by Yasuko Ako
Yasuko is currently a staff in the Women’s Center of Osaka and a counsellor at Haru Women’s Clinic.
It was experiences in the three encounters in the early 1980s that made me think of working with women’s health problems. I was working at a union at that time and it was always one of our top priorities to gain rights regarding menstrual and maternity leave. However, our discussions only focused on issues relating to the social systems and not on women’s body or health. For instance, we spent time discussing about menstrual leave, but never talked specifically about “my own body” or the importance of menstruation to women’s bodies. Personally, even after I experienced abortion and childbirth, I was still having a hard time relating to my own body and consulting with medical treatments in obstetrics and gynecology.
My first encounter was the case of the Fujimi obstetrics and gynecology clinic. When I was collecting signatures for a case of medical malpractice, people asked me why women went to such a clinic. In this case, it was not the fault of women who went to the clinic which happened to have bad doctors. It could happen to other women like me. The case happened in Tokyo and although I have no direct contact with this clinic, I was wondering what I could do to help them from Osaka where I lived.
The second encounter was a protest for the amendment of the Eugenic Protection Law.
Yuriko Ahino, Yuriko Marumoto, and Yumiko Jansson have a movement against the amendment of the law, and in the meantime, worked on promoting better understanding among women about our own bodies.
Thirdly, after the Women’s Conference held in 1975 in Mexico, the Convention for Elimination of All Forms of Discrimination against Women was submitted to the United Nations. Issues relating to gender roles such as household sharing, became topics that were openly discussed. However, issues related to women’s bodies, such as birth control and abortion, were still topics that were widely neglected. I wanted to talk specifically about “my body” among issues of women’s body, and to know more about my own body.
In 1984, about 20 of us gathered together to establish a clinic for women and to learn more about women’s body and our gynecological organs. At that time, the only available information on women’s body came from overseas in translated forms, so there was a need for a center to provide information in Japan. As a first step, we decided to provide a place to have study, discussion-groups and also to provide a telephone consultation service.
One of the issues that we wanted very much to study and discuss was abortion rather than childbirth as abortion was the most common experience among us. There was a movement started by Ms. Ashino and others to socialize the abortion issue through a movie by Gail Singer called “Abortion Stories from North and South”. However, there was almost no opportunity to discuss or write about our own abortion experiences. Why do we have to suffer so much? Let us share our experiences. This is how we came to publish the book called “Abortion-Message from Women” with funding raised from supporters. This book sold well and was a breakthrough in the discussion of abortion issues.
The three major issues that people call us for consultation are: menstruation, medical care in obstetrics and gynecology, and sex. Those people who call for the former two issues can be divided by their age. Women have menstruation until late 40’s or early 50’s, and even after that, they need to have regular medical checks on their gynecological organs and often require operations for ovarian tumours or other causes. Some women hesitate to visit obstetrics and gynecologists especially after the menopause which could lead to worsening of any illnesses.
The vaginal prolapse caused by the weakness of the sphincter muscle is also a problem. Patients become upset to see a portion of the vaginal canal protruding from the opening of the vagina, and some even try to push it back by themselves, rather than being able to ask for help. Since this is the beginning of the aging society, it is especially important for our telephone consulting service to promote women to talk more freely and openly about “body and sex.” We receive phone calls from women of all ages on sex problems, and they ask us why they have to put up with having sex against their will.
From the experience of interacting with women through the telephone consulting service, I realized that we do not consult only on issues of women’s body but also on women’s way of life. Those women, who were constantly worrying about their daughters’ breasts being so small or the shapes of their vaginas being different form other women, cannot accept the idea that their own bodies are unique and different from others. They look at their bodies through the point of view of a socialised female gender role.
Since 1990’s, women’s centers with consulting services became available all over Japan. However, I think the basic problem remains that important issues of women’s body are often separated from other gender issues. We have been thinking how women can live a fruitful life and our focus happens to be on the women’s body issue. However, women’s total well-being including sex-and work-life.
When we talk about health, we tend to focus on the aspects of exercise and relaxation. However, it is also and important barometer of one’s health to know about menstruation conditions. For instance, the menstruation stops when you lose 10 kg of body weight, and this is a signal from your body. For women to live independently, I think it is one of the most important health managements to think about how we associate with our own body, work, and sex. Unfortunately, we were not educated to do so.
Many women, who visited obstetrics and gynaecology, call us when they are not convinced by the doctors. Women do not usually visit obstetrics and gynecologists too often in their life time, thus, it is an unknown world for them. It usually takes only three minutes for a medical examination, and the examination results given by the doctors with specialist terminology are difficult to understand. It creates an even more difficult environment for patients to ask question than other clinics. For instance, when you are told that you have a fibroid, you cannot judge how bad the condition is or if the operation is your only choice. For people in the medical institute, you are just one patient among many others, but for a patient, it is a matter of one’s life.
Through our long experience with the telephone counselling service that we had established, we thought of an idea to open a clinic as a part of the health support center. In this clinic, we organized a team of doctors, medical assistants, counsellors, and receptions to work on a holistic medical care for women. For example, a young pregnant woman could ask for advice in this clinic to think through her own future and decided if she would prefer to have a child or get an abortion. We are fully aware of the danger of being in debt as a result of running this clinic, but we hope this clinic can be a place where a woman can consider health in the context of her whole life, even as a career woman.
Although there are many cases of post-natal syndromes, there are only a few support systems for women’s healthcare while there are many support systems for newborn babies in Japan. There is financial support for the treatments of incurable illnesses such as collagen disease from which many women suffer. However women who are suffering from illnesses are nothing but familiar scenario of a traditional household in Japan an extremely fixated gender roles where the husband has a job and the wife stays home, only in this case, the wife stays at home because of her illness. If we were to view this situation from the gender equality point of view, if a wife has an illness that prevents her from having a healthy physical, mental and social life, there should be a support system for her living situation as an individual. If we were to consider our bodies from women’s point of view, we should claim that we have the individual right to be healthy regardless of marital status (single or married) or job status (part-time or full-time). Currently, women in the Japanese society are divided by marital and social status.
Reproductive health rights mean that the physical, mental and social health of women is considered to be an important issue of women’s health in their whole life. We want the government to be more actively involved in this concern. Each of us could spend our own money to go for massage treatments for health reasons, but this will not help all other women to become healthy. We need to work harder to establish a social system that allows every woman to be financially supported in order to live a healthy life.