Panel Prepares to OK Use of Pill After 30-Year Ban

Today’s Japanese women can surf the Internet, run for parliament and drive bulldozers, but they can’t take birth control pills.

That could change soon. Thirty years after vetoing the use of contraceptive pills, a government committee is expected to announce next week whether it will recommend legalization of the low-dose birth control pill.

The Japanese media predict that the pill will at last prevail. But pro-pill groups are wary, because even a positive recommendation from the committee could be quashed.

In 1992, the Health and Welfare Ministry was on the brink of approving the drug when it suddenly got cold feet. Officials said they feared legalizing the pill would discourage condom use--currently Japan’s main form of birth control--and thus increasing the spread of AIDS and other sexually transmitted diseases.

Now officials have set the pill up for another shot at approval by announcing that low-dose pills are safe and effective and their use would have negligible effect on transmission of acquired immune deficiency syndrome.

Critics wonder what has taken so long. Some point to the medical community, charging that doctors who perform abortions do not want to lose that lucrative source of income. Abortion is legal and ends one in four pregnancies in Japan.

Others blame the lack of a potent women’s movement, or government concern over one of the world’s lowest birthrates. Some Japanese feminists believe that the pill is a health hazard and have not crusaded to end the ban.

“Japan is still a developing country” when it comes to hormonal birth control methods, said Dr. Kunio Kitamura, director of the Japan Family Planning Assn.

Pill production was banned in Japan in 1967. By 1973, medium- and high-dose pills were available by prescription, but only for use in correcting menstrual disorders.

Kitamura said he and other Japanese doctors do sometimes prescribe the high-dose pills for contraception; about 200,000 Japanese women, or 1.3% of women of childbearing age, are believed to be taking them. Ironically, because these pills contain higher doses of hormones than the banned low-dose variety, they put women at higher risk for such severe side effects as blood clotting.

“They say they haven’t approved the [low-dose] pills because they’re not supposed to be used as contraception,” said Yuriko Ashino of the Japan Family Planning Federation. “Yet they haven’t done anything to check the use of the high- and medium-dose pills as birth control.”

Most doctors are for pill legalization, said Dr. Kazunori Ochiai of the Assn. of Gynecologists and Obstetricians.

“Women have the right to have the pill as a contraceptive choice,” he said.

Some Japanese women already pick up the pill during trips overseas.

In the 1960s, American women embraced the pill as a ticket to sexual independence. But in Japan, oral contraceptives were shunned in the wake of medical scandals, including fetuses malformed by Thalidomide and infants poisoned by arsenic in milk powder, that fostered fear and mistrust of drugs.

Reports of severe side effects from the high-dose pills of the 1960s flooded Japan. A lack of updated information has meant the pill’s nefarious image has not changed much in three decades, Ashino said.

Some women say they might try the low-dose pills because they have so few other choices. Under-skin implants, contraceptive shots and “day-after” pills are banned in Japan, as are some types of intrauterine devices.

Motoko Katayama, 21, said she won’t try the pill, for fear of side effects.

“Condoms are good enough, but there are men who don’t want to use them,” she said. “So it’s men’s consciousness that’s lacking.”