KUMAMOTO--Around the clock at Jikei Hospital here, 12 counselors at Jikei Hospital offer support through email and by phone to women wanting to give birth to their babies anonymously. 

The hospital in Kumamoto is the sole medical center in Japan that offers a confidential birth program. Through the service, women only need to disclose their identities to specialized staff members at the establishment.

Those wanting to utilize the system should first contact Jikei Hospital’s neonatal consultation office. Six full-time staffers are deployed there and the others telework from home.

Counselor Yuki Nishimori, 53, said that troubled women often convey simple messages when seeking help, such as, “I have no one to share my problems with” or “I don’t know what to do.”

“Their short texts and simple requests make us understand how urgent their circumstances are,” explained Nishimori.

She added that Jikei Hospital occasionally receives phone calls late at night from mothers who “may already be in labor.”

“They must have suffered from severe dilemmas and anxieties before reaching out to us,” said Nishimori. “I make a point of expressing gratitude first for their decision to contact us. Then, I show empathy for their hardships and assure them that they have a range of options to choose from, so that we can work together to select the best one.”

FIRST DROP-OFF SYSTEM IN JAPAN

In 2007, Jikei Hospital set up its newborn drop system called Konotori no Yurikago (cradle of storks), aiming to allow mothers to safely leave their unwanted babies anonymously in the care of the medical center.

Jikei Hospital has since experienced a succession of cases of women entrusting their newborns to the system. In that fashion, the operator became aware that these women often deliver babies with no doctors in attendance.

Seeing mothers confronted by unwanted pregnancies and forced to choose between delivering their babies on their own, Jikei Hospital considered what kind of support it can offer to save the lives of mothers and children.

“The stillbirth rate significantly rises in solitary births, compared with hospital deliveries,” said Takeshi Hasuda, 58, director of Jikei Hospital. “Additionally both mothers and children are exposed to a higher risk of death, and newborns are more likely to be abandoned.”

The confidential birth mechanism was therefore put in place to create a place in which women can “have babies at a medical center to avoid solitary births as a first step.”

Starting with its first confidential birth in December 2021, Jikei Hospital helped 37 women to give birth under the system by October this year.

Individuals seeking assistance now show up at Jikei Hospital from not only the Kyushu region around Kumamoto but also eastern Japan, remote islands and elsewhere across the country.

“Some come to our hospital only after they go into labor,” said Hasuda. “At least one such medical center should exist in each prefecture nationwide to reduce risks.”

LAWS NEEDED ON CONFIDENTIAL BIRTHS

Acting on this thought, Hasuda has been calling for the central government to legislate the confidential birth practice.

While describing confidential births as “not violating laws” for now, the government still maintains that “cautious discussions are essential” to legalize the practice.

Hasuda noted that the state’s calling the delivery practice as “not violating laws” is insufficient, given various challenges physicians could face in handling confidential births with no legal basis.

Women wanting a confidential environment may happen to give birth at public transit facilities, or mothers and babies might be involved in accidents while out. Emergency medical interventions may be required at times.

“Every time difficulties arose, I emotionally struggled and wavered at the thought of taking on relevant risks on my own,” recalled Hasuda. “Other doctors should not be compelled to do the same without a legal foundation.”

Hasuda continued, “No additional hospitals with confidential birth systems will emerge unless further action is taken, though a lot of women are in trouble.”

Another concern involves how to guarantee children’s “right to be informed of their origins.”

At Jikei Hospital, all counselors are eligible to listen to women. But identity data obtained is managed exclusively by Makoto Hasuda, 47, head of the neonatal consultation office.

In South Korea, France and Germany, the details of newborns’ origins are stored officially by public organizations under legally confidential birth systems. Procedures and age requirements for disclosing birth information are specified by law in these nations.

Makoto, who keeps in contact with mothers for continuous support as necessary even after they return home following their deliveries, said that she is “seriously concerned” about the current situation at Jikei Hospital.

“I am wondering if I can handle it all on my own as more women turn up,” lamented Makoto. “What would happen if anything happens to me?”

Makoto argued that defining confidential births via legislation will likewise free numerous women from feelings of guilt.

“Once the practice is given legal status, I will tell women that their choice is a valid option recognized by the government to protect their rights,” she said. “I want to make it clear that they have nothing to worry about.”