#Nandenaino project demands more affordable, accessible birth control options in Japan

Female contraceptives allow women to take charge of their health and reproductive rights. Women need to be able to choose the most suitable method based on their lifestyle, health conditions and preferences. However, the reality in Japan is that only birth control pills and IUDs are accessible due to current government regulation. Emergency contraception pills are available at pharmacies but require a prescription and cost between 60 and 200 US dollars.

#Nandenaino, or “why don’t we have it?” in English, is a grass-roots initiative that advocates access to a wider range of contraceptives for women. Their bilingual website lists the types of highly effective contraceptives that are not currently approved in Japan.

What’s not available in Japan?

One type of contraceptive that’s unavailable in Japan is the birth control implant. This is a matchstick-shaped rod inserted under the skin of your upper arm and protects you from getting pregnant for up to five years. This is a method of hormonal birth control that suppresses ovulation and can be removed at any time if you wish to get pregnant.

While they are effective for a shorter period than implants, there are other hormonal birth control methods such as vaginal rings and contraceptive injections. A vaginal ring is a soft plastic ring that you place in your vagina. Once you insert it, you leave it in for 21 days. After that period, you have a 7-day ring-free period where you are still protected from pregnancy.

The contraceptive injection is also useful when you don’t want to take pills every day. Plus, there are types of injections that contain no estrogen, and it can be a good alternative for those who don’t do well on low-dose contraceptive pills. Injections are recommended to be taken every three months.

All of the above are hormonal birth control methods recommended by the WHO, but none of them are available in Japan. However, it is important to state that hormonal birth controls can’t protect against sexually transmitted diseases (STDs), so you still need to use condoms.

How did #Nandenaino start?

The founder of #Nandenaino, Kazuko Fukuda, is currently pursuing her master’s degree in Sweden. When she first lived in Sweden as an undergraduate exchange student, she learned that women in Sweden have access to a range of birth controls such as those mentioned above, in addition to birth control pills. She was also surprised to learn how affordable and accessible they are in Sweden. For instance, women in Sweden can get contraceptive counseling for free. In some counties, young people under 25 can also get subsidized birth control and emergency pills.

When she returned to Japan, she felt that women are not provided enough resources to make the right decisions about their reproductive health. Since then, she set up #Nandenaino to spread information about sex and contraception among the Japanese media, doctors and politicians.

Fukuda is also part of a citizen group started in 2020 to promote the legalization of prescription-free emergency pills in Japan. Thanks to their hard work, the Japanese government is currently in talks to rethink the policy on emergency contraception.