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Japan's
Fertility-Treatment Boom Pressures Women
January 13, 2004 By
Suvendrini Kakuchi
WeNews correspondent
In Japan, fertility
treatments are booming as more couples have trouble
conceiving. Women's activists say the trend puts more
pressure on women in a culture that too often judges
women by their ability to reproduce.
TOKYO, Japan (WOMENSENEWS)--After
spending thousands of dollars on
painful fertility treatments over the past two decades,
Keiko and her husband, both in their early 40s, called
it quits last October.
"While it is still
tough being childless, I have to acknowledge that not
running after doctors has given me some relief. I am now
going through the hardest part, which is accepting my
infertility," says the English teacher, who requests
that only her first name be used.
Keiko, as with Japan's
growing number of infertile patients, longs for a baby
not only to fulfill her own desire but also to meet high
social pressure to produce an offspring.
"I desperately wanted
to have a child as my husband works all the time.
Moreover, my mother-in-law kept asking me when she could
see her grandchild and I felt so bad for not doing my
duty," she says.
According to the latest
government statistics, the nation's birth
rate--currently 1.3 babies per woman--is down from
postwar highs of between 1.4 and 1.7 in the 1960s. Some
activists say the inability to bear children takes a
heavy toll on many women.
Childless, Feeling
Guilty
"Childless women in
Japan grapple with extreme loneliness and guilt," says
Junko Kurihara, spokesperson for the Tokyo-based Friends
of Finrrage, a support group dealing with infertility.
"We have programs to help them regain their confidence."
But for infertile women
the struggle to overcome a sense of inadequacy is uphill
in a country where women find immense social esteem in
bearing children. Instead, many women, like Keiko, are
turning in droves to fertility treatments.
Data compiled by the
Japan Society of Obstetrics and Gynecology in 1999
indicate that 1 in 10 couples--or close to 300,000
patients--are currently undergoing fertility treatments
in Japan.
The trend, according to
health authorities here, is consistent with other
industrialized countries where lifestyle choices--such
as late marriages--have produced higher infertility
rates. In Japan, however, the struggle to overcome
fertility through technological interventions is
outstanding. For instance, Japan, with a population of
126 million, has 474 medical institutions (including
privately-owned clinics) that offer fertility
treatments, compared with 350 in the United States, with
a population of 280 million.
Government statistics
also reveal that every year, about 12,000 babies--1 in
every 100--are conceived through the aid of fertility
technology. Doctors predict the ratio to rise to 1 in 50
in a few years.
The country is also
seeing its share of fertility-treatment landmarks. A
Japanese woman in her 60s last year underwent extensive
treatments to become the country's oldest woman to give
birth. About 50 couples have resorted to surrogacy and
circumnavigated Japanese law against the practice by
working with surrogate mothers from overseas. Meanwhile,
a doctor recently began operating the nation's first egg
bank for healthy women who want to delay their
pregnancies.
Government Effort to
Boost Fertility
To redress the falling
birth rate, which could decline more steeply with any
further economic decline, the Ministry of Health, Labour
and Welfare set up an infertility department in
September to boost fertility treatment. While full
details about it are not yet public, the program is
expected to allow women to use their health insurance
for fertility treatments.
Tomoko Kashiwage, an
official at the new infertility treatment center, says
the average cost for a couple undergoing fertility
treatments is almost $50,000 over four years, a price
too high for most couples. "A new subsidy plan will be
launched in April 2004 to pave the way for more couples
to undergo treatment," she says.
While activists welcome
insurance coverage as a means of easing the financial
burden, they caution that the boom in infertility
treatments increases societal pressures on women having
difficulty conceiving. These activists want fertility
treatments to offer a range of options to women,
including the choice that Keiko recently made, to give
up fertility treatments. Medical programs, they say,
must emphasize the safety risks of fertility treatments
and help women feel comfortable about choosing,
possibly, not to have a child at all.
"What is urgently
needed is not more invasive and psychologically damaging
medical treatment, but a concrete debate and legislation
to raise consciousness and protect the reproductive
rights of women," says Yuko Ashino, director of Japan
Family Planning Services in Tokyo, a leading provider of
reproductive-health services.
Trying to Deepen
Public Awareness
Against the current
backdrop, Friends of Finrrage--which stands for Feminist
International Network of Resistance to Reproductive and
Genetic Engineering--now has 400 members and is working
urgently to promote a deeper understanding of the issue
in Japan. This year the Tokyo branch of Friends of
Finrrage conducted six workshops on women's reproductive
rights, which included sessions on the social pressures
borne by women without children, such as feelings of
being unwomanly or derelict in upholding a social duty
to procreate. In the seminars, participants revealed
callous treatments by male doctors who blamed them for
being infertile or called them old when they sought help
for being unable to conceive.
Friends of Finrrage is
also spearheading a movement against conservative male
politicians who often make disparaging remarks against
childless women. In July, the group demanded but did not
get an apology from a former prime minister, Yoshinori
Mori, who joked during a public debate on declining
birth rates, saying "women who do not have children are
a drag on the economy."
Women reacted with
outrage. "His comments show clearly that nothing has
changed," said Keiko Yamauchi, an opposition politician.
"Male politicians continue to view women as only
worthwhile to support men."
In addition, Friends of
Finrrage's monthly newsletters have become a useful
source of independent research material on reproduction
technology and treatments, a breakthrough in Japan where
infertility is treated as a disease needing special
treatment.
Kurihara also reports
their seminars are now drawing more husbands, something
of a landmark in public concern for women's reproductive
health. "Traditionally men see reproduction as a woman's
business, leaving important sexual and fertility issues
to their female partners," says Kurihara. "With more men
participating, we see a change in old attitudes."
Surveys by Friends of
Finrrage also indicate adoption is not a popular option.
Children available for adoption number around 38,000,
but only 2 percent of couples seeking fertility
treatments saw the practice as a viable alternative to
treatment.
"The focus on fertility
technology has actually worked against adoption because
couples believe doctors can help produce a child. There
is now more pressure on women," says Kurihara.
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