In a major victory for women’s reproductive health, Japan’s Ministry of Health, Labor, and Welfare (MHLW) says it will make the morning-after pill available via pharmacies without a prescription on a limited trial basis. It’s a fight that activists have fought for years – and delivers on a promise that the former Prime Minister made three years ago.
The rollout plan
According to Japan’s Kyodo News, the MHLW will grant permission to certain pharmacies to sell levonorgestrel, a.k.a. the morning after pill, starting this summer 2023.
Levonorgestrel is an emergency contraception. Taken within 72 hours of unprotected intercourse, it’s highly effective (80%) in preventing pregnancy. It’s available in 30+ countries without a prescription but has remained prescription-only for all ages in Japan.
Pharmacies will need to meet a set of four conditions in order to sell the pill:
- The pharmacists must have received training in the morning-after pill and its proper dispensation
- They must make the medicine available for sale in the evening and on weekends
- They should partner with ob/gyns in their area to assist women when needed
- They must have an individual consultation room or some other area that guarantees patient privacy
The rollout is provisional for now and will only be available in certain pharmacies and certain areas. However, MHLW says it plans to roll it out to more prefectures over the course of the next year, with a goal of full country coverage by March 2024.
The committee in charge of the rollout says they are aiming for an official rollout “quickly”. It’s also “considering” allowing OTC sale of the drug to those under 18 years of age.
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Fighting the prejudice that “women can’t be trusted”
Women’s rights activists have fought for years for both easier as well as more cost-effective access to contraception. Condoms remain the primary form of contraception. Less than 5% of women in Japan say they use contraception, mainly due to the cost.
Activists say women in Japan should have easier access to the morning-after pill, especially in cases of sexual assault or sexual abuse. In 2020, the government under former Prime Minister Suga Yoshihide said it would respond by making the morning-after pill available without a prescription. Today’s news is the first major movement toward OTC retailing in three years.
When the Suga administration announced its original plan, some people and groups in Japan pushed back. One of the most unlikely complainants was Maeda Tsukio, the head of Japan’s ob/gyn association, who argued that women in Japan didn’t have a high enough level of sexual education to use the pill responsibly. Women’s rights activists pilloried his remarks both online and in mainstream media.
That wasn’t the only case where a man thought women should have less access to contraception. In 2021, Linepharma in the UK applied for permission to sell a two-step abortion pill using mifepristone, which can induce abortion up to 10 weeks. (Levonorgestrel prevents a pregnancy from occurring in the first place.) The new head of the ob/gyn association (who was, for some reason, also a dude) said that the pill should cost around 100,000 yen (around USD $697) to prevent “abuse”.
Japan has a long history of accepting abortion as a necessity, with abortion being commonplace since the country’s Edo era.
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