Growing voices for morning after pill access in Japan

Emergency contraception (EC), also known as the morning after pill, reduces a woman’s risk of getting pregnant by preventing or delaying ovulation. When taken within 72 hours of intercourse, this kind of contraception can prevent more than 80% of pregnancies.

In Japan, this time-sensitive contraception can only be obtained with a prescription. You have to visit a clinic and receive a consultation from a doctor, and pay between 6,000 and 20,000 yen in total to get the pill. Not all clinics open at night or on holidays. Moreover, for victims of sexual assault, the hurdle of visiting a clinic is too high.

Access to non-prescription EC has been tightly shut for nearly a decade. In June, however, the government finally decided to consider revising the current process in response to insistent public pressure.

While 30 years of research have shown the efficacy and safety of EC, it was only in 2011 that Japan approved the use of the pill with a doctor’s prescription. In 2017, the Ministry of Health, Labor, and Welfare (MHLW) rejected the motion of making EC available at pharmacies citing irresponsible overuse of EC as one of their main concerns. MHLW backed the decision stating that Japan’s sex education still needs to be improved.

How have Japanese women been fighting for non-prescription EC?

Groups such as Pilcon and the #Nandenaino Project, or “why don’t we have it” project in English, have been calling for prescription-free EC by collecting online petitions and spreading awareness of reproductive health rights in Japan.

In April 2020, due to the spread of COVID-19, MHLW approved the time-limited implementation of online medical care for EC. Consequently, it is now possible for women to receive a prescription online and purchase EC at a pharmacy.

The ongoing uncertainties of COVID-19 have increased the number of women seeking advice for unintended pregnancies. The director of Pilcon, Asuka Someya, says her organization saw a surge in inquiries from teens worried after using pregnancy test kits or missing periods.

In June 2020, Someya formed a new group specifically aimed at liberalizing purchases of EC at pharmacies with the director of #Nandenaino, Kazuko Fukuda as well as the obstetrician and gynecologist Enmi Sakiko. These mission-driven leaders note that the discussion regarding making prescription-free EC available at pharmacies has long been conducted without understanding the feelings and circumstances of women. They advocate that the discussion has been solely based on several meetings and events with politicians and MHLW. The group collected about 100,000 signatures supporting the project and submitted them to MHLW in October 2020.

Thanks to the ongoing movement, the people’s voice shifted policy. The Suga administration decided to resume the discussion of prescription-free EC last month. If the reform comes to fruition, Japan will be one of nearly 100 other countries that give women access to EC without a prescription.

本日、緊急避妊薬のスイッチOTC化要望申請を提出致しました。
それに伴い、記者会見を11:00より行います！
科学的根拠に基づき、女性の権利の枠組みの中で実現するよう、声をあげていきます✨ pic.twitter.com/uV66MBgyGD

— #緊急避妊薬を薬局で 署名活動実施中！ (@kinkyuhinin) May 28, 2021

Emergency Contraception should be readily available for emergencies

EC gives a chance for women to protect themselves from unintended pregnancies when a regular protection method fails, no protection was used or sex was forced. Access to EC should be an essential part of reproductive health rights for women. Better accessibility would help Japanese women make the right decision about family planning and their bodies.