The Japanese Journal of Population, Vol.4, No.1 (March 2006)

Contraceptive Use and Induced Abortion in Japan:
How Is It So Unique among the Developed Countries?

Ryuzaburo Sato
Miho Iwasawa
Abstract
Although Japan is among countries of low fertility, that is common to the developed countries today,
its situation of fertility control is very different from others. In this paper, we review the trends ofcontraceptive practice and induced abortion in postwar Japan, examine demographic characteristics ofcontraception users, and estimate the contraceptive prevalence rates for women of reproductive age
for international comparison.
The transition from induced abortion to contraception began in the 1950s and ended in the 1970s,
but more than a few abortions have been reported even after this period. The contraceptive behavior
in Japan appears unique among developed countries, with generally lower rates of contraceptive
prevalence, predominance of condom use, and very low use of medical methods. The age of wives,
marital duration, parity, and the desire for the next child are associated with contraceptive use, andthere exists an “unmet need” for family planning among Japanese couples.

Key Words: contraception, family planning, fertility control, induced abortion, reproductive health,Japan, international comparison

1.

and making efforts to establish a comprehensive

INTRODUCTION

Today, the fertility of most industrialized countries

theory to explain the low fertility in these coun-has fallen below the replacement level (fewer thantries (for instance, refer to Caldwell and Schindl-

2.1 children per woman). Moreover, the total fer-

mayr 2003, and discussions of it). However, there

tility rate (TFR) of some countries has dropped

are great differences in several demographic pat-even under 1.3 (refer to Kohler, et al. 2002). In

terns between Japan and Western countries. One

2003, with the continuously decreasing TFR, Ja-of the differences is in the pattern of fertility con-

pan recorded the lowest level of 1.29, and joined

trol. At a glance, the early legalization of induced

the “lowest-low fertility” group of countries,

abortion and very low rate of use of the pill andwhich so far includes Italy, Spain and some ofother medically provided methods of contracep-

other Southern and Central and Eastern European

tion in Japan and the late legalization of induced

countries and countries of the former USSR.

abortion and much higher rates of use of the

Researchers are searching for common causes

33

medical methods of contraception in Western

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
countries form a contrast. Japan is a very uniquesample surveys conducted every five years by thecountry that has completed the fertility transition

National Institute of Population and Social Secu-

without relying on the pill and other highly effec-

rity Research. From the results of two recent

tive contraception methods. On this point, therounds of the JNFS (in 1987 and 1997), we pro-

Second Demographic Transition theory, in which

vide general features of contraceptive use among

the introduction of new, highly efficient contra-

married Japanese women and changes over the

ception is viewed as one of the important neces-past 10 years.

sary factors (van de Kaa 2003), does not suffi-

So far it has been usual to measure the contra-

ciently explain the recent demographic changes in

ceptive prevalence rate for only married couples

Japan. We need to study in more detail the demo-

with wives in reproductive age. There has been agraphic situation of fertility control and its im-

growing interest in the contraceptive prevalence

pacts on fertility in Japan, which will make a con-rate for all (including both married and single)

tribution to establishing the grand theory of very

women of reproductive age to compare the level

low fertility in developed countries.

of contraceptive use to other developed countries.

Our study has a twofold purpose. In the first

Up to now, the JNFS has usually measured con-stage, we collect data and analyze it on levels andtraceptive prevalence rates for married women

trends of fertility control in Japan from the end of

only, and it had previously given no information

World War Two until the present day. In otherabout single women’s sexual and contraceptive

words, we aim to describe how Japan is so uniquebehavior1. The 1997 JNFS is a newly introducedin contraceptive use and induced abortion com-questionnaire on single women’s sexual experi-pared with other developed countries. In the sec-ence and contraceptive use during their most re-ond stage, we aim to examine the social, eco-cent act of sexual intercourse. Using the results,

nomic, cultural and historical conditions and re-we estimate the contraceptive prevalence rate for

lated policies to which the peculiar pattern of fer-single women, and by uniting these two rates

tility control has been attributed. In other words,(married plus single), we present here an estima-

we aim to make clear why Japan is so unique intion of the contraceptive prevalence rate for all

contraceptive use and induced abortion among theJapanese women of reproductive age, which isdeveloped countries.

beneficial for international comparison.

In this paper, as part of the whole study plan,we will (1) review the trends of contraceptive

2. TRENDS OF CONTRACEPTIVE USE AND

practice and induced abortion in postwar JapanINDUCED ABORTION

based on published data sources, (2) examine

1) Data sources

demographic characteristics of contraception users

In Japan we have only three nationwide serial

based on data from the Japanese National Fertility

statistical data sources on contraception and in-

Survey, and (3) estimate the contraceptive preva-

duced abortion. First, the Ministry of Health, La-

lence rates for all women of reproductive age inbor, and Welfare reports every year the total num-

Japan.

ber of registered induced abortions (Maternal

The Japanese National Fertility Survey (JNFS)

Body Protection Statistics). Second, the National

is a series of nationally representative fertility

Survey on Family Planning, which has been con-34

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
ducted almost every two years by the Mainichi

KAP (knowledge, attitude, and practice) surveys

Shimbun newspaper (from 1950-2000), provides

on family planning, which was conducted bienni-

us with time series data on the contraceptive

ally by the Mainichi Shimbun (one of the major

prevalence (and methods) among married women

newspapers in Japan). This survey has a history ofand the percentage of women who have experi-

half a century from its first survey in 1950 to theenced induced abortions. Third, the Japanese Na-

25th survey in 2000. Each time about 4,000 mar-tional Fertility Survey, which is conducted by ourried women not older than 50 responded, and ininstitute, recently investigated the contraceptive

recent surveys unmarried women of the same ages

prevalence (and methods) among married couples

were added as subjects. The family planning sur-(data is available for the years 1987 and 1997).

vey came to an end with the 2000 survey and a

Hereafter, the three data sources are briefly ex-

new survey tilted the Survey on Population, Fam-plained.

ily and Generation (SPFG) was carried out in
April 2004. The SPFG contains similar questions(1) Maternal Body Protection Statistics (MBPS)

on contraceptive practice among married women,

Under the Maternal Body Protection Law (for-making it possible to follow the trend until 2004.

merly, the Eugenic Protection Law), a woman canseek an induced abortion in cases where she has(3) Japanese National Fertility Survey (JNFS)

health problems for physical or economic reasons,

The JNFS is a series of nationally representative

or she has been raped. The fact is though, induced

fertility sample surveys conducted every five

abortions are performed on demand in Japan, be-years by the National Institute of Population andcause no proof is necessary for these reasons.

Social Security Research. From the results of two

Only the authorized OB/GY doctors can do thisrecent rounds of the JNFS (in 1987 and 1997), we

operation within 22 weeks (i.e., by 21 weeks in

can provide general features of contraceptive usefull) of gestation. Every doctor who performs anamong married Japanese women and changes overinduced abortion is required to report it to thethe past 10 years (the latest 2002 survey did not

Ministry of Health, Labor and Welfare through theinclude questions on contraception). Each time,

local health center. The ministry tallies the num-

about 9,000 married women aged 15-49 re-bers and publishes an annual report, titled thesponded.

Maternal Body Protection Statistics.
Since 2002, the ministry has reported the2) Trend of induced abortions

numbers and rates of induced abortions in the(1) Annual numbers and rates for induced abor-

periods of the fiscal year. Accordingly, the re-tions (MBPS)

ported numbers and rates for “2002” and “2003”

Figure 1 shows the trend of the annual number ofcorrespond to those for the period April 2002 to

induced abortion, from 1949 to 2003. The re-March 2003 and the period April 2003 to March

ported number was the largest in 1955 (1.17 mil-

2004, respectively.

lion). Since that year, the number has almost continuously decreased until the middle of the 1990s.

(2) National Survey on Family Planning (NSFP)

Recently it has remained at almost the same num-

The NSFP is a series of nationally representativeber (319,831 in the fiscal year of 2003).

35

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
Figure 1.

Number of Induced Abortions, 1949-2003

1,200,000

1,000,000

800,000

600,000

400,000

200,000

0
2000

1995

1990

1985

1980

1975

1970

1965

1960

1955

1950

Source: Maternal Body Protection Statistics

Figure 2.

Induced Abortion Rate (per 1,000 women), by age group, 1955-2003

100
90

under 20
20-24
25-29
30-34
35-39
40-44
45-49

80
70
60
50
40
30
20
10
0

2000

1995

1990

36

1985

1980

1975

1970

1965

1960

1955

Source: Maternal Body Protection Statistics

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
Trends of age-specific induced abortion rates,

women, we can say that this trend is probably duefrom 1955 to 2003 are shown in Figure 2. For all

to changes in sexual behavior among unmarried

age groups of women, the rates have almost con-young women (the tendency to engage in sex ear-tinuously decreased, except for the rate for womenlier and have more sexual partners than before),younger than 20. This increasing trend of the teen

because the proportion of never-married women

abortion rate is one of the greatest concerns

among women aged 15-19 and 20-24 is very highamong adolescent health specialists. Another no-in recent years (in 2000, 99.1% and 87.9%, re-ticeable trend is the recent increase in the rate forspectively). (Refer to Goto, et al. 2000)

women aged 20-24. Although the MBPS does notdistinguish between married and unmarried

Figure 3.

Percentage of Induced Abortions, by Period of Gestation

1955

Year

1970

1985

2001

0%

20%
-7 weeks40%

60%
8-11 weeks

80%

100%

12+ weeks

Source: Maternal Body Protection Statistics

Figure 3 shows when induced abortions wereabortions (NSFP)

performed during the gestational periods. Since

The trend in the proportion of married women of1955 more than 90% of them have been per-reproductive age who have experienced induced

formed within 12 weeks. At the present time,

abortion generates a three-phase pattern (Figure 4).

more than 50% of induced abortions are per-

The percentage of those having had an induced

formed within 8 weeks of gestation.

abortion at least once was less than 20% in the
NSFP in 1952. The percentage steeply increased,(2) Experience and attitude with regard to induced

37

exceeding 40% in 1961, then it stabilized, re-The Japanese Journal of Population, Vol.4, No.1 (March 2006)
maining on almost the same level at nearly 40%

2000, about a quarter of respondents had experi-

between 1961 and 1984. Since 1986 it has been

enced an induced abortion at least once.

slightly decreasing. According to the last NSFP in

Figure 4.

Percentage of Married Women Who Have Experienced an Induced Abortion

90
(%)

80
70
60
50

Have experienced
Never experienced40

No answer

30
20
10
0
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1982
1980
1978
1976
1974
1972
1970
1968
1966
1964
1962
1960
1958
1956
1954
1952
1950

Source: National Survey on Family Planning, Mainichi Shimbun

We can speculate that the steep increase be-

induced abortions unconditionally. Since thetween 1952 and 1961 was due to the easing of

1980s, the proportion of those who approved ofrestrictions on the conditions permitting abortion

induced abortions unconditionally has gradually

in 1952, in addition, the availability of contracep-

increased to 23% in 2000.

tion was very low at that time. This sudden in-

The all time majority was those who approved

crease of abortions persuaded the government andof induced abortions conditionally, with an almost

non-governmental organizations to start family

consistent 60% share. They were asked whether

planning activities (Refer to Norgren 2001). We

they approved of induced abortions on the three

can say, the continued relatively stable level ofconditions: “when contraception fails,” “when theabortion experience after 1963 was caused by themother lives in financial hardship,” and “when the

progression of the transition from abortion to con-mother is not married or can’t get married.” 38.4%,

traception in the 1960s (see also Figure 6).

66.4%, and 81.0% of them respectively approved

Figure 5 shows the trend in the attitude toward
induced abortion among married women of reproductive age. Before the mid 1970s, the proportion of respondents who disapproved of induced
abortions was higher than those who approved of38

of abortions for each condition in 1998. (Refer toAtoh 1988, Muramatsu 1990, Hayashi 1996)

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
Figure 5. Attitude toward Induced Abortion among Married Women
(%)

80
70
60
Approve50

Disapprove40

Conditionally30

No answer

20
10
0
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1982
1980
1978
1976
1974
1972
1970
1968
1966
1964
1962
1960
1958
1956
1954
1952
1950
Source: National Survey on Family Planning, Mainichi Shimbun

Figure 6.

Contraceptive Practice among Married Women

70
(%)

60
50

Current users
Past users

40

Never users

30

No answer

20
10
0
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1982
1980
1978
1976
1974
1972
1970
1968
1966
1964
1962
1960
1958
1956
1954
1952
1950
Source: National Survey on Family Planning (1950-2000), and the Survey on Population, Family andGeneration (2004), Mainichi Shimbun

39

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
3) Trend of contraceptive practicechange in the age-structure of marred women of(1) Trend of contraceptive prevalence (NSFP)

reproductive age. The proportion of wives in their

The NSFP series provides us with the trend of

20s and 30s, who are assumed to be more sexuallycontraceptive practice among married women of

active than wives in their 40s, has been decreasing

reproductive age (Figure 6). In this questionnaireremarkably due to later marriages in recent years.

the respondents are asked to choose: (1) they are

Moreover, we must consider a new view that sex-

currently using a method of contraception, (2)less couples may be increasing in present-day

they have practiced contraception but currently

Japan. According to a nationwide sexuality survey,

don’t, or (3) they have never practiced contracep-

named The Second Survey on Life and Con-

tion. In the 1950 survey the proportion of current

sciousness of Men and Women, conducted in 2004,

users was only about 20%, but it steeply increased

the proportion of married women who had not hadto the level of about 60% by the early 1970s, thensex during the past month of the survey wasit stabilized, remaining at that level. Its recent

17.6%, 33.3%, and 30.5% for those aged 20-24,

downward trend from 59% in 1994 to 52% in

25-29, and 30-34, respectively (Kitamura 2005).

2004 attracts attention. One possible reason is a

Figure 7.

Contraceptive Methods among Current Users (Married Women)

90
(%)
80
70

Ogino method
Withdrawal

60

Condom50

Douche40

Diaphragm

Spermicide (tablet)
Sterilization

30

IUD
Pill

20

BBT method

10
0
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1982
1980
1978
1976
1974
1972
1970
1968
1966
1964
1962
1960
1958
1956
1954
1952
1950

Source: National Survey on Family Planning (1950-2000) and the Survey on Population, Family, andGeneration (2004), Mainichi Shimbun

Figure 7 shows trends of contraceptive meth-time of the survey. We must take note of thisods among married women of reproductive age

question allowing multiple choices (except 1950).

who were currently practicing contraception at the

As shown in the figure, the proportion of condom

40

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
users was constantly predominant (the drop inincrease in the proportion for the withdrawal

1981 may have been influenced by a very highmethod in 2000 may be caused by the change ofrate of no answers in the survey of that year). The

the word designating withdrawal in the question-

proportion of users of the Ogino method has been

naire, from “Coitus interruptus” to “Extra-vaginal

relatively high. On the other hand the proportion

ejaculation (coitus interruptus).”of medical methods such as the pill, IUDs andsterilization has been extremely low. The sudden

Figure 8.

Contraceptive Practice among Sexually Active Never-Married Women

1990

1994

1996

1998

2000

0%

20%
Current users

40%

60%

80%

100%

Past users

Never users

No answer

Source: National Survey on Family Planning, Mainichi Shimbun

The NSFP had originally surveyed only mar-means that the practice of contraception has rap-

ried women not older than 50. Since the 1990

idly

pervadedamong

sexually

activesurvey, unmarried women of the same ages havenever-married women through the 1990s in Japan.

also been included in the survey (except 1992).

(Refer to Kobayashi 1988, 1990a, 1990b; Kubo

Figure 8 shows the change of contraceptive prac-

1988; Hayashi 1998; Wagatsuma 1996,1998)

tice among never-married women who have experienced sexual intercourse. The proportion of(2) Current level and pattern of contraceptive use

current users was less than 40% in 1990, sharply(JNFS)

increasing to nearly 60%. In contrast, the propor-

The 1987 and 1997 JNFS also provides data totion of never users, having been nearly 30% in

describe the current level and pattern of contra-

1990, decreased to only about 5% in 2000. This

ceptive use among married women.

41

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
It was found that a total of about 60% of mar-life. Comparing the contraceptive prevalence be-ried women aged 15-49 were using some method

tween 1987 and 1997, 58.9% in 1997 is about 5of contraception, while about 20% of them had

percentage points lower than 63.5% in 1987.

used contraception but were not using it at the

However, we cannot affirm that married couples'time of the survey, and about 10% of them had

contraceptive prevalence is declining recently, as

never used any method of contraception (Figure 9).

the percentage "not stated" has increased.

This means that about 80% of married couples
practice contraception throughout their married

Figure 9. Contraceptive Practice among Married Women
0

10

20

30

40

50

60

70
(%)

Currently practice

Have practiced,
but currently not

1987

Never practiced

1997

Not stated

Among the married women currently usingof medical methods (the pill, IUDs, sterilization,some method of contraception, the proportion of

etc.)

is

popular,among

Japanese

couples

those who were using condoms (73.9% in 1987,

non-medical methods (condom, withdrawal, peri-

75.2% in 1997) was overwhelmingly high, while

odic abstinence, etc.) are predominant. The total

the proportions using other methods such as

proportion of users of sterilization, the IUD andspermicides (0.4%, 1.2%), periodic abstinence

the pill is as low as around 10%. One noticeable(13.7%, 8.6%), the IUD (4.8%, 2.7%), the pillchange is an increase in the users of the with-(1.4%, 1.2%), withdrawal (15.5%, 20.6%), maledrawal method (from 15.5% to 20.6%).

sterilization (1.7%, 1.3%), and female sterilization

In general, the contraceptive levels and pat-

(5.9%, 3.9%) were relatively low (multiple an-terns among married Japanese couples shownswers were given by respondents) (Figure 10).

from the 1987 and 1997 JNFS are similar to those

In contrast to western countries, where the use

42from recent NSFP.

The Japanese Journal of Population, Vol.4, No.1 (March 2006)

Figure 10. Contraceptive Methods among Current Users
0

10

20

30

40

50

60

70

80
(%)

CondomSpermicide
Periodic abstinence
IUD
Pill
Withdrawal

1987

Male Sterilization
1997

Female Sterilization
Others(3) Combinations of Contraceptive Methods

drawal method.
All users of male or female sterilization and(JNFS)We examined the combined use of contraceptive

almost all users of the IUD used the said method

methods based on data of the JNFS. The percent-only. In summary, we can say that in Japanese

age of married women currently using specified

users of non-medical methods whose contracep-

contraceptive method combinations is shown intive effect is uncertain (such as withdrawal, peri-

Figure 11. Among married women currently using

odic abstinence) tended rather to use it in combi-

some method of contraception in 1997, 83% reliednation with condoms or other methods than to use

on one method, 13% used two methods simulta-that method alone.

neously, and just 1% used three methods.
The majority of condom users relied on this3.

DEMOGRAPHIC

CHARACTERISTICS

method alone, and a portion of them used it in

OF CONTRACEPTIVE USERS

combination with withdrawal, periodic abstinence

We examined some demographic characteristics

or other methods. Among those using the with-of contraception users based on data from the

drawal method, about a half used only this method,

1987 and 1997 JNFS. The following figures show

and many others used it together with a condom,

the distribution of married women in 1997, by theand a small portion of them used it with periodic

situation of contraceptive practice and the speci-

abstinence. Among those practicing periodic ab-fied group (a) and by method and the specified

stinence, a few used only this method and manygroup (b).

used it in combination with a condom or the with-

43

The Japanese Journal of Population, Vol.4, No.1 (March 2006)

Figure 11. Combinations of Contraceptive Methods among Current Users
0

10

20

30

40

50

60

70

80

(%)

Condom only
Condom and Withdrawal
Condom and Periodic abstinence
Periodic abstinence only
Condom,Periodic abstinence and Withdrawal
Pill only
Condom and Spermicide

1987

Condom and others

1997

Not stated on methods

Figure 12a. Contraceptive Practice, by Age,1997

Figure 12b. Contraceptive Methods among Current
Users, by Age,1997

0

20

40

60

80

0

(%)

40

60

80

100
(%)

CondomCurrently
practice

Spermicide
Periodic abstinenceHavepracticed,
but currently
not

IUD

Never

Withdrawal

Pillpracticed

Male Sterilization

20s
30s

Not stated20

Female Sterilization

20s
30s
40s

40s

Others1) Wife’s age

users is consistently high through all age groups

The proportion of those currently using some

(Figure 12b). The shares for the withdrawal

method of contraception is highest when they aremethod and periodic abstinence, as well as con-in their 30s (Figure 12a). The share of condom

doms, drop when they reach their 40s. The shares

44

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
for the IUD and sterilization increase as age in-

40s as well as those in their 20s (not shown in thecreases, but the levels are low as a whole. Com-

figures).

pared to 1987, in 1997 the share for the withdrawal method increased for those in their 30s andFigure 13a. Contraceptive Practice,

Figure 13b. Contraceptive Methods among Current

by Marital Duration,1997

Users, by Marital Duration,1997

0

20

40

60

80

0

(%)

20

40

60

80

100
(%)

CondomCurrently practice

Spermicide
Periodic abstinence

Have practiced,
but currently not

IUD
Pill

Never practiced

Not stated

Withdrawal

4 years and less

4 years and less

5-9

Male Sterilization

5-9

10-14

Female Sterilization

10-14

15 and more

Others15 and more

2) Marital durationof the IUD and female sterilization increases re-

The proportion of current users of contraception ismarkably after the couple have had two children

highest in the period 10-14 years after marriage(Figure 14b). The share for male sterilization in-(Figure 13a). The shares for condoms, the with-creases after the couples have had three children.

drawal method, periodic abstinence and the pill,with the highest level at 0-4 years after marriage,4) Desire for the next childdecrease as the marital duration increases (Figure

The proportion of current users among married

13b). On the other hand, the shares for the IUD

women who want one or more children is as highand male and female sterilization increase as

as 40.5%, while the proportion among those whomarital duration increases, with the peak at 15 andwant no more children is 68.0% (Figure 15a). The

more years after marriage.

shares for condom, withdrawal and periodic abstinence are higher among those who want more

3) Parity

children, while the IUD and male and female ster-

The proportion of current users increases as parity

ilization are used almost exclusively among thoseincreases, from 29.2% at parity 0 to 71.7% at par-who want no more children (Figure 15b).

ity 3 and so on (Figure 14a). The shares of users

45

The Japanese Journal of Population, Vol.4, No.1 (March 2006)

Figure 14a. Contraceptive Practice, by Parity,1997

Figure 14b. Contraceptive Methods among Current
Users, by Parity,1997

0

20

40

60

80

0

20

40

60

80

(%)

100
(%)

CondomCurrently
practice

Spermicide
Periodic abstinenceHavepracticed,
but currently
not

IUD
Pill

Never
practiced

Withdrawal

parity 0

Not statedparity 0

1

Male Sterilization2

Female Sterilization

3 and more

1
2
3 and more

OthersFigure 15a. Contraceptive Practice,

Figure15b. Contraceptive Methods amongby Desire for the Next Child,1997

Current Users, by Desire for the Next Child,1997

0

20

40

60

80

0

(%)

20

40

60

80

100
(%)

CondomCurrently
practice

Spermicide
Periodic abstinenceHavepracticed,
but currently
not

IUD
Pill

Never
practiced

No moreWithdrawal

Want more

Male Sterilization

Not statedFemale Sterilization

Not stated

OthersNo moreWant more
Not stated5) Desired timing of the next birth

possible is as low as 19.7%, otherwise the propor-

Figure 16a shows the distribution of marriedtion among those who want to postpone the next

women who want one or more children by thebirth is 71.2%. Figure 16b shows the distribution

situation of contraceptive practice and the desiredof current users by the method and the desired

timing of the next birth. The proportion of current

timing of the next birth. Among contraception

users among those who want a child as soon as

users who want a (another) child later, the use rate

46

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
for condom (81.2%), withdrawal (24.2%) andare currently pregnant; and (3) those who have no

periodic abstinence (9.1%) is relatively high.

idea on the timing of the next birth. The firstgroup is the group which needs at least some form

6) Attitude toward the next birthof contraception. Figure 17a shows that the pro-

By combining the data of the desire for the next

portion of current users for this group is as high aschild (Figures 15a and 15b) and the data of the

68.3%. But even in this group, 26% are not cur-desired timing of the next birth (Figures 16a andrently using contraception. It suggests the exis-16b), we classified married women into threetence of an “unmet need” for family planninggroups: (1) those who want no more children or

among married Japanese couples.

who want a (another) child later; (2) those whowant a (another) child as soon as possible or who

Figure 16a. Contraceptive Practice,

Figure 16b. Contraceptive Methods among Current

by Desired Timing of the Next Birth,1997

users, by Desired Timing of the Next Birth,1997

0

20

40

60

80

0

20

40

60

80

CondomCurrently
practice

Spermicide
Periodic abstinenceHavepracticed,

IUD

but currently
not

Pill

Never
practiced

Withdrawal

Pregnant

Pregnant

Male Sterilization

Want sooner

Not stated

100
(%)

(%)

Female Sterilization

Want later
No idea

OthersWant sooner
Want later
No ideaFigure 17b shows the distribution of current

induced abortion (66.8%) than among those whousers by the method and the attitude toward thehave not (58.4%) (Figure 18a). While the propor-

next child. The shares for the IUD, and male andtion of condom users is higher among those who

female sterilization are higher among the firsthave not experienced an induced abortion, thegroup than among the third group, but the levels

proportion for withdrawal, the IUD, the pill andof the use of these methods are very low.

male or female sterilization is higher among those
who have experienced an induce abortion (Figure7) Experience of induced abortions

18b). The difference is particularly large in the

The proportion of current contraception users iscase of married women currently using the pillhigher among those who have experienced an(1.2% of those who have not experienced an in-

47

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
duced abortion, compared to 2.4% of those who

Another presumed reason is that sexually activehave). One possible reason is that those who have

women are more likely to have an induced abor-

bitter experiences with induced abortions aretion and are more likely to use contraceptive

likely to seek reliable methods of contraception.

methods.

Figure 17a. Contraceptive Practice, by Attitude

Figure 17b. Contraceptive Methods among Current

toward the Next Birth,1997

users, by Attitude toward the Next Birth,1997

0

20

40

60

0

80

20

40

60

80

100

(%)

(%)

CondomCurrently
practice

Spermicide
Periodic abstinenceHavepracticed,

IUD

but currently
not

Pill

Never

Withdrawalpracticed

No more or want later

No idea

Not stated

No more or want later

Male Sterilization

No idea

Female Sterilization

Pregnant or wantsoonerPregnant or wantsoonerOthersFigure18a. Contraceptive Practice,

Figure 18b. Contraceptive Methods among Current

by Experience of Induced Abortion,1997

Users, by Experience of Induced Abortion,1997

0

20

40

60

0

80

20

40

60

80

(%)

CondomCurrently
practice

Spermicide
Periodic abstinenceHavepracticed,
but currently
not

IUD

Never
practiced

Withdrawal

Not stated

Pill

No

Male Sterilization

No

Yes

Female Sterilization

Yes

Not stated

Others48

Not stated

100

(%)

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
4. CONTRACEPTIVE PREVALENCE FOR

for all women of reproductive age in Japan based

ALL WOMEN OF REPRODUCTIVE AGE

on the data from the 1997 JNFS.

We estimated the contraceptive prevalence rates

Figure 19. Contraceptive Practice among Single Women, by Age,1997
100
(%)

80

Never sexual relation,
Not stated60

Not practice40

Not stated on practice
Practice

20

0
-19

20-24

25-29

30-34

35-39

40-44

45-49

Age of Single Women

1) Contraceptive prevalence among single

those aged 30-34; after which it declines. The

women

overall rate is 35.8%, but it may be overestimated,

The situation of contraceptive practice amongespecially among older single women, because thesingle women at the time of survey was not ques-

women who practiced contraception in the pasttioned in the JNFS series, but the 1997 JNFS in-are not necessarily sexually active at present.

vestigated single women’s sexual experience andthe contraceptive practice used during their most2) Contraceptive prevalence among married

recent act of sexual intercourse. Using the contra-

women

ceptive practice used during the most recent act ofThe contraceptive prevalence rate for married

sexual intercourse as the contraceptive practicewomen by age group is shown again in Figure 20.

used at the time of survey, we estimated the con-

The rate reaches a peak of 66.8% for those aged

traceptive prevalence among single women.

35-39; after which it declines to 52.5% for those

Figure 19 shows the estimated contraceptive

aged 45-49. The overall rate is 58.9%.

prevalence rate for the single women population
by age group. It is only 17.5% among single

3) Contraceptive prevalence among all women

women younger than 20, but it steeply rises forof reproductive age

those in their 20s, reaching a peak of 44.6% for

The estimated contraceptive prevalence rate for all

49

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
women by age group was calculated using thecensus. The women who did not state whether

sum of the rate for single women and the rate forthey had experienced sexual intercourse or

married women, both weighted using the popula-whether they had practiced contraception weretion distribution by marital status in the 1995

excluded.

Figure 20. Contraceptive Practice among Married Women, by Age,1997
100
(%)

80

Not practice60

Not stated on practice40
Practice
20

0
-19

20-24

25-29

30-34

35-39

40-44

45-49

Age of Married Women

Figure 21. Percentage of Women of Reproductive Age Currently Practicing Contraception,1997
100

(%)

90
80
70

54.5

60

Single women

50

Married women

40
30
20
10
0
-19

20-24

25-29

30-34

35-39

40-44

45-49

Age of Women

50

ALL

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
As a result, the rate is less than 20% among

The overall rate is 54.5%. Because the rate forwomen younger than 20, but it increases as age

single women may be overestimated as mentioned

increases to a peak of nearly 70% for those aged

above, the rate for all women may be overesti-

35-39; after which it slightly declines (Figure 21).

mated.

Figure 22. Percentage of Women Currently Practicing Contraception, Selected Industrialized Countries
100
(%)
90
80
70
60
50
40
30
20
10
0
Belgium, Germany,
1991(20-40)1992(20-39)Great
Britain,1992(18-44)Australia, Denmark,France,1986-87(20-49)1995(20-44)1989(15-44)

UnitedStates,1995(15-44)

Canada,Japan,

1995(18-49)1997(18-49)Sources: Australia, Belgium, Denmark, Germany and Great Britain - United Nations (1996); France Toulemon and Leridon(1998); United States - Piccinino and Mosher (1998); and Canada - Martin and Wu(2000). We added a bar for Japan to the bars of 8 other countries from figures of Martin and Wu (2000).

4) International comparison

having sexual intercourse among Japanese single

Finally, we would like to compare the estimatedwomen, (2) lower marriage rates among Japaneselevel of contraceptive prevalence for all Japanesewomen of reproductive age, and (3) relatively low

women of reproductive age (54.5%) with otherrates of contraceptive use among Japanese mar-countries. In a comparison of 8 industrialized

ried couples. The cultural and social backgroundcountries (Belgium, Germany, Great Britain, Aus-behindtralia, Denmark, France, United States and Can-

man-woman relationships should be further ex-ada), Martin and Wu (2000) concluded that Can-amined.

thewife-husband

partnership

andada’s overall contraceptive prevalence is among
the lowest in the industrialized world. In this pa-

5. CONCLUSION

per, however, our estimation suggests that Japan’s

Although the reported number of induced abor-

contraceptive prevalence is far lower than Canada

tions seems to be underestimated because of(Figure 22). This is arguably due to the combina-

losses in registration and insufficient statistics ontion of three factors: (1) presumably lower rates ofcontraceptive practice were available, we can still

51

The Japanese Journal of Population, Vol.4, No.1 (March 2006)
get a good understanding of the levels and trends

methods use them in combination with otherof contraceptive practice and induced abortion inmethods. A wife’s age, marital duration, parity,

Japan. And, in this paper, we have highlighted

and desire for the next child are viewed as impor-some current aspects of demographic patterns oftant determinants of contraceptive use. There ex-contraceptive behavior among Japanese women ofists an “unmet need” for family planning among

reproductive age.

married Japanese couples. These findings suggest

First, we can see a transition from abortion to

the existence of more than just a few numbers ofcontraception, that is, from a pattern with a very

unplanned pregnancies in Japan2. We shouldhigh abortion level and a very low contraception

tackle these problems from the standpoint of re-level to a pattern with a relatively low abortion

productive health.

level and a relatively high contraception level. The

We can say that the Japanese contraceptive

data included in this report indicated that the tran-

usage pattern is very unique in the world. The

sition began in the 1950s and ended in the 1970s.

peculiar tendencies in contraceptive behavior

Second, there are some problems associatedamong Japanese women of reproductive age aswith contraception and abortion levels and pat-compared with other industrialized countries -terns of the post-transition phase in Japan. Al-

generally lower rates of contraceptive prevalence,

though the abortion rates have dramatically de-predominance of condom use, and very low use ofcreased, its level is still not low, even now. More-medical methods - need to be further examined.

over, recent increases in abortion rates among
women aged 15-19 and 20-24 is posing a new

NOTES

issue.

1 In this paper, “married” means currently mar-Third, although the contraceptive prevalence
among married Japanese couples remains stable atried, and “single” includes both never marriedand formerly married.

a level of around 60%, the level is relatively low

2 Iwasawa (2002) proposed a model to estimate

compared internationally. In this paper, we esti-

the number of conceptions during the course of

mated the contraceptive usage rates for the single

one year by all Japanese women of reproductive

women population and presented the contracep-

age, and suggested that the percentage of unin-

tive usage rates for all women (single and mar-tended pregnancies could be between forty andried) by uniting the rates among single women

sixty percent and the amount of unintended

and the rates among married women. This esti-

births could be between thirty and fifty percent

mate suggested that Japan’s overall contraceptiveof all births in Japan in 1997.

prevalence (less than 60%) is among the lowest in
the industrialized world.

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(National Institute of Population and Social SecuACKNOWLEDGEMENT

rity Research, Tokyo.

This paper was presented at the 25th IUSSP In-

E-mail: iwasawa@ipss.go.jp)

ternational Population Conference in Tours on

54