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Please make emergency contraceptive accessible for all women!

●  Some people don't have access to emergency contraception in Japan

The emergency contraceptive pill (morning-after pill) is a pill that can prevent pregnancy in emergency situations, such as after having sex without sufficient protection, or after sexual assault. Though not 100%, the effectiveness rate is high.

I represent a non-profit organization called Pilcon which strives to support young people’s sexual health issues. Just from reading the messages that young people have sent to us at Pilcon, it’s apparent that young people have no knowledge surrounding contraception in the first place, and for these people, the emergency contraceptive pill is extremely difficult to access.

There are many people who have sent messages asking, “I had unprotected sex. What should I do?” Even if they do know that emergency contraception is an option, they’ve encountered further barriers: “I’m worried about what others would think, so it’s difficult for me to go to the gynecologist,” “I can’t be absent from work,” “The clinic is closed during weekends and holidays.” It’s clear that accessibility to emergency contraception is very low for many.

The only nationally approved emergency contraception brand, NorLevo, costs about 10,000 yen (about 93 USD) per dose. Also, emergency contraception is a prescription-needed medicine so that not available at pharmacy and one always has to see a doctor. Combined with medical consultation fees, the total cost may come out to about 6,000-20,000 yen (55-180 USD). In addition, not all obstetricians/gynecologists provide this option; clearly, the morning-after pill is not something one can easily buy in Japan. If the person seeking emergency contraception does get pregnant in the end, they would be forced to choose between giving birth to the baby or getting an abortion.

Victims of sexual assault can receive financial assistance for getting emergency contraception, but only 3.7% of victims actually go to the police (*1). Furthermore, the police do not provide emergency contraception. The need for a prescription and uncertainty of availability present serious problems for someone who needs to take the emergency contraceptive pill as soon as possible within 72 hours.

It’s not just sexual assault victims who need emergency contraception. In Japan, 82% of people use condoms as a method of contraception (*2). The failure rate of condoms with typical use is almost 20% - even with efforts to prevent pregnancy on a regular basis, condoms can often tear or be misused. This risk is exacerbated by the fact that in Japan, people are often not properly taught how to use a condom.

On the other hand, there are countless businesses that sell emergency contraceptive pills online. As concerns over haphazard use rise, the unregulated presence of internet vendors is a danger to those who need emergency contraception, and contradictory to the concerns of the Ministry of Health, Welfare, and Labour.

I myself have experienced a painful unwanted pregnancy and abortion.

Failed contraception is something that every one of us could encounter in our lives.

That includes you, your partner, your friends, siblings, children and parents. I speak openly about my past because I want to convey the ubiquitousness of this issue.

●      Over-the-counter sale of emergency contraception, and the unheard voices of the people

In recent developments, the Ministry of Health, Welfare and Labor has been considering making the emergency contraceptive pill over-the-counter (can be purchased at a drugstore without a prescription) in response to citizens’ requests. Public comments showed an overwhelmingly positive response; however, over the investigative commission’s concerns that “pharmacists would have a hard time explaining usage to customers,” “haphazard use would increase,” the decision was made that emergency contraception will not be made over-the-counter.

Why did the ministry ask for public comments in the first place?

●      Japan’s emergency contraception problem: abandoned by international society

Emergency contraception is deemed safe and can be purchased from a pharmacist without requiring a prescription in 76 countries, over-the-counter in 19 countries (ICEC, March 2019). In most cases, it can be purchased at a drugstore, and the cost is below the equivalent of 5,000 yen (46 USD). It’s also not uncommon for governments to provide the option to youth at no cost. In 2018, WHO recommended that “[all] women and girls at risk of an unintended pregnancy have a right to access emergency contraception and these methods should be routinely included within all national family planning programmes.”

References:

#Nandenaino movement

https://www.nandenaino.com/know-the-truth-2

 

Please make emergency contraceptive accessible for all women!

Our requests are as follows.

○      Make emergency contraception over-the-counter. Eliminate the difference in cost compared to other countries.

○      Collaborate with the Ministry of Education, Culture, Sports, Science, and Technology to bolster sex education programs so that students may be equipped with proper knowledge about the oral contraceptive pill and other contraceptive methods. This should take place through middle school (mandatory education).

○      The fact that there are online vendors selling emergency contraception and oral contraception is dangerous. As a transitional measure, ensure that emergency contraception acquired through online consultation with a healthcare provider is guaranteed safe to use, and that people who seek emergency contraception would be able to access it without an in-person medical consultation.

ー In July 2019, they lifted the online consultation of emergency contraceptives from the first visit conditionally.

We will deliver this petition to the Minister of Health, Welfare and Labor, the chairperson of Japan Society of Obstetrics and Gynecology, and the chairperson of the Japan Pharmaceutical Association, and appeal for their cooperation in the measures stated above.

At Pilcon, we have also worked towards providing adequate resources for those carrying anxieties about pregnancy, by developing an automated messaging service on LINE and by gathering support via crowdfunding.

▼Let us spread the LINE bot(a mobile app) that delivers appropriate information and support to all people who have anxiety about unintended pregnancy（CampFire）

Please join me in supporting all women’s rights to safely access emergency contraception.

Pilcon Board Chairperson, Asuka Someya

#Nandenaino chairperson, Kazuko Fukuda

 

(*1) Japan Cabinet Office “Research on violence between men and women” (2011)

(*2) Japan Family Planning Association “Research on the lifestyles and awarenesses of men and women” (2016)