Photo/Illutration Takeshi Hasuda, the head of Jikei Hospital in Kumamoto city, speaks to an Asahi Shimbun reporter on Feb. 20. (Rina Horikoshi)

KUMAMOTO--The head of Jikei Hospital here is calling on Japan to establish a legal framework for confidential births to protect the safety of the babies and their mothers.

“If mothers are determined to not reveal their identities, there is no way to protect the safety of babies other than by allowing a confidential birth,” Takeshi Hasuda said in an interview with The Asahi Shimbun on Feb. 20.

The hospital went ahead with allowing what is believed to be Japan’s first confidential birth in December, in which a teenager gave birth anonymously, only revealing her identity to one hospital staff member.

The woman told the hospital she desired a confidential birth and a special adoption arrangement for her baby. The hospital and the Kumamoto city government are now preparing to create a family register entry for the baby set up under the mayor’s authority.

“(Japan’s system) is too incapable and the people involved (in the country’s first case of a confidential birth) do not know what to do as a result,” Hasuda said.

He said allowing confidential births can prevent tragic incidents, such as infanticides or abandoned babies, and can prevent mothers from giving birth alone at home--something that can put both their lives and their newborns at risk.

Hasuda said he wants to create a better understanding of the issue among the public and stressed that the aim of allowing a confidential birth is to ensure a safe birth and the safety of the baby.

The hospital introduced its system for permitting confidential births in 2019. It assumes that the mother will reveal her identity to one hospital staffer to protect her child’s right to know their mother’s identity later in life.

The hospital has also operated a drop-box system called Konotori no Yurikago (cradle of storks) since 2007 to save unwanted babies that the mother can safely leave in the hospital’s care.

Hasuda said he has learned from the drop box--and from his own experiences helping defendants in cases where babies were abandoned or killed--that complex issues, such as family problems, history of abuse, mental illnesses and intellectual disorders are usually behind cases of abandoned babies, infanticides and instances of mothers giving birth by themselves.

He suggests that roughly one in every 10,000 pregnant women need a confidential birth based on the annual statistics of these tragic incidents.

Hasuda defended confidential births against criticisms made by some that women who chose to give birth anonymously are irresponsible.

“I guess there are many aspects (about confidential births) that people could criticize,” he said in response. “However, if you are too morally righteous, you will lose contact with the woman who wants to have a confidential birth, which will lead her to give birth by herself or lead to an incident.

"We need people to understand why some women don’t want to reveal their identity when giving birth. And even if people don’t understand it, there is no other way to ensure the safe birth of a baby.”

There are still many challenges with providing confidential births.

They include how to treat information on the birth of a baby who was born from an anonymous mother and cases where the lives of the mother and the baby are in danger during birth.

Although Hasuda is calling for a legal framework to ensure the hospital can perform confidential births, he is pessimistic about the prospect of it being established anytime soon.

He cited differences between Japan and European countries, where confidential births are legally protected and people’s values surrounding them are based on religious beliefs.

Hasuda also points out that Japanese politicians and the public are not particularly interested in the issue of confidential births. 

“Vulnerable people are invisible in Japan, unless you try to see them,” he said. “I believe that I have a duty to explain to people the realities concerning confidential births and incidents (of abandoned babies and infanticides).”

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