【Aging, safety net and fiscal crisis in Japan】No.63: Is Japan's Obstetric Medicine the Safest in the World?

In this column series, Yukihiro Matsuyama, Research Director at CIGS introduces the latest information about aging, safety net and fiscal crisis in Japan with data of international comparison.

The United Nations Children's Fund (UNICEF) works in 190 countries and territories to protect the rights of every child and improve the lives of children and their families. UNICEF published a report named "Every Child Alive: The urgent need to end newborn deaths" in February 2018. According to this report, Japan is the country with the lowest newborn mortality rate in the world (Table 1).

However, the Japanese are currently raising about the safety of obstetric medicine due to frequent medical malpractice in pain-free labor. For example, there was a case where both a mother and a child fell into a coma due to pain-free labor. The UNICEF report defines mortality as the number of babies who died within a month after their birth per 1,000 live births. Therefore, the child who was in a coma is not reflected in the mortality rate statistics.

In response to the growing public distrust of obstetric medicine, the government established a committee to improve the safety of pain-free labor and is planning to draw a conclusion on it by March 2018. The Japan Association of Obstetricians and Gynecologists distributed a survey nationwide, which led to the following conclusions.

  • # The proportion of pain-free deliveries to the total number of deliveries was 6.1% in 2016.
  • # 53% of pain-free labor is done in clinics and 47% in hospitals.
  • # In some facilities the obstetricians themselves perform anesthesia due to a shortage of anesthesiologists.
  • Overall, the survey results showed that pain-free labor is done at medical institutions that are not fully equipped with resources and facilities to perform such services. There is no certification system to become a doctor specialized in pain-free labor in Japan, and obstetricians can freely display the specialist signboard.

    Table 1 Newborn mortality rates in developed countries


    (Source)UNICEF, [Every Child Alive: The urgent need to end newborn deaths]

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