TOKYO -- This land of high tech and recurring health fads is preparing, with no little trepidation, for a medical invention the rest of the industrialized world adopted three decades ago.
The pill, the small hormone tablet that has been profoundly changing both personal lives and national population curves in other societies since the 1960s, is expected to get Ministry of Health approval later this year for use as a means of birth control.
Akira Kawahara, assistant director of the ministry's New Drugs Division, said last week that the first pills could be on the market by late 1991.
That would end decades of a controversial anomaly in which the pill has been banned while abortion has been legal and so widely practiced that it is often compared to a visit to the dentist.
It may also relieve controversy that has often pitted Japan's small community of family planning advocates and nascent feminist movement against bureaucrats who have a long history of insisting on local testing of new medicines no matter how widely they are used elsewhere.
Whether and how much it will change Japanese birth-control habits remains to be seen.
Family planning advocates, backed by poll results, say that fewer than 10 percent of Japanese women of childbearing age use the pill for birth control, usually after getting doctors to prescribe it as a corrective to irregular menstruation or some other gynecological problem.
The same survey results show that millions of Japanese women deeply fear side effects from the pill and have little knowledge of the increased safety of the low-dose varieties developed in the past decade.
Family planning groups say they will gear up to spread knowledge of the safer low-dose pills, but Japanese schools have virtually no sex education, and the voluntary organizations are not nearly as well financed or widespread here as in Eu
rope and the United States.
As recently as 1989, Japanese overwhelmingly preferred a technology first developed four centuries ago -- the condom, which is used by 75 percent to 80 percent of Japanese practicing birth control.
Even after its resurgence in response to the AIDS epidemic, the condom is seldom chosen by more than 10 percent of those who practice birth control in most cultures, both advanced and Third World, according to United Nations estimates.
Throughout the years of recurring controversy, the Ministry of Health has always found a reason, usually related to side effects, to limit use of the pill to treating gynecological ailments.
Some Japanese feminists have long argued that the ban has deprived women of the most convenient means of making their own decisions about birth control and thus has worked to keep power over women's bodies and daily lives in the hands of their husbands and lovers.
Family planning advocates have argued that, by keeping the pill illegal while abortion is legal and widely practiced, the ban has greatly increased the number of pregnancies that are ended surgically.
But it was not until 1986, when two mainline organizations from Japan's health and welfare establishment -- the Association for Maternal Welfare and the Society of Obstetrics and Gynecology -- publicly asked for consideration of the low-dose pills, that the ministry assigned the issue to the task force that broke the ice.
The following year, the study group recommended that Japanese manufacturers be given the green light to develop low-dose pills and test them on humans.
Earlier this year, three pharmaceutical companies applied for permission to begin marketing their pills as prescription drugs.
Others are expected to follow suit.
Both Japanese and foreign makers are scrambling for position, even though no one dares to predict either how big the market will be or how much resistance there will be to foreign brands.
The competitors include Johnson & Johnson, the maker of Ortho, the biggest-selling U.S. brand, which is working through its Japanese affiliate, Janssen-Kyowa.