csua.org/u/dko -> www.stanford.edu/dept/news/pr/96/960214japanabort.html
Stanford University News Service NEWS RELEASE 2/14/96 CONTACT: Stanford University News Service (415) 723-2558 Djerassi on birth control in Japan - abortion 'yes,' pill 'no' STANFORD -- The number of abortions performed each year in Japan is gross ly under-reported, a factor that contributes to continued resistance to the legalization of oral contraception, a team of Stanford researchers r eport in the Feb. In the article, "Why Japan Must Legalize the Pill," chemistry Professor C arl Djerassi and James Raphael and Hiromi Maruyama of the Asia/Pacific R esearch Center estimate the actual number of abortions in Japan at two t o three times the "official" number of about 410,000 a year. Djerassi, inventor of the modern oral contraceptive, and his colleagues s aid legalization of the "normal," or low-dose, oral contraceptives in Ja pan would modernize birth control there "by 50 years," and significantly lower the number of abortions. The authors said their estimates on actual numbers of abortions in Japan are the most reliable ever assembled. They were made under several diffe rent assumptions of contraceptive use and coital frequency, and included all available data on women in the 15-44 age group. Japan is the only industrialized country except for Ireland where oral co ntraceptives are illegal, the authors noted. "Yet, Japan was the first industrialized nation after the Second World Wa r where abortion (through the private sector) became the principal metho d of officially sanctioned birth control," they wrote. The Japanese Ministry of Health and Welfare, or Koseisho, is currently co nsidering legalizing oral contraceptives, although previous attempts hav e failed and there is continued resistance to such a move in Japan for a number of reasons. Contrary to media and industry expectations that the government would leg alize the pill by early 1992, "approval was withheld on the grounds that it might lead to reduced condom use at a time when AIDS prevention was considered the highest priority." But, the Stanford authors said, this resistance to legalize oral contrace ptives could be attributed to other "more complicated reasons that had e xisted long before Koseisho became belatedly concerned with AIDS in 1991 ." These include lingering government concern about the potential loosening of sexual mores; opposition to the pill by condom manufacturers and by private physician abortion-providers who fear a large loss of income; and the lack of pressure from Japanese women for legalization of oral contraceptives. On the lack of pressure from Japanese women for a legal pill, the authors attribute it "in part because of their ignorance of the greatly reduced risks and non-contraceptive benefits of low-dose oral contraceptives." On the birth rate, the authors say using this argument "as a basis for co ntinuing a ban of one of the most widely used methods of contraception i s both illogical and unacceptable," since "economic and socio-cultural f actors control the birth rate of a modern population; the quality or use of contraceptive methods is a secondary effect." would have no effect on the low birth rate in Japan and that sexual mores among the younger Jap anese population have been changing without the pill . two of the th ree cited objections to approval of the pill have little merit," the aut hors wrote. "The third - loss of income to abortion providers - clearly should not drive Koseisho policy." Abortion and contraception are "about the only things not covered" by Jap an's national health care system, Djerassi said, and the private abortio n industry is currently worth at least $400 million (US) annually. "The cost per abortion is about three times what it is in the United Stat es," Djerassi said. "It's an enormous source of income for Japanese phys icians, and they have a major incentive not to report abortions" for tax reasons, he said. In addition, some women may be hesitant to report the y had abortions, adding to the low numbers. Raphael, who is director of research at the Asia/Pacific Research Center, said the team found that many women, in an attempt to keep the abortion s private, pay in cash, which makes it even more tempting for the physic ian to not report the procedure. "The time has arrived for the Japanese government and media to acknowledg e the persistent high rate of abortion in Japan, and to consider its red uction a high priority on medical and social grounds," the researchers w rote. Legalizing the pill, they estimated, could reduce the number of ab ortions performed each year by at least 300,000, that figure reached usi ng "conservative" sets of data. Legalization should be augmented by an extensive public education campaig n, the authors wrote, given the low level of sex education in Japanese s chools and the "very long history of unfavorable publicity in Japan abou t the pill's negative side-effects," which is due in part to the fact th at most Japanese women's knowledge of the pill is based on problems asso ciated with a high-dose version that is legally prescribed to treat mens trual difficulties. "When the pill is eventually legalized, it should be packaged with a deta iled insert (listing risks and benefits as well as instructions on use) of the type required by the US Food and Drug Administration," the rese archers concluded. "A sensitively written insert accommodating Japanese cultural practices and up-to-date medical facts would offer an education al bonus far beyond that of ensuring proper contraceptive use. If the le itmotif of government policy became 'The Pill Yes! Any images shown in the release are provided at publishing quality.
|