Pregnant women in need of special support lacking residential facilities in Japan

Courtesy of Comomotie
A resident of a facility for specially designated pregnant women, right, bathes a baby with help from a midwife at the Comomotie support center in Fukuoka City on July 21.

Pregnant women designated as needing special support are suffering from a lack of residential facilities. The Health, Labor, and Welfare Ministry in fiscal 2017 launched a system to subsidize the operators of such establishments, but at present, there are only eight such facilities in the country.

Securing the requisite medical personnel has been a major stumbling block.

Once local governments have been notified about a pregnant woman facing difficulties for such reasons as poverty or isolation, the woman is registered with a “regional council for children in need of protection,” comprising child consultation centers and police. Public health nurses visit these women on a regular basis and help them receive public assistance and other support, if necessary.

24-hour care

In the winter of 2020, a woman in her 20s contacted Comomotie, a support center for prenatal and postnatal mothers in Fukuoka City, telling them she was pregnant but did not know who the father was.

The woman had been a live-in worker at a brothel but was evicted when she became pregnant. Estranged from her parents, she turned to the center, which she had learned about on the internet.

Comomotie, which offers counseling to women affected by poverty, unexpected pregnancy and domestic violence, was commissioned by the Fukuoka city government to operate a facility where pregnant women in need of special support can live before and after childbirth. Midwives, childcare workers and other professionals provide around-the-clock health care and support, as well as help with finding employment.

The woman in her 20s gave birth at the facility. Initially, she had expressed a lack of confidence about raising her child, but staffers met with the woman’s parents and arranged for support. The woman now lives in her parents’ house while raising the child.

The center has accepted 11 expectant and nursing mothers since it began operating in October 2020. “Supporting specially designated pregnant women not only helps the women, but also reduces the number of children who become victims of abuse,” said center chief Makoto Ogami, 57.

Mothers involved in abuse

Mothers are often responsible for child abuse. According to the welfare ministry, of the 78 children who died due to abuse in fiscal 2019, more than 50%, or 41 children, were abused by their biological mothers.

Pregnant women designated as needing special help became eligible for public support when the Child Welfare Law was revised in 2009. The number of such women increased more than eight-fold from 994 in 2009 to 8,253 in 2019.

The subsidy program established by the ministry in fiscal 2017 is designed to provide 50% of costs to local governments offering counseling services and residential facilities for specially designated pregnant women.

Currently however, only eight facilities — in Osaka, Gifu, Fukuoka, Oita and Kumamoto prefectures — operate under the system. This figure is significantly lower than the number of so-called mother and child living support bases — 217 as of March last year — that accept victims of domestic violence and mothers and children in need.

Shortage of medical staff

A dearth of qualified workers is a major barrier to providing targeted help.

The Yamaguchi prefectural government has placed a coordinator at an obstetrics and gynecology hospital in Shunan to help women receive public support and other assistance. However, the prefecture has no residential facilities for pregnant women designated as needing special support.

“To respond to sudden births, midwives and other professional workers are indispensable, but it’s difficult to secure relevant medical personnel,” a prefectural government official said. “There are also budgetary challenges.”

An official of a ward office in Tokyo said, “Public health nurses make regular visits to pregnant women in special need [of assistance], so we don’t think it’s necessary to establish a residential facility for them.”