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Japan in Depth


Japan in Depth

Struggling to Deliver

Misaki Fujii, NHK WORLD

Japanese policymakers have been trying to find ways of reversing the country's declining population. They're being urged by hospital workers in rural areas to address one root cause... a severe shortage of obstetricians.

Suzu is a small coastal municipality at the tip of the Noto Peninsula in central Japan. It has a population of 16,000, and just one hospital with a functional maternity ward.

Gen Yamashiro is the only obstetrician. Last year, he handled 164 births. That's 50 percent more than the average for his colleagues across Japan. He has also had to work weekends and outside normal hours more than 100 times a year.

Dr. Yamashiro is 65, and he was hoping to retire next year. But no one's available to replace him, so he has decided to keep working as long as his body will allow it.

Keiju Hospital in Nanao City has devised a way of reducing the burden on obstetricians.

Tetsuya Yoshioka is a family doctor with broad experience in pediatrics, obstetrics and gynecology. He's been handling prenatal checkups and deliveries for the past 5 years.

Here, obstetricians and family doctors work as a team, with the consent of the expecting mothers. Family doctors handle normal deliveries, allowing obstetricians to focus on high-risk cases, such as later age pregnancy.

Doctor Yoshioka has detected an irregularity-- the amount of amniotic fluid seems to be low. He's concerned about the risk to the fetus, so he immediately contacts an obstetrician.

The obstetrician arrives immediately to perform an ultrasound and check the amount of amniotic fluid. He explains to the problem to the expecting mother, and advises her to stay in hospital. From here onwards, the obstetrician will be taking over the case.

The pregnant woman says she has no concerns about being examined by a family doctor, because she knows he'll refer her to an obstetrician if there's any problem.

For now, the hospital believes it has found the right recipe to deal with the shortage of obstetricians.

Dr. Yoshioka says the participation of family doctors like himself helps relieve some of the pressure on obstetricians and gives them more elbow room. He says it could also help improve the quality of their maternity services.

The gap between rural and urban areas is growin to the point some women have to travel hundreds of kilometers to give birth. If Japan hopes to boost its population, making sure obstetricians are available everywhere is a top priority.

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