeda is missing what the general public desires. According to Fukuda the morning-after pill should be accessible, you don’t have to take it in front of the pharmacist, you do not have to go to the gynecologist after you take it if they get a period, an optimal price near 10 dollars and everybody can buy it with no limitation.

More than Contraception

COVID19 has shed a light to what is missing or wrong in our society. With the increased consultations of teenagers about pregnancy under quarantine, there is lack of discussion about consent and contraception, thus lack of sex education. RunaRuna, Health Information Service for Women’s survey showed that 34% of the women cannot say that they want to use contraception to their partner. The second most answered response to the question “Which contraception do you use the most?” has been “I don’t use anything” after the answer of male condom (78.2%). The inaccessibility of the information or the contraception itself is political and not new. The women’s control over their body and their lives has been limited by the government for many years and there is no improvement. Thus, the accessibility of a morning-after pill is more than contraception, it is political.  

If you would like to know about the clinics/hospitals that would provide you with contraception you can use this site. If you are not comfortable with going to the clinics or hospitals because of the pandemic you can choose the “online medical examination” オンライン診療.