FOCUS: Japanese Lawmakers Work on Aid for Confidential Birth Hospitals

Tokyo, July 28 (Jiji Press)–Momentum is building in both Japan’s ruling and opposition parties to support medical institutions offering confidential childbirth services and to establish a system in which only designated hospital staff would have access to a mother’s identity. For women facing unexpected pregnancies with no one to turn to, this form of anonymous birth services serves as a last line of defense in Japan, helping prevent unassisted deliveries and the abandonment of newborns. Despite the need for a better institutional and legal framework for them, however, cautious views remain deep-rooted within the ruling Liberal Democratic Party, particularly among conservatives, suggesting high hurdles to writing needed measures into legislation. On June 25, an LDP project team on confidential childbirth released a “summary of issues” related to confidential births. The document calls on relevant ministries and agencies to consider enhanced consultation support for pregnant and postpartum women; assistance to medical institutions and local governments; sex education mainly for junior and senior high school students; the right to know one’s biological origins; and fathers’ responsibilities. Tackling the Issues At present, only two institutions in Japan accept confidential births: Jikei Hospital in the southwestern city of Kumamoto and San-ikukai Hospital in Tokyo’s Sumida Ward. While many pregnant women lack financial means, Jikei Hospital covers childbirth expenses on their behalf, because public financial support such as lump-sum birth allowances is not available for women who give birth while concealing their identity. The summary of issues noted that as the current confidential childbirth arrangements depend on the goodwill of specific medical institutions, an excessive burden is concentrated on them, and called for discussions on support measures, including cooperation from public and private organizations. Regarding confidential childbirths, ensuring the children’s “right to know their origins” is also a major challenge. Currently, each hospital keeps information about the mother’s identity, but establishing a public management system is an urgent task to prevent the information from being scattered or lost. Hirokazu Matsuno, head of the LDP project team, expressed belief that legal arrangements will be needed in the future, while proposing the use of notary offices among measures for the time being. Jikei Hospital has accepted about 70 confidential births since Japan’s first such case in 2021. For its part, the government reversed years of hesitation and drew up in 2022 its first guidelines outlining how medical institutions and local governments should address confidential childbirths. The guidelines state explicitly, among other things, that a child’s family register should be created on the authority of the mayor of the municipality. In May this year, the opposition Democratic Party for the People submitted a bill to the House of Councillors, the upper chamber of parliament, aimed at providing a better environment for confidential childbirths. The bill calls on the government to secure medical institutions for such births, reduce financial burdens on women and establish a system to guarantee the children’s right to know their origins. In light of a past example in which the identity of a woman who had given birth anonymously was uncovered through a survey conducted by a central or local government agency to obtain basic data for policy planning and administrative management, the bill calls for consideration to personal information in such surveys. “There are issues that cannot be overcome by the guidelines,” Takako Ito, an Upper House member who submitted the bill, said. “A legal framework is necessary to establish hubs” for medical institutions that are capable of handling such cases, she said. Day Zero Deaths Calls for legislation and public support have also come from medical institutions and local governments. Within the LDP, however, caution remains that such steps would be undesirable because the state would be granting official recognition to confidential childbirth. According to the Children and Families Agency, of abuse deaths other than murder-suicides identified in fiscal 2023, 16 infants died “on day zero after birth,” meaning the day of birth. Of these, 15 cases involved abandonment, and in 13 cases the biological father was unknown. Matsuno emphasized that the project team “does not advocate confidential childbirth.” Still, he argued that the issue must be viewed in light of the lives at stake. “The reality is that babies are dying on day zero,” he said. “We must save the babies and mothers who are right before our eyes.” END [Copyright The Jiji Press, Ltd.]