Abortion before birth control: The interest group politics behind postwar Japanese reproduction policy

Journal of Japanese Studies

Volumn 24, Issue 1, 1998, Pages 59-94

  Norgren, Tiana ^a  

^a Och Spine at New York Presbyterian Hospitals   (United States)

Author keywords

[No Author keywords available]

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EID: 0013043967     PISSN: 00956848     EISSN: None     Source Type: Journal    
DOI: 10.2307/132939     Document Type: Article

References (215)

1. Cohen and Arato define civil society as "a sphere of social interaction between economy and state, composed above all of the intimate sphere (especially the family), the sphere of associations (especially voluntary associations), social movements, and forms of publication communication." Jean Cohen and Andrew Arato, Civil Society and Political Theory (Cambridge, Mass.: MIT Press, 1992), p. ix.
2. There are a variety of definitions of the term "interest group." In this paper, interest groups are defined as "membership- or nonmembership-based organizations or institutions that engage in activities to seek specific policy or political goals from the state." Mark Petracca, ed., The Politics of Interests: Interest Groups Transformed (Boulder: Westview Press, 1992), p. 7.
3. The difference between interest groups (rieki dantai, atsuryoku dantai) and citizens' groups (shimin dantai) is not immediately clear, since both types of group engage in the same lobbying, fundraising, and information-providing activities - although, normatively speaking at least, the term "citizens' group" has more positive, democratic connotations than the term "interest group." In this paper, I apply Graham Wilson's definitions of economic and noneconomic interest groups to interest groups and citizens' groups, respectively. Economic interest groups (or interest groups) "represent economic forces . . . [i.e.,] the means by which people obtain their incomes," whereas noneconomic groups (or citizens' groups) "are not based on economic sectors of society." Graham Wilson, "American Interest Groups in Comparative Perspective," in The Politics of Interests: Interest Groups Transformed ibid., pp. 80-81. Using these definitions, we can place doctors', midwives', and family planning groups, as well as pharmaceutical companies, into the interest group category; women's groups, religious groups, and groups representing the handicapped, retarded, and mentally ill fall into the citizens' group category. Some of the groups that I identify as citizens' groups call themselves NGOs (nongovernmental organizations).
4. For the concept of the state as follower or referee, see Margaret McKean, "State Strength and Public Interest," in Gary D. Allinson and Yasunori Sone, eds., Political Dynamics in Contemporary Japan (Ithaca: Cornell University Press, 1993).
5. The term "conservative" is defined here as restrictive and averse to change; the term "liberal" indicates the opposite of conservative, i.e., unrestrictive and unaverse to change.
6. Marilyn Jane Field, The Comparative Politics of Birth Control (New York: Praeger, 1983), pp. 32-33, 182-83.
7. In fact, abortion is still a criminal offense under Japan's Penal Code, which was written in 1907 and is still in effect. The Eugenic Protection Law (now called the Maternal Protection Law) established criteria for when exceptions could be made to the Criminal Abortion Law (Articles 212-16, Chapter 29 of the Penal Code). Anyone who deviates from these criteria may be prosecuted for criminal abortion. While this is uncommon, there was a case of criminal abortion that went before Japan's Supreme Court as recently as 1988. See "Gyōmujō datai, hogosha iki chishi, shitai iki hikoku jiken," Saikō saibansho keiji keireishū, Vol. 42, No. 1-6 (January-July 1988).
8. For a summary and analysis of the case, see Nakatani Kinko, "Datai ni yori shussei saseta mijukuji o hōchi shita ishi to hogosha iki chishizai no seihi," Jūrisuto rinji zōkan: Shōwa 63 nendo jūyō hanrei kaisetsu, No. 935 (1989).
9. Stanley K. Henshaw and Evelyn Morrow, Induced Abortion: A World Review (New York: The Alan Guttmacher Institute, 1990), pp. 27-31. The legal abortion period in the United States is based on fetal viability, as it is in Japan. But these are exceptions: the majority of democracies limit abortion to the first trimester of pregnancy.
10. The legal abortion period used to be longer: between 1953 and 1976, abortion was legal through the twenty-eighth week of gestation. In 1976, MHW shortened the legal abortion period to 24 weeks in accordance with World Health Organization standards for fetal viability. MHW further reduced this period to 23 weeks in 1978, then 22 weeks in 1991. The MHW vice-minister makes these changes via tsūtatsu (directives).
11. An exception to this rule is the United States, where abortion is available at the woman's request (on demand).
12. Hereditary illnesses included, for example, muscular dystrophy, color blindness, deafness, and hemophilia. See Appendix to the Eugenic Protection Law.
13. Furthermore, the law requires that both the woman and her spouse must consent to have the abortion performed, although this provision is not enforced very strictly. The phrasing of the law in terms of "the person in question and that person's spouse" (honnin mata wa haigūsha) leaves the legal status of abortion for the unmarried in a grey area. Up until the mid-1980s the majority of abortions were, in fact, performed on married women in their late 20s, 30s, and 40s, but since 1985 the percentage of abortions obtained by married women has dropped below 50 per cent of the total, while the percentage of abortions obtained by unmarried women in their teens and early 20s has increased. Thus, the demographics of abortion in Japan may be moving in the direction of other industrialized democracies, where a large percentage (often the majority) of abortions are obtained by teenagers. See Samuel Coleman, Family Planning in Japanese Society: Traditional Birth Control in a Modern Urban Culture (Princeton: Princeton University Press, 1983), p. 5;
14. Miho Ogino, "Abortion and Women's Reproductive Rights: The State of Japanese Women, 1945-1991," in Joyce Gelb and Marian Lief Palley, eds., Women of Japan and Korea: Continuity and Change (Philadelphia: Temple University Press, 1994), pp. 74-76;
15. and Noriko Tsuya, "Proximate Determinants of Fertility Decline in Postwar Japan," in Population Problems Research Council (a division of Mainichi Newspapers), ed., The Population and Society of Postwar Japan - Based on Half a Century of Surveys on Family Planning (Tokyo: Mainichi Newspapers, 1994), p. 117.
16. See Proceedings of the House of Councilors, June 14, 1996.
17. The leprosy provision was actually deleted in accordance with the abolition of the Leprosy Prevention Law (Rai Yobo Hō, 1907), effective April 1, 1996. Soshiren nyūsu, April 1996.
18. The legal status of abortion in Japan is similar to that of abortion in France and Germany, where prewar bans are still in effect but may be superseded under exceptions established in the mid-1970s. See Mary Ann Glendon, Abortion and Divorce in Western Law (Cambridge, Mass.: Harvard University Press, 1987), for a discussion of the differences between French, German, and American abortion law.
19. See Population Reports, Vol. 7, No. 3 (May 1979). In fact, IUDs first became available in Japan in the mid-1930s, when a Japanese doctor (Ōta Tenrei) invented a gold and goldplated IUD design.
20. "Teiyōryō keikō hininyaku no sōki ninka ni kansuru yōbōsho," petition submitted to the Health and Welfare Minister by the Japan Association of Obstetricians and Gynecologists, Nichibo, the Japan Family Planning Association, and the Family Planning Federation of Japan, May 12, 1993; personal communication, Suga Mutsuo, Marketing Department, Nippon Organon KK, December 8, 1994.
21. The other countries are North Korea and, according to some sources, the Republic of Ireland. "Teiyōryō piru ni kansuru shitsumon shuisho," written questions submitted to the cabinet by Rep. Yokomitsu Katsuhiko, March 6, 1995; Hiromi Maruyama, James Raphael, and Carl Djerassi, "Why Japan Ought to Legalize the Pill," Nature, Vol. 379 (February 15, 1996), p. 579. There are a small number of countries, such as Saudi Arabia, where all forms of birth control - including the pill - are illegal.
22. E. Ketting, ed., Contraception in Western Europe: A Current Appraisal (Park Ridge, N.J.: Parthenon Publishing Group, 1990), p. 81;
23. United Nations Department for Economic and Social Information and Policy Analysis, Population Division, World Contraceptive Use Chart, 1994 (New York: United Nations, 1994).
24. Muramatsu Minoru, Atarashii kazoku zō o motomete (Tokyo: Mainichi Shinbunsha, 1994), p. 61. The percentage of Japanese contraceptors reporting sterilization as their method of birth control has fluctuated between 4 and 10 per cent since 1955; IUD use peaked around 9 per cent between 1973 and 1977; pill use peaked around 3 per cent between 1975 and 1979.
25. For definitions of "typical" and "perfect" use, see Contraceptive Technology Update, Vol. 17, No. 2 (February 1996), p. 14.
26. Irene B. Taeuber, The Population of Japan (Princeton: Princeton University Press, 1958), pp. 272, 278, and 282-83.
27. LaFleur argues that mizuko kuyō provide a socially acceptable ritual outlet for women who have aborted (and their partners) to acknowledge their pain and guilt and to gain release without being condemned. William LaFleur, Liquid Life: Abortion and Buddhism in Japan (Princeton: Princeton University Press, 1992), pp. xiii-xiv, 26-29, 196-97, and 216.
28. However, Hardacre argues that mizuko kuyō "is a minority phenomenon rejected by the majority of religious institutions in Japan, [and] we would be very much mistaken to gloss it simply as 'Japan's way of dealing with abortion.'" Even when mizuko kuyō was at its peak of popularity, only an estimated 20 per cent of women who had abortions performed services. Furthermore, many temples and shrines will not perform the services, at least in part because they view mizuko kuyō as crass capitalization on people's fears. The services are performed for a fee, and the popular press and some mizuko kuyō practitioners have promoted the notion that if a woman does not perform mizuko kuyō after an abortion, both she and her living children could be subject to spirit attacks (tatari) by the aborted fetus. Helen Hardacre, Marketing the Menacing Fetus in Japan (Berkeley: University of California Press, 1997), pp. 17, 81-100, 190-96, and 209.
29. LaFleur, Liquid Life, ch. 6 and p. 205.
30. In opinion polls taken in Japan at two-year intervals from 1963 to the present, in 1965, 16 per cent of those surveyed approved of abortion unconditionally, 62 per cent approved conditionally, and 15 per cent disapproved; in 1975, the figures were 9, 68, and 11 per cent; in 1984, the figures were 16, 66, and 13 per cent; and in 1994, the figures were 26, 55, and 10 per cent. Population Problems Research Council, ed., The Population and Society of Postwar Japan, pp. 222-396;
31. Muramatsu, "Atarashii kazoku zō o motomete," p. 69. In opinion polls taken in the United States at irregular intervals from 1975 to 1995, in 1975, 21 per cent of Americans surveyed felt that abortion should be legal under any circumstances; 54 per cent felt it should be legal under certain circumstances; and 22 per cent felt it should be illegal in all circumstances; in 1983, the numbers were 23, 58, and 16 per cent; and in February 1995, the numbers were 33, 50, and 15 per cent. Personal communication, Maura Strausberg, reference librarian, Gallup Organization, May 17, 1996. Thus, if one combines the categories of those who favor access to abortion conditionally and those who favor access to abortion unconditionally, it becomes clear that the proportion of both Americans and Japanese who in some form favor access to abortion has basically remained constant for the last several decades and that these numbers are roughly equivalent in the United States and Japan. The same can be said for the proportion of Americans and Japanese who do not favor access to abortion.
32. Ian Reader, review of Liquid Life, The Journal of Japanese Studies, Vol. 21, No. 1 (Winter 1995), pp. 196-97.
33. Coleman, Family Planning in Japanese Society, p. 3.
34. Historical institutionalists have identified similar phenomena in other countries. Immergut, for example, discusses "veto points" which "emerge, disappear, or shift their location [as a result of changes in exogenous conditions,] creating 'strategic openings' that actors can exploit to achieve their goals." Kathleen Thelen and Sven Steinmo, "Historical Institutionalism in Comparative Politics," in Sven Steinmo et al., eds., Structuring Politics: Historical Institutionalism in Comparative Analysis (Cambridge: Cambridge University Press, 1992), p. 7. Similarly, Thelen describes a "dynamic constraints model" in which groups and individuals maneuver strategically within institutions, "acting on 'openings' provided by . . . shifting contextual conditions in order to defend or enhance their own positions."
35. Kathleen Thelen and Sven Steinmo, "Structuring Politics: Historical Institutionalism in Comparative Analysis Ibid., p. 17.
36. See Ōta Tenrei, Nihon sanji chōsetsu 100-nen shi (Tokyo: Shuppan Kagaku Sōgō Kenkyūjo, 1976), pp. 329-45.
37. For a description of some of these policies, see Yoshiko Miyake, "Doubling Expectations: Motherhood and Women's Factory Work Under State Management in Japan in the 1930s and 1940s," in Gail Lee Bernstein, ed., Recreating Japanese Women, 1600-1945 (Berkeley: University of California Press, 1991).
38. For primary sources, see Ichikawa Fusae, ed., Nihon fujin mondai shiryō shūsei, Vol. 6: Hoken (Tokyo: Domesu Shuppan, 1978), e.g., pp. 153-68.
39. Boshi Eisei Kenkyūkai, ed., Boshi haken no omo naru tōkei (Tokyo: Boshi Hoken Jigyōdan, 1994), p. 18.
40. U.S. National Archives, WNRC, RG. No. 331, Box No. 9344, "Birth Control" file, SCAP PHW Section, Administrative Division, Nursing Affairs and Health Statistics.
41. Deborah Oakley, "The Development of Population Policy in Japan, 1945-1952, and American Participation" (Ph.D. diss., University of Michigan, 1977), pp. 224, 226-27;
42. Katō Shizue, Aru josei seijika no hansei (Kyoto: PHP Kenkyujo, 1981), pp. 153-56.
43. There is some evidence that Taniguchi resurrected the socialists' bill at the urging of SCAP Public Health and Welfare Section Chief General Crawford Sams, who favored legalizing abortion in order to curb population growth. However, it is important to note that SCAP maintained a low profile - what Oakley terms "protective neutralism" - in this sensitive policy area. In other words, SCAP officials avoided openly advocating birth control or abortion and at the same time avoided interfering in the drafting of the Eugenic Protection Law - even though SCAP's Legal Section found the eugenic content and other aspects of the law dangerous and objectionable. SCAP adopted this neutral stance on abortion not only to avoid Catholic religious objections and Soviet accusations of genocide, but also in an effort to foster democratic behavior in Japan. General Sams wished the bill to be presented as a "people's cause" initiated by Japanese lawmakers rather than by Japanese or occupation bureaucrats. See Oakley, "The Development of Population Policy in Japan," pp. 198, 201-2, 226. See also May 11, 1948 Memo by Alfred Oppler, Chief, Courts and Law Division, U.S. National Archives, WNRC, RG. No. 331, Box No. 9322, SCAP PHW Section, Administrative Division, Publications File, "Eugenic Protection Law" file.
44. Nishiuchi Masahiko, Nihon no boshi hoken to Moriyama Yutaka: Subete no haha to ko ni hoken to iryō no onkei o (Tokyo: Nihon Kazoku Keikaku Kyōkai, 1988), p. 217.
45. Although it is not clear how many of these cases were actually prosecuted, a study of 590 cases of professional criminal abortion in provincial courts between 1927 and 1931 shows that roughly 10 per cent of defendants were doctors. Ishii Michiko, "Yūsei hogo hō ni yoru datai gōhōka no mondaiten," Shakai kagaku kenkyū, Vol. 34, No. 4 (1982), p. 120.
46. Ogino concurs in this assessment, stating that "the fact that 8 out of 10 Diet members who introduced the bill were physicians suggests that the law was designed to protect the professional interests of legitimate ob-gyns." Ogino, "Abortion and Women's Reproductive Rights," p. 72.
47. This provision, Article 16, stated that "physicians may freely [jiyū ni] take steps to [enable patients to] temporarily avoid reproduction." For the full text of the socialists' 1947 Eugenic Protection Bill, see Proceedings of the House of Representatives Health and Welfare Committee No. 35 (February 1, 1947), pp. 272-74.
48. This kind of drive to establish physician control over reproductive health care - particularly by pushing midwives out of business - was not unique to Japan. According to Petchesky, in the United States "prior to the mid-twentieth century, if there was a state policy on population and fertility, it was created not directly by the state apparatus but by emerging elites [in the American Medical Association] who sought control over the dispensing of private reproductive health care and the state's backing to legitimate that control." Rosalind Pollack Petchesky, Abortion and Woman's Choice: The State, Sexuality, and Reproductive Freedom (Boston: Northeastern University Press, 1990), pp. 78-79.
49. In his research on France in the nineteenth century, McLaren finds that gaining a monopoly over women's health care represented a means for French doctors to establish the medical profession as an authoritative, elite body. Angus McLaren, Sexuality and Social Order (New York: Holmes and Meier Publishers, Inc., 1983), pp. 44-45, 63.
50. Ōta Tenrei, Datai kinshi to yūsei hogo hō (Tokyo: Keieisha Kagaku Kyōkai, 1980), p. 170;
51. Katō, Aru josei seijika no hansei, pp. 156-57;
52. Oakley, "The Development of Population Policy in Japan," p. 229.
53. Ōta, Datai kinshi to yūsei hogo hō, p. 171; interview with Ashino Yuriko, Deputy Executive Director, Family Planning Federation of Japan, April 24, 1995.
54. Nichibo changed its Japanese name to Nihon Bosei Hogo Sanfujinkai Kai in 1994.
55. It has been a common pattern in twentieth-century Japanese politics for interest group officials to concurrently hold elected office. Aurelia George, "The Comparative Study of Interest Groups in Japan: An Institutional Framework," Australia-Japan Research Centre, Australian National University, Research Paper No. 95 (1982), pp. 8-13. Currently, there are about 16,000 ob-gyns in Japan, roughly 13,000 of whom are members of Nichibo. The number of-ob-gyns and JAMW membership has remained relatively constant throughout the postwar period. Thus, while the overall number of physicians and physicians per capita has increased greatly in the last 50 years, the ob-gyn specialty has shrunk. From 1955 to 1965, 12-14 per cent of doctors specialized in obstetrics and gynecology, but by 1975 that number had dropped to 7 per cent, and it has continued to decrease slowly ever since. Minoru Muramatsu, "Fertility Control in the Postwar Years - an Overview," in Population Problems Research Council, ed., The Population and Society of Postwar Japan, p. 94;
56. Boshi Eisei Kenkyūkai, ed., Boshi hoken no omo naru tōkei, p. 114. One ob-gyn cites the decline in the birth rate as the reason for the declining percentage of doctors choosing the ob-gyn specialty. Interview with Wagatsuma Takashi, International Medical Center, International Medical Cooperation Bureau, November 17, 1994.
57. See, e.g., the comments of a member of the Tokushima chapter of Nichibo, who wrote in 1967 that Nichibo was originally nothing more than Taniguchi's electorate (senkyo botai). Basei hogo i hō, March 1967.
58. For concrete evidence of Nichibo's role as Taniguchi's kōenkai, see the organization's newsletter, Bosei hogo i hō, between 1949 and 1963 when it was dominated by news of Taniguchi's election campaigns and Eugenic Protection Law-related legislative efforts.
59. See Yūsei hogo tōkei hōkoku, 1993 (Tokyo: Kōseishō Daijin Kanbō Tōkei Jōhōbu, 1994), p. 23.
60. Mark Petracca, "The Rediscovery of Interest Group Politics," in Petracca, ed., The Politics of Interests, p. 24.
61. Frank Baumgartner and Bryan Jones, Agendas and Instability in American Politics (Chicago: University of Chicago Press, 1993), p. 83.
62. Ōta, Nihon sanji chōsetsu 100-nen shi, p. 359.
63. Nishiuchi, Nihon no boshi hoken to Moriyama Yutaka, p. 236.
64. August 1958 newsletter of Nihon Kazoku Keikaku Fukyūkai, reprinted in Bosei hogi i hō, October 1958.
65. Nishiuchi, Nihon no boshi hoken to Moriyama Yutaka, p. 236;
66. interview with Katō Shizue in Agora, Vol. 28 (June 1983).
67. Coleman, Family Planning in Japanese Society, p. 4.
68. Tsuya, "Proximate Determinants of Fertility Decline in Postwar Japan," pp. 116-23. The problem with Tsuya's study is that she only estimates underreporting for abortions performed on married women. Abortions performed on unmarried women are thought to go unreported at a higher rate than those performed on married women
69. (Coleman, Family Planning in Japanese Society, p. 6), so it is safe to assume that the degree of underreporting for all abortions is higher than Tsuya estimates.
70. Minora Muramatsu, "The Japanese Experience," in Henry P. David, ed., Abortion Research: International Experience (Lexington, Mass.: Lexington Books, 1974), pp. 133-36;
71. Minoru Muramatsu and Jean van der Tak, "From Abortion to Contraception: The Japanese Experience," in Henry P. David et al., eds., Abortion in Psychosocial Perspective: Trends in Transnational Research (New York: Springer, 1978), pp. 145-67.
72. For example, according to Tsuya, there was little underreporting of abortions performed on married women between 1975 and 1990, but Tsuya also states that the percentage of abortions being performed on married women declined from around 60 per cent in 1980, to 50 per cent in 1985, to 45 per cent in 1990. Tsuya, "Proximate Determinants of Fertility Decline in Postwar Japan," p. 117. This means that underreporting of abortions performed on unmarried women may still be occurring.
73. Maruyama et al. estimate that in 1992, the actual number of abortions was two and a half to four times greater than the official number (the official number for 1992 was 409,069; Maruyama et al. estimate the number to be between 1 and 1.5 million). Maruyama et al., "Why Japan Ought to Legalize the Pill," pp. 579-80.
74. Baumgartner and Jones, Agendas and Instability in American Politics, pp. 6-9.
75. Or, as Baumgartner and Jones would put it, the mobilization of bias changed over time. Ibid., p. 175.
76. See Kozy Amemiya, "The Road to Pro-Choice Ideology in Japan: A Social History of the Contest between the State and Individuals over Abortion" (Ph.D. diss., University of California, San Diego, 1993), p. 258;
77. Shirohato, July 1952.
78. Seichō no Ie was involved in many other right-wing causes during this time, including the movement to revise the postwar constitution and the movement to reestablish Foundation Day as a national holiday. For a discussion of the latter, see Kenneth Ruoff, "Reviving Imperial Ideology: Citizens' Movements from the Right," paper presented at the Annual Meeting of the Association for Asian Studies, Honolulu, April 1996.
79. In general, see Seichō no Ie Honbu, ed., Seichō no Ie 40-nen shi (Tokyo: Nippon Kyōbunsha, 1970)
80. and Seichō no Ie Honbu, ed., Seichō no Ie 50-nen shi (Tokyo: Nippon Kyōbunsha, 1980).
81. Bosei hogo i hō, September 1957;
82. Kazoku keikaku, January 1958.
83. Kazoku keikaku, August 1961.
84. See Bosei hogo i hō, May 1972.
85. This clause would have allowed for abortion on grounds of fetal disease or defect. Handicapped people viewed the proposed "fetal conditions" clause as a threat to their very existence.
86. Asahi shinbun, February 9, 1983. Only 75 Diet members joined the antirevision Diet Members' League to Promote Maternal Welfare (Bosei no Fukushi o Suishin Suru Giin Renmei).
87. Asahi shinbun, March 24, 1983.
88. JAOG News, July 1996;
89. Soshiren nyūsu, April 1996.
90. The April 1996 Soshiren nyūsu refers to gaiatsu generated by Josei Shōgaisha Nettowāku member Asaka Yūho at the 1994 Cairo Population Conference. The October 1995 Soshiren nyūsu describes a workshop on the Eugenic Protection Law held by handicapped people's and women's groups at the 1995 Beijing Women's Conference. Approximately 100 people attended, two-thirds non-Japanese.
91. Article 4 reads, "In cases where, as the result of his or her examination, a physician confirms that a person suffers from one of the ailments listed in the appendix to this statute, and recognizes that in order to prevent hereditary transmission of the disease it is necessary, for the public good, to perform an eugenic operation, said physician shall apply to the Metropolitan, Hokkaido, or Prefectural Eugenic Protection Commission."
92. This was a conscious strategy. For example, at a meeting sponsored by the DPI Josei Shōgaisha Nettowāku on June 2, 1995 at the Nakano Ward Women's Hall, group members specifically said they would try to generate outside pressure on the Japanese government at the Beijing Conference because the government is "susceptible to outside pressure" (gaiatsu ni yowai). Other groups in Japan seem to have the same idea, since it is not uncommon for Japanese groups to travel to the United States or take out full-page advertisements in major U.S. newspapers to explain their cause and try to generate gaiatsu. See, e.g., Kenneth Ruoff, "Mr. Tomino Goes to City Hall: Grass-roots Democracy in Zushi City, Japan," in Joe Moore, ed., The Other Japan (Armonk, NY: M. E. Sharpe, 1996), p. 330.
93. JAOG News, July 1996.
94. Soshiren nyūsu, October 1996. In addition to Soshiren, women's groups include: Boshi Hoken Hō Kaiaku ni Hantai Suru Onnatachi Ōsaka Renrakukai, Josei to Kenkō Nettowāku, and Karada to Sei no Horitsu o Tsukuru Onna no Kai.
95. In addition to DPI Josei Shōgaisha Nettowāku, these groups include: Nihon Nōsei Mahisha Kyōkai Zenkoku Aoshiba no Kai Sōrengōkai (Aoshiba no Kai), and Zenkoku Shōgaisha Kaihō Undō Renrakukai. See, e.g., "'Yūsei hogo hō' kanzen teppai o motomeru yōbōsho," petition submitted by Aoshiba no Kai to the Ministry of Health and Welfare Mental Health Section, January 26, 1996.
96. See, e.g., "Yūsei hogo hō no minaoshi ni tsuite no yōbōsho an," draft petition to be submitted by Nihon Shōgaisha Kyōgikai to the Ministry of Health and Welfare, January 1996.
97. Yomiuri shinbun, April 18, 1996.
98. Soshiren nyūsu, April 1996;
99. Seimei sonchō nyūsu, June 1996.
100. The LDP Social Policy Committee formed a group to study revising the Eugenic Protection Law in December 1995.
101. JAOG News, July 1996.
102. See Representative Dōmoto Akiko's comments on the exclusion of women from the drafting process, September 12, 1996, House of Councilors Financial Settlement Committee. See also Soshiren nyūsu, June 1996, for the roster of those who attended an LDP Social Policy committee meeting. These groups did have opportunities to meet with opposition politicians and MHW officials (including high-ranking ones such as MHW Minister Kan Naoto) to ask questions, but they were not included in the actual drafting process.
103. In concrete terms, this involved changing the title and purpose of the law, deleting all articles providing for involuntary and voluntary sterilization and abortion on grounds of physical handicap, mental illness, or retardation, and replacing the term "eugenic operation" (yūsei shujutsu) with the term "sterilization procedure" (funin shujutsu). Since almost no sterilizations or abortions have been performed on eugenic grounds for the last 20-30 years, the revision will have little effect on actual practice.
104. According to Joyce Outshoorn, in Western Europe there is a similar pattern of political elites trying to keep the issue of abortion off the policy agenda because it is so controversial. Outshoorn, "The Stability of Compromise: Abortion Politics in Western Europe," in Marianne Githens and Dorothy McBride Stetson, eds., Abortion Politics: Public Policy in Cross-Cultural Perspective (New York: Routledge, 1996), pp. 154-57.
105. Kathleen Uno, "Death of 'Good Wife, Wise Mother'?" in Andrew Gordon, ed., Postwar Japan As History (Berkeley: University of California Press, 1993), pp. 308-10, 317.
106. Kathleen Uno, Postwar Japan As History 1993), pp. Ibid., pp. 307, 319.
107. Proceedings of the House of Representatives Health and Welfare Committee No. 35 (February 1, 1947), p. 274.
108. This bears out the argument Jenson makes in her comparative studies of reproduction policy in England, France, and the United States - which is that different social and economic situations, political configurations, and "universes of political discourse" can produce widely divergent policy responses to similar issues over time and across countries. Jenson's work dovetails nicely with the current historical institutionalist literature. See Jane Jenson, "Gender and Reproduction; or Babies and the State," Studies in Political Economy, Vol. 20 (Summer 1986);
109. Jane Jenson, "Changing Discourse, Changing Agendas: Political Rights and Reproductive Policies in France," in Mary Fainsod Katzenstein and Carol McClurg Mueller, eds., The Women's Movements of the United States and Western Europe: Consciousness, Political Opportunity and Public Policy (Philadelphia: Temple University Press, 1987);
110. Jane Jenson, "Representations of Gender: Policies to 'Protect' Women Workers and Infants in France and the United States before 1914," in Linda Gordon, ed., Women, the State, and Welfare (Madison: University of Wisconsin Press, 1990).
111. For a discussion of the concept of principals and agents, see J. Mark Ramseyer and Frances M. Rosenbluth, Japan's Political Marketplace (Cambridge, Mass.: Harvard University Press, 1993).
112. Kazoku keikaku, November 1955, p. 5. The last Japanese doctor's response was perhaps most typical of the larger international scientific and financial community. Through the late 1950s, most observers did not believe that the pill would be marketed as a contraceptive any time in the near future. An April 1958 Fortune magazine article predicted that it would take ten years and clinical data on thousands of women before drugs such as Enovid would receive FDA approval as contraceptives.
113. Bernard Asbell, The Pill: A Biography of the Drug that Changed the World (New York: Random House, 1995), p. 163.
114. Chronology from personal communication with OC liaison committee representative (a Mr. Katō), Nihon Schering, May 8, 1995.
115. Asbell, The Pill, p. 156.
116. Asbell, The Pill, p. Ibid., pp. 166-68.
117. Asahi shinbun, April 18, 1961.
118. See the news clipping file entitled "Suiminyaku asobi" at the National Diet Library in Tokyo.
119. Kazoku keikaku, August 1964.
120. See the Thalidomide news clipping file at the National Diet Library in Tokyo. Thalidomide was an over-the-counter sleeping medicine that was thought to be safe for pregnant women. Before it was withdrawn from the market, it caused tens of thousands of babies to be bom with terrible deformities, particularly to their arms and legs.
121. Asahi shinbun, August 10, 1964.
122. Asahi shinbun, January 24, 1965.
123. Asahi shinbun, September 10, 1964.
124. Asahi shinbun, January 24, 1965.
125. Kazoku keikaku, August 1964;
126. Asahi shinbun, September 10, 1964;
127. Yomiuri shinbun, September 22, 1964;
128. Asahi shinbun, January 24, 1965; interview with Matsumoto Seiichi, chairman, Japan Family Planning Association, May 9, 1995.
129. The MHW planned to require that the pill be sold as a prescription drug not to be advertised outside of medical journals and not to be used for more than two years at a time. Asahi shinbun, January 24, 1965.
130. Interview with Matsumoto Seiichi, May 9, 1995.
131. Proceedings of the House of Councilors Budget Committee No. 8 (October 20, 1961), pp. 27-28.
132. See Asbell, The Pill, and James Reed, From Private Vice to Public Virtue: The Birth Control Movement and American Society Since 1830 (New York: Basic Books, 1978).
133. Asbell, The Pill, and James Reed, From Private Vice to Public Virtue: The Birth Control Movement and American Society Since 1830 1978). Ibid.
134. Proceedings of the House of Councilors Budget Committee No. 17 (March 22, 1962), p. 3.
135. My interview with Matsumoto Seiichi, May 9,1995, and Coleman, Family Planning in Japanese Society, pp. 36-37, confirm that MHW bureaucrats were wary of taking the blame if problems with the pill developed.
136. Yomiuri shinbun, September 22, 1964.
137. Kazoku keikaku, August 1964;
138. Asahi shinbun, January 24, 1965;
139. interview with Matsumoto Seiichi, May 9, 1995; personal communication, Shirota Kumeo, vice-president, Japan Behringer-Sohn, August 1, 1995.
140. Asahi shinbun, September 10, 1964;
141. Asahi shinbun, January 24, 1965;
142. Yomiuri shinbun, September 22, 1964.
143. Kazoku keikaku, August 1964;
144. Asahi shinbun, January 24, 1965.
145. Kazoku keikaku, August 1964.
146. Yomiuri shinbun, September 22, 1964;
147. Kazoku keikaku, September 1964.
148. Over the last 50 years there has been a complete changeover from midwives, who performed the majority of deliveries until the late 1950s, to doctors, who now dominate the field. In 1947, 92.1 per cent of births were attended by midwives and only 3.5 per cent were attended by physicians. Midwives' share of deliveries decreased to 71.5 per cent in 1957, and further decreased to 32.7 per cent in 1964; meanwhile, physicians' share of deliveries increased to 25.1 per cent in 1957 and then to 66.6 per cent in 1964. This trend persisted over time so that by 1990, midwives were attending the minority of births - only 2 per cent - while physicians attended the rest. Source: Maternal and Child Health in Japan, compiled under the supervision of the Maternal and Child Health Division, Children and Families Bureau, Ministry of Health and Welfare (Tokyo: Mothers' and Children's Health and Welfare Association, 1992), p. 60.
149. The number of midwives in Japan has also declined dramatically during the postwar period, from 55,356 in 1955 to 22,690 in 1992. Source: Boshi hoken no omo naru tōkei, p. 114.
150. Chojiro Kunii and Tameyoshi Katagiri, eds., Basic Readings in Population and Family Planning in Japan (Tokyo: Japan Organization for International Cooperation in Family Planning, 1976), p. 68;
151. Coleman, Family Planning in Japanese Society, p. 45. According to Joyce Gelb, one-fourth of family planning groups' revenue is still derived from condom sales.
152. Gelb, "Abortion and Reproductive Choice: Policy and Politics in Japan," in Githens and Stetson, Abortion Politics, p. 125.
153. Asahi shinbun, January 24, 1965; interview with Matsumoto Seiichi, May 9, 1995.
154. Bosei hogo i hō, October 1964.
155. Kunii and Katagiri, eds., Basic Readings in Population and Family Planning in Japan, p. 153;
156. Coleman, Family Planning in Japanese Society, p. 38.
157. Yomiuri shinbun, September 22, 1964;
158. Kazoku keikaku, September 1964.
159. Asahi shinbun, January 24, 1965.
160. Kazoku keikaku, August 1964.
161. Asahi shinbun, September 10, 1964.
162. See William Steslicke, Doctors in Politics: The Political Life of the Japan Medical Association (New York: Praeger, 1973).
163. As recently as the 1980s, Calder found that "the power of the JMA [Japan Medical Association] . . . contrasts strongly to the relative political weakness of the pharmaceutical firms" in struggles over a drug pricing and distribution system that benefits physicians. Kent Calder, Crisis and Compensation: Public Policy and Political Stability in Japan (Princeton: Princeton University Press, 1988), p. 356.
164. Dorothy Robins-Mowry, The Hidden Sun: Women of Modem Japan (Boulder: Westview Press, 1983), p. 167,
165. cited in Sandra Buckley, "Altered States: The Body Politics of 'Being-Woman,'" in Gordon, ed., Postwar Japan as History, p. 351. For evidence of Satō's conservatism in the related area of abortion policy,
166. see also Amemiya, "The Road to ProChoice Ideology in Japan," pp. 263,271. Satō was prime minister from 1964 to 1971.
167. It is not clear who or what prompted Satō to make this call - nor is it even possible to verify whether he actually made it. Rumor also has it that Satō's wife feared the pill would corrupt popular morals and asked him to intervene. But given that many members of the antipill interest groups had connections with the LDP (e.g., Japan Midwives Association and LDP Women's Bureau president Yokoyama Fuku), it is entirely possible that they asked Satō, or his wife, to come to their aid - or that the whole story is apocryphal.
168. However, Kato Shizue did give the pill a qualified endorsement, remarking in 1974 that while she personally would rather use another method of birth control, she thought that it was necessary for the pill to be approved in order to promote birth control widely. Nihon keizai shinbun, November 22, 1974.
169. Chupiren was an acronym for Chūzetsu Kinshi Hō ni Hantai Shi Piru Kaikin o Yokyū Suru Josei Kaihō Rengō, or The Women's Liberation Federation for Opposing the Abortion Prohibition Law and Lifting the Pill Ban. Chūpiren came into being in 1972 as a splinter group from another small feminist group called Urufu Kai; it was dissolved in 1977, after its leader unsuccessfully tried to organize a Japan Women's Party. Among generally small, anonymous feminist groups, Chūpiren garnered media attention and a certain notoriety in Japan because its members conducted sensational protests while wearing pink helmets. For example, on October 23, 1973, 30 pink-helmeted Chūpiren members crashed a meeting of midwives and public health nurses (who were antipill), charged up to the stage, and argued loudly with audience members over whether the pill ban should be lifted. They departed an hour later, shouting to the assembled group that they were responsible for two million abortions. Asahi shinbun, October 24, 1973. Members of other feminist groups disliked and distrusted Chūpiren's leader, whose pseudonym was Enoki Misako, both because they suspected that her group was a front for the pharmaceutical industry and because they felt that her particular brand of splashy, publicity-seeking protest tactics (hade na katsudō) gave the feminist movement as a whole a bad reputation. Akiyama Yōko, "Enoki Misako to Chūpiren - 'ribu shishi nōto' yori - " Joseigaku nenpō, Vol. 12 (October 1991);
170. interview with Yonezu Tomoko of Soshiren (who at the time was a member of Ribu Shinjuku Sentā, one of the main feminist groups in the early 1970s), June 20, 1995. See also Yumiko Ehara, "Japanese Feminism in the 1970s and 1980s," U.S.-Japan Women's Journal, English Supplement, No. 4 (1993),
171. and Onna no Tame no Kurinikku, ed., Piru: watashitachi wa erabanai (Osaka: Onna no Tame no Kurinikku, 1987), pp. 76-77.
172. Particularly Barbara Seaman's 1969 book, The Doctor's Case Against the Pill.
173. See Yūsei Hogo Hō Kaiaku Soshi Jikkō Iinkai publication, June 1973, reproduced in Mizoguchi Akiyo et al., eds., Shiryō Nihon ūman ribu shi, vol. 2: 1972-75 (Kyoto: Yūgen Kaisha, 1994), p. 175;
174. see also quote from Tanaka Mitsu, Yomiuri shinbun, March 26, 1974. This fear was not unfounded: quite a few politicians and bureaucrats made the connection between abortion and the pill, emphasizing the need to promote birth control more widely before placing limits on abortion. See, e.g., House of Representatives Society and Labor Committee Meeting No. 25 (May 16, 1974), No. 28 (May 22, 1974), and No. 29 (May 23, 1974).
175. According to Steslicke, "as of 1960 only 14 per cent of all Japanese pharmacies had actually filled a doctor's prescription more than once." Steslicke, Doctors in Politics, pp. 46-48.
176. Two months after the pill was so designated, a general recall removed the pill from pharmacy shelves where it had been available previously without a prescription. "Piru nenpyō," Ribu Shinjuku Sentā publication, April 1974, reproduced in Mizoguchi Akiyo et al., eds., Shiryō Nihon ūman ribu shi, Vol. 2, p. 76;
177. Asahi shinbun, December 1, 1973.
178. While it might seem a foregone conclusion that the contraceptive pill would become a prescription drug since the therapeutic pill had been so designated, pharmacists clearly felt that there was some leeway for lobbying. Perhaps they reasoned that if conservative forces succeeded in revising the Eugenic Protection Law and restricting access to abortion, the government would be persuaded of the need to make the most reliable forms of birth control available over the counter.
179. See, e.g., Asahi shinbun, May 26, 1973, February 5, 1974;
180. Bosei hogo i hō. March 1974;
181. Proceedings of the House of Councilors Budget Committee, 4th Part (April 5, 1973), pp. 28-30.
182. Bosei hogo i hō, January and November 1973.
183. The pill had the potential to make up for lost abortion revenue, as it was quite expensive at the time: ¥1,500-3,000 per month. Asahi shinbun, December 1, 1973.
184. Proceedings of the House of Councilors, December 1, 1913; Asahi shinbun, February 5, 1974;
185. Bosei hogo i hō, March 1974.
186. And because the pill's status remained ambiguous, those doctors who were willing to prescribe the pill did so somewhat furtively, often without giving patients a medical exam or an explanation of possible side effects. Asahi shinbun, December 1, 1973. It should be noted that several types of IUD were approved in 1974, but doctors did not promote them and they never became popular.
187. The FPFJ, Nichibo, and the Japan Association of Obstetricians and Gynecologists all submitted similar petitions to MHW in 1985 and early 1986, requesting permission to do clinical tests on the low-dose pill. See, e.g., Nichibo i hō, October 1985.
188. See Yumiko Jansson, "Piru 'kaikin' o mae ni ima, hinin to kyōiku o mitsumenaosu," Human Sexuality, No. 5 (November 1991), p. 18;
189. Mariko Jitsukawa and Carl Djerassi, "Birth Control in Japan: Realities and Prognosis," Science, Vol. 265 (August 19, 1994);
190. Japan Times, September 7, 1991. It should be noted, however, that all of the ob-gyns and family planners I spoke to discounted this theory.
191. Interviews with Wagatsuma Takashi, November 17, 1994; Ashino Yuriko, April 24, 1995; Matsumoto Seiichi, May 9, 1995; Honda Hiroshi, Japan Association of Maternal Welfare, June 13, 1995.
192. As in the 1960s, what the drug shingikai actually announced was that "ongoing deliberations" (keizoku shingi) on the pill were necessary. But since deliberations have been "ongoing" for five years now, it is fair to say that the process was frozen.
193. In a meeting with representatives from family planning and ob-gyn groups, MHW Minister Niwa pointed out that many women's groups opposed the pill. Kazoku keikaku, June 1993. It should be noted, however, that there have been some indications recently that the attitude of Japanese feminists may be evolving toward what might be described as reluctant or grudging approval of the pill. For example, a member of the Women's Center in Osaka wrote in 1992 that it would be better to approve the low-dose pill than have women continue using the more dangerous high-dose pill. Sumie Uno, "The Oral Contraceptive Pill in Japan," Issues in Reproductive and Genetic Engineering, Vol. 5, No. 3 (1992). The group Onna no Karada to Iryō o Kangaeru Kai stated that the range of birth control options should be increased, and Asia Josei Kaigi and some members of Soshiren took the position that the pill should be approved so that individual women could weigh the health risks for themselves and decide whether to use it.
194. Even groups such as Nihon Joseigaku Kenkyūkai and Nihon Fujin Kaigi, which did not favor the pill as a form of birth control, still criticized the government for putting public health before women's health by not approving the pill. Misako Iwamoto, "Seishoku no jiko ketteiken no ima: Nihon ni okeru piru kaikin tōketsu o megutte," Joseigaku, Vol. 2 (May 1994), p. 197; group interview with Soshiren members, June 20, 1995.
195. The percentage of women who said they would want to take the pill if it was approved was 12.9 per cent in 1986; it then dropped to 9.9 per cent in 1990, and 6.9 per cent in 1992, but rose again to 12.8 per cent in 1994. Population Problems Research Council, ed., The Population and Society of Postwar Japan, pp. 305-98;
196. Muramatsu, Atarashii kazoku to zō o motomete, p. 56.
197. Ogino, "Abortion and Women's Reproductive Rights," pp. 84-85.
198. Calder, Crisis and Compensation, p. 354;
199. William E. Steslicke, "The Japanese State of Health: A Political-Economic Perspective," in Edward Norbeck and Margaret Lock, eds., Health, Illness and Medical Care in Japan (Honolulu: University of Hawai'i Press, 1987), p. 46.
200. MHW Minister Kan told a BBC reporter in July 1996 that the drug shingikai might reach a decision to approve the pill in 1997. Kazoku to kenkō, August 1996.
201. Margaret McKean, Duke University, discussant for panel, "Citizen Activism in Postwar Japanese History," Annual Meeting of the Association for Asian Studies, Honolulu, April 12, 1996; and personal communication, May 28, 1996. McKean's comments focused primarily on the government's handling of the Minamata mercury poisoning case. John Campbell makes the similar point that bureaucrats tend to be less active than politicians in highly ideological policy areas.
202. Campbell, "Democracy and Bureaucracy in Japan," in Takeshi Ishida and Ellis Krauss, eds., Democracy in Japan (Pittsburgh: University Pittsburgh Press, 1989), p. 129.
203. Amemiya, "The Road to Pro-Choice Ideology in Japan," p. 187.
204. Yūkan Yomiuri, August 6, 1952.
205. Ōbayashi Michiko, Josanpu no sengo (Tokyo: Keisō Shobō, 1989), p. 214.
206. Asahi shinbun, February 14, 1996.
207. It should be noted, however, that there are numerous instances of state involvement in reproductive life that are generally viewed as benign. For example, Article 15 of the Mother and Child Health Law (Boshi hoken hō) requires that women register their pregnancies with the local government. The compliance rate is almost 100 per cent. Maternal and Child Health in Japan, p. 60. Also, the government gives out child allowances that increase with the number of children. The allowance is roughly $50 per month for the first child and for the second and $100 per month for the third child, and some local governments have additional incentives.
208. Naoko Miyaji and Margaret Lock, "Monitoring Motherhood: Socioculturel and Historical Aspects of Maternal and Child Health in Japan," Daedalus (Fall 1994), p. 92. And tax codes and pension schemes have been structured to benefit families in which there is a wife and mother who does not work, or who works only part-time and devotes the rest of her time to childbearing, childcare, elder care, and housework.
209. Nancy Rosenberger, "Gender and the Japanese State: Pension Benefits Creating Difference," Anthropological Quarterly, Vol. 64, No. 4 (October 1991).
210. Sheldon Garon and Mike Mochizuki, "Negotiating Social Contracts," in Andrew Gordon, ed., Postwar Japan as History, p. 147. Garon and Mochizuki define a social contract as "a political exchange relationship between the state and social groups that is mediated by interest organizations and that establishes public-policy parameters that endure over time. Typically the social groups use their market and political power to extract policy concessions from the state, while the state adopts such policies in exchange for their support . . . [which may take the form of] direct electoral backing . . . restraints on collective action and a general acceptance of the socioeconomic order."
211. Sheldon Garon and Mike Mochizuki, Postwar Japan as History, p. Ibid., pp. 145-46.
212. "Members of the general public face high transaction costs in gathering information about interests and in getting and staying organized, all in the face of small per capita gains." Frances McCall Rosenbluth, "Financial Deregulation and Interest Intermediation," in Allinson and Sone, eds., Political Dynamics in Contemporary Japan, p. 114. On the other hand, "groups whose interests are intense and concentrated . . . are far more likely to be heard in the deliberative arena than groups whose interests are dispersed . . . . Because the members of groups with concentrated interests get a greater individual payoff from organization, they are more likely to pay the costs of organizing."
213. Jane Mansbridge, "A Deliberative Theory of Interest Representation," in Petracca, ed., The Politics of Interests, p. 47.
214. Petracca, ed., The Politics of Interests, pp. 7-11.
215. Of course, women have diverse interests in all policy areas, including abortion and contraception policy, so it would be impossible for any one group to properly represent the range of women's interests. One could argue that by representing the interests of some women and not others, these groups are guilty of the same sins as the professional and religious groups. But given that women were grossly underrepresented prior to the emergence of these women's groups, one could also argue that their entrance into the policymaking arena tends to make the environment favorable for other women's groups, representing other concerns, to do so as well.