A government proposal to restrict Japan's liberal abortion law has angered women's groups and provoked a heated debate over women's rights to family planning in a country that has not yet approved oral contraceptives.
The Health Ministry plans to cut the time limit for a legal abortion to 22 weeks of gestation from the current 24 weeks to comply with new definitions of viability expected to be adopted by the World Health Organization in May, according to Toshihiro Hara, deputy director of the mental health division, which is working out the new abortion guidelines.
A Japan Obstetric and Gynecological Society study has shown that premature babies born at 22 weeks have survived, said Dr. Eikichi Matsuyama who serves on the advisory body urging the change.
He added that doctors' groups are recommending better sex education along with the abortion restrictions.
Women's groups have petitioned the Health Ministry to abandon the proposed change in the abortion law, which they see as a further restriction on what few reproductive rights Japanese women have.
"This is an example that the government does not recognize a woman's right to control her own body," said Yayoi Aoki, feminist author and historian who actively opposes the proposed change.
Women's organizations and many doctors are pressing the government to promote education on sex and contraceptive methods so as to increase family planning options and reduce the need to resort to abortion.
Condoms, sold in vending machines, are the most common form of birth control in Japan, while intrauterine devices are rare and diaphragms nearly non-existent, according to gynecologists.
Oral contraceptives are illegal although hormone-based drugs of a similar composition are used to treat gynecological problems.
"When it comes to contraception, Japan is not just a developing country, it's underdeveloped," said Yuriko Ashino of the Japan Family Planning Federation.
Opponents are bitterly fighting the proposed abortion law change.
They argue that tighter restrictions will hurt the weakest--more than half of the 2,000 annual abortions during the 23rd and 24th weeks of pregnancy are performed on women younger than 25.
The Health Ministry does not expect tighter rules to cut the number of abortions, which was 15.6 per 1,000 women in 1988, or a total of roughly 486,000.
Japan has built up a reputation for reliance on abortion because of its common practice among married women in their 30s, Matsuyama said.
Japanese law permits abortion for economic reasons, which are cited in more than 90% of cases, doctors say.
A legal contraceptive pill, once promised by the end of the 1980s, will not be on the market until at least early 1992, according to Akira Kuwahara in the Health Ministry's pharmaceutical affairs bureau.
Doctors are allowed to prescribe pills with the same ingredients as oral contraceptives to treat gynecological conditions or for other health reasons but those available are high in the hormone estrogen and have a reputation for causing side effects.
"Many young people believe that abortion is less dangerous than contraceptive pills," said Dr. Takako Kiyokawa, a gynecologist at Toride Kyodo General Hospital. "The danger of the pill is emphasized because of the kind of pill we use."
Eight Japanese companies are testing the so-called mini-pill, with lower doses of estrogen, and they are expected to apply to the Health Ministry for approval in September.
Although oral contraceptives have been tested and marketed in other countries, Japan frequently conducts its own research on drugs that have been pronounced safe elsewhere.
"We're not saying women should be on the pill, but they must be able to choose from all the options," Ashino of Family Planning said.
Sex education is almost non-existent in Japan, and clinics are utilitarian rather than informative.
"The single most important point is that Japan needs better sex education," said Ashino. "Sex and birth control are still not considered proper topics for a woman.
"Women's clinics are for having babies or abortions," said a 31-year-old teacher. "There's no such thing as counseling."
But other information channels are expanding.
Recent articles in women's magazines freely discuss the hazards and benefits of abortion and contraception.
"The magazines used to just tell you how to use a condom," said one 25-year-old writer.
"Japanese women used to be obedient, but they are getting wiser," said feminist writer Aoki.
Family planners predict a struggle in a country where sexual innocence is idealized but violent pornography is widely available, where adoption is frowned upon but young women have trouble getting straight answers about sex and contraception until it is too late.