Childbirth facilities disappearing from Fukushima towns
Medical facilities capable of delivering babies are vanishing from Fukushima Prefecture's rural regions.
In the town of Hanawa, Hanawa Kousei Hospital stopped handling childbirths at the end of February, leaving just 26 medical facilities in seven cities in the prefecture that can handle deliveries.
The number represents a decrease of about 40% over the past decade, which reflects a growing concentration of childbirths in urban areas. Municipal governments are increasingly concerned that changes in the environment for pregnancy and childbirth may accelerate population decline.
On Jan. 22, Hanawa Kousei Hospital posted a notice on its website, saying, 'We have worked for many years to enhance perinatal medical services. However, due to various circumstances, it has become difficult to maintain our delivery system, and we have decided to suspend inpatient delivery practices in our obstetrics and gynecology department.'
The hospital's OB-GYN department was established in 1966. For nearly 60 years, it catered to the needs of pregnant women from municipalities in the Higashi-Shirakawa district — Tanagura, Yamatsuri, Hanawa and Samegawa — handling around 600 deliveries annually at its peak. In recent years, it remained the only delivery facility in the district, managing about 50 births a year.
Behind the suspension is a shortage of medical personnel. The hospital used to have about eight midwives, but the number has gradually declined due to retirement and resignations. Most recently, deliveries were handled by just one OB-GYN doctor and three midwives.
Although the hospital continues to offer prenatal checkups and cancer screenings at its OB-GYN department, its withdrawal from the delivery of babies has created a strong sense of loss and anxiety about the future among local residents.
Hanawa Mayor Hidetoshi Miyata, 75, expressed deep concerns, saying the suspension is a 'serious blow' to the town. 'If there's no environment in town where people can give birth with a sense of security, more young people may leave, which will accelerate the decline in the number of children."
The number of births in Hanawa has been steadily falling, with the town's population dropping from about 13,500 in 1970 to around 7,800 today.
The town is rushing to boost support for pregnant women and new mothers.
There is a national program that subsidizes 80% of transportation costs for prenatal checkups at the nearest delivery facility if it takes over an hour to reach by public transportation or private car. The town expands on this program and fully covers transportation costs — be they for trains, buses or taxis — regardless of travel time.
How to maintain the childbirth environment is a challenge shared by rural communities across Japan.
Over a decade ago, Iwasa Clinic in Daigo, Ibaraki Prefecture, which borders the southern part of Fukushima Prefecture, also stopped handling deliveries. It now only provides outpatient services.
'From the perspective of hospital management, some reduction in delivery facilities is unavoidable,' Miyata said. However, the mayor stressed that municipalities in the Higashi-Shirakawa district will continue to urge hospitals not to reduce obstetric services any further, given the importance of perinatal care.
Hanawa Kousei Hospital in Fukushima Prefecture stopped handling childbirths at the end of February. |
Fukushima Minpo
As of April 1, there were 26 facilities that can handle deliveries in Fukushima Prefecture, down from 41 in 2015. Only seven cities — Fukushima, Koriyama, Sukagawa, Shirakawa, Aizuwakamatsu, Minamisoma and Iwaki — had such facilities, while 52 other municipalities in the prefecture had none.
According to the prefecture's regional medical service division, medical institutions have suspended deliveries due to the retirement of doctors and the declining birth rate, among other reasons. Municipalities without delivery facilities are facing a growing need to ensure that women can give birth safely and with peace of mind outside their residential areas.
Saki Ohira, who lives in the town of Tanagura with her husband, Masataka, is expecting twins in late July. But she is worried about having to go to a hospital far away to give birth as her town has no delivery facility.
The couple, both 34, are eagerly awaiting the arrival of their first children as they look at ultrasound images of them. Ohira has been preparing to give birth at the International University of Health and Welfare Hospital in Nasushiobara, Tochigi Prefecture, which is about an hour's drive from her home using the expressway.
'To be honest, I wish there was a nearby place to give birth safely,' she said.
The couple met as classmates at a local high school, got married in 2019 and now run a stationery store in their town.
After confirming the pregnancy in November, Ohira has been going for checkups about once every two weeks. Her parents, who live in the town of Yabuki, have been taking her to the hospital while her husband works. The financial burden for the trips is not small. In addition to fuel costs, using the Tohoku Expressway incurs about ¥1,500 ($10.40) in toll fees each way.
Ohira finds it troubling that there are so few OB-GYN facilities nearby. She had hoped to give birth at a medical facility closer to home, such as Shirakawa Kosei General Hospital in the city of Shirakawa, but her primary doctor recommended the one in Nasushiobara because she is expecting twins.
'I'm worried there is nowhere to go if my condition suddenly changes,' she said.
Her husband also worries, saying, 'In an emergency, even a slight delay could affect the safety of both mother and children.
"If there were a more reassuring environment for childbirth, it would ease our mental burden," he added.
Their concerns about crossing prefectural borders for childbirth extend into the postnatal period as well. It is said that around 10% of new mothers experience postpartum depression, a condition in which feelings of sadness or anxiety occur after childbirth.
However, no medical facilities in the Higashi-Shirakawa district appear to offer postpartum care services. Before reaching the stable period of her pregnancy, Ohira learned that deliveries would be suspended at Hanawa Kousei Hospital. 'Traveling to a distant hospital is going to be really difficult while taking care of two infants,' she said.
For couples such as the Ohiras, the growing dearth of medical facilities capable of handling deliveries means more long-distance travel for childbirth.
In response, prefectural and municipal governments have increased financial support for such couples, such as by providing them with transportation subsidies for prenatal checkups and lodging expenses so that they can stay near hospitals before the due date.
Beyond just financial assistance, however, Ohira feels there is a need for support channels to provide a sense of security to expectant parents.
'If we had a local consultation desk staffed by experienced midwives or nurses who could listen to our concerns, I think that would really help pregnant women feel more secure,' she said.
Ohira noted that her and her husband's visits to the out-of-prefecture hospital began with infertility treatment. Experts say expanding medical services that assist couples looking to conceive is also crucial in addition to maintaining the perinatal care system.
This section features topics and issues covered by the Fukushima Minpo, the prefecture's largest newspaper. The original articles were published April 29 and April 30.
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