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OBs and Maternity Clinics Sharply Declining in Japan

"Congratulations, but unfortunately, our hospital does not deliver babies. You'll have to look for one with an obstetrics ward." The joy of expecting a baby often comes with the news that many hospitals in the community no longer deliver babies. This is the reality that pregnant women face as an increasing number of hospitals close their obstetrics ward.

According to the results of a national poll taken by Asahi Newspaper announced on March 25, 2007, 105 hospitals in Japan had closed or had decided to close their obstetric units between April 2006 and March 2007. This amounts to 8.2% of the 1,273 hospitals offering obstetric services as of December 2005. Hospitals are facing a shortage of obstetricians due to retirement, young doctors are not entering the field to take their place, and they want to avoid the risk involved in having only one doctor present during delivery.

Obstetricians work under difficult conditions because it is not possible to know when labor will start and the health of the mother and fetus can suddenly change. A vicious circle starts when even one doctor leaves practice--this puts pressure on other doctors, which only leads to harsher conditions and more doctors quitting. Furthermore, obstetricians were shocked when a doctor in Fukushima Prefecture was arrested for negligence after a pregnant woman under his care died from obstetrical hemorrhage during childbirth. The main reason for negligence was the fact that he had handled the delivery alone, but this is not uncommon among doctors in private practice and small hospitals. Since this incident, an increasing number of doctors in private practice are closing their practice or no longer delivering babies. Doctors who want to avoid working at hospitals with only one obstetrician are retiring or seeking employment elsewhere, which has resulted in a sharp decline in obstetrics units.

Pregnancy and childbirth are not illnesses and they are not covered by health insurance. People generally believe that children are conceived naturally and after the usual length of time, a healthy child is born. This certainly is not a mistaken notion considering that maternal and fetal mortality are low in Japan. Nevertheless, many problems can occur before a child is ever born. One out of about ten couples is not able to conceive; miscarriages in the early stages of pregnancy are not infrequent, the condition of the mother and child can change suddenly during delivery, and a given percentage of infants develop a disability at birth. I believe that, when renovating obstetrics units now facing a crisis, it is important to ensure that people also understand the risks that accompany pregnancy and childbirth, both considered felicitous events. Of course, we will also have to work to prevent any further decline in the number of practicing obstetricians.

At a time when the total fertility rate is declining and the government is pressed for policies to deal with the falling birthrate, we need environments where mothers can safely carry and give birth to these precious lives.
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