My health topic will cover the aspects of women giving birth in Japan, and more specifically the treatment of the mother. Japan had the highest birth of maternal mortality with it being 9.5 per 100,000 births (Nagaya et al, 2000). With many of those deaths found to be preventable or possibly preventable. Many of the maternal deaths are due to postpartum hemorrhaging (Nagaya et al, 2000; Hasegawa et al, 2016). In 2014, the maternal mortality rate was 23% when coupled with postpartum hemorrhaging. What is most concerning is that another article stated that Japan had some of the “perinatal outcomes that remain among the best in the world” (Behruzi et al., 2010). This statement was only referring to the rate of infant mortality, which is about 2.7 per 1000 live births. While there is a consistent movement for the humanization of birthing practices in Japan, there still is a lot of work that can be done. Like much of the rest of the world, there is also a large movement for midwifery and the acceptance of having a midwife during the birthing process. When looking at a group of 19 women, one study found there to be no maternal fatalities with the presence of a midwife (Katoaka et al., 2013). For my project I want to dive into the culture surrounding birth practices, and what can be done to help make the birthing process and outcome safer for women.
From a cultural perspective, it is not necessarily surprising that the maternal mortality rate is so high for Japan. Most of the traditional culture surrounding Japan is very male based. The men are the ones that make the decisions for the entire family. Women are held to the idea that they must do as their husband pleases, even when it comes to the birthing practice. Modern day Japan is having a large movement in women having more control of their lives. This includes the idea of having more say in how hospitals treat them, and what medicinal route they choose to participate in. As the culture of how women are treated with society changes, it is also important to look at how the culture of how women are treated within the medical world changes with it.
From a public health standpoint, it is concerning the amount of maternal deaths that are experienced when compared to the rest of the world. Especially with the amount of modern medicine that is able to be practiced within Japan. Giving birth is a part of life, and a part of many different people’s lives. With the practice of giving birth in Japan being seen as one of the lowest for infant mortality rates, it is concerning that the amount of maternal mortality rates is so high. Women in Japan should be concerned with the rate at which they are dying after giving birth. There are plenty of things to worry about when becoming a parent and going through the process of giving birth, having to worry about keeping your life should not be one of the most prevalent worries. This is also cause for concern for the medical practitioners and what they are being taught. Why can’t the medical practitioners save these new moms? What kind of medical techniques are they lacking in that they can’t keep these women alive? It really is a huge cause for concern.
Nagaya K, Fetters MD, Ishikawa M, et al. (2000). Causes of Maternal Mortality in Japan. JAMA, 283(20), 2661–2667. doi:10.1001/jama.283.20.2661
Hasegawa, J., Tomoaki, I., Sekizawa, A., Tanka, H., Nakamura, M., Katsuragi, S., Osato, K., Tanka, K., Murakoshi, T., Nakata, M., & Ishiwata, I. (2016). Recommendations for saving mothers’ lives in Japan: Report from the Maternal Death Exploratory Committee (2012-2014). Journal of Obstertrics and Gynaecology Research, 42(12). Doi: https://doi.org/10.1111/jog.13136
Katoaka, Y, PhD., Eto, H, PhD., & Iida, Mariko. (2013). Outcomes of independent midwifery attended births in birth centres and home births: A retrospective cohort study in Japan. Science Direct, 29(8), 965-972. Doi: https://doi.org/10.1016/j.midw.2012.12.020
Behruzi, R., Hatem, M., Fraser, W., Goulet, L., Li, M., & Chizuru, M. (2010). Facilitators and barriers in the humanization of childbirth practice in Japan. BMC Pregnancy and Childbirth, 10(25). Retrieved from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-10-25