For Immediate Release:	January 2, 2001
For More Information:	Christina Horzepa, The Population Council, chorzepa@popcouncil.org, (212) 339-0520
Sponsor Organization:	Population Council
FAMILY PLANNING POLICY IN JAPAN
Women younger than 25 should be the principal concern of family planning policy in Japan, notes a report in the December issue of Studies in Family Planning, a peer-reviewed journal published by the Population Council. After analyzing data for 1975 to 1995 from the Japanese Ministry of Health and Welfare's annual reporting of abortion, Aya Goto and colleagues suggest that the country can prevent an increase in unintended pregnancies and abortions by developing a comprehensive family planning program and improving gynecological care and reproductive health education. In 1995 the total number of abortions reported was 343,024, representing a 49 percent decrease from the number reported for 1975. The overall abortion rate changed from 22 to 11 abortions per 1,000 women in 1975 and 1995, respectively; and the overall abortion ratio changed from 353 to 289 abortions per 1,000 live births in the same 20-year period. In the years from 1995 to 1998, however, the reduction in the overall abortion rate stopped, remaining at 11 abortions per 1,000 women. Furthermore, the abortion rate for women younger than 20 increased during the study period and the proportion of abortions experienced by women younger than 25 increased from 18 percent between 1976 and 1980 to 30 percent between 1991 and 1995. A slight increase in the abortion ratio was also observed among women aged 40-44. If recent abortion trends continue, Japan's overall abortion rate could rise in the next decade, the authors say. The authors point to three main factors as influencing abortion trends. Sexual behavior and fertility among young people are changing. Although young people are likely to postpone marriage and childbearing until their late 20s, they become sexually active at an earlier age than ever before, and thus their need for contraceptives is increasing. A second factor is the limited number of contraceptive methods available and the extensive reliance on condoms in Japan. Oral contraceptives and the copper IUD were not approved until 1999, and other hormonal methods and progestin IUDs are still not available. The rare use of IUDs and sterilization could help explain why Japan's abortion rates among women in their late 20s and 30s are as high as are those among women in their early 20s. Poor access to abortion services is a third factor contributing to a delay in seeking abortions among young women. Abortion is legal in Japan, but physicians are required to obtain consent from the husband if the woman is married, from the partner if the woman is not married, or from the parent if the woman is single and younger than 20. For a young, single woman, obtaining this consent can be a difficult process. The cost of abortion may also be a barrier, because the procedure is not covered by insurance. "Japan should improve its national programs for sexual and reproductive health education," the authors suggest. "Young people in Japan today need practical reproductive health knowledge and skills, including information on the newly approved contraceptives and on sexually transmitted diseases." Furthermore, they say, gynecological practice in Japan needs to become more woman-friendly, and family planning, an important part of primary care, should receive greater attention in gynecological and obstetrical practice. The country should also improve its collection and analysis of epidemiological data on reproductive health. Efforts should be made to reduce the high level of underreporting of abortions and to adjust the existing data for underreporting. In addition, the authors suggest more research on unintended pregnancy leading to abortion. Aya Goto is Public Health Fellow, Population Council. Akira Fukao is Professor, Yamagata University School of Medicine, Department of Public Health. Chihaya Fujiyama-Koriyama is Lecturer, Kagoshima University School of Medicine, Department of Public Health. Michael R. Reich is Chair, Harvard School of Public Health, Department of Population and International Health. Other articles, reports, data, Vol. 31 No. 4, December 2000 Articles: Can Poor Countries Surmount High Maternal Mortality?, by Jeremy Shiffman Methodological Issues in Community-based Studies of Gynecological Morbidity, by Jagdish Bhatia and John Cleland The Effect of Gender Preference on Contraceptive Use and Fertility in Rural Egypt, by Kathryn M. Yount, Ray Langsten, and Kenneth Hill Reports: Women's Reports of Severe (Near-miss) Obstetric Complications in Benin, by Véronique Filippi, Carine Ronsmans, Timothée Gandaho, Wendy Graham, Eusèbe Alihonou, and Paul Santos Mobilizing Demand for Contraception in Rural Gambia, by Margaret Luck, Ebrima Jarju, M. Diane Nell, and Melville O. George Data: Cameroon 1998 DHS; Niger 1998 DHS Book Review: Judith Helzner on Let Every Child Be Wanted: How Social Marketing Is Revolutionizing Contraceptive Use Around the World, by Philip D. Harvey For subscription information on Studies in Family Planning, call 212-339-0514, fax 212-755-6052, or email pubinfo@popcouncil.org. # # # The Population Council is an international, nonprofit, nongovernmental organization that seeks to improve the wellbeing and reproductive health of current and future generations around the world and to help achieve a humane, equitable, and sustainable balance between people and resources. The Council conducts biomedical, social science, and public health research and helps build research capacities in developing countries. Established in 1952, the Council is governed by an international board of trustees. Its New York headquarters supports a global network of regional and country offices.