This morning we started our day with a tour of St. Luke’s Birth Clinic. It’s located just five minutes on foot away from St. Luke’s International Hospital and was founded by a very famous midwife in Japan (we were informed later that she is probably the most famous midwife in Japan), Horiuchi-sensei, in response to complaints from midwifery students that how they were practicing in clinical was not reflective of what they were learning in class. Horiuchi-sensei worked for two years to find funding and garner support for the birth clinic and the clinic has now been open for three years. At first, they were concerned that no one would come to birth at the clinic, but now their rooms are always full and they do about 20 births per month (approximately 30 women intend to give birth at the clinic each month. Of the 10 that transfer, 8 risk out during pregnancy and the other two transfer during labor). They have an exercise room on the first floor, where their midwives teach various movement-based classes. Then they have a floor with Japanese style birthing rooms and another with Western style birthing rooms. In both types of rooms, there are bean bags, birth balls and private bathrooms with tubs. The bathrooms are equipped with windows so that mothers can take showers or use the bathroom while continuing to keep on eye on their babies. The Japanese style rooms have added features, such as a hanging rope, and bars mounted to the walls at various heights for squatting. Horiuchi-sensei said that both styles of rooms were designed to encourage women to move about as much as possible and that there is a focus on moving during pregnancy to prepare for the work of labor (e.g. they tell women to do 100 squats per day in their last month of pregnancy!). Upstairs is a salon/spa where women can go to get skin treatments and massages.
One of the biggest differences between birthing in America vs. birthing in Japan is that in America, women stay in the hospital for two days after a vaginal birth and four days after a c-section. In Japan, women who give birth vaginally stay in the hospital or birth clinic/center for 5-7 days and up to 10 days after a c-section. During this time in Japan, women are offered a lot of support around lactation, newborn care and how to care for their own bodies in the postpartum period. To this end, one of the main focuses of the birth center is nutrition. They have a kitchen downstairs where they prepare nutritious meals for their clients and charts with pictures that show examples of balanced meals (including dessert!). Toward the end of our visit at the birth clinic, we were able to sit in on a blessing ceremony for new mothers. The chaplain led the women in song and then said a prayer over each of the women and their newborns asking for health and protection. The ceremony was deeply moving and suffice to say, a lot of tissue was passed around.
We had a quick lunch back at St. Luke’s College and then Lisa and I gave our presentation about midwifery in America to five students in both the bachelor’s and master’s programs. The master’s students were all practicing midwives (in Japan, you can practice midwifery with a bachelor’s degree). After the presentation, the students filled out our surveys about their thoughts and opinions regarding birth and midwifery in Japan and then we held a focus group to discuss some of their ideas. The focus group took a long time because K had to do so much translating back and forth and by the end of it, we were all pretty tired. That being said, I feel like we got a lot of good information from the discussion and was surprised to learn how similarly Japanese midwives felt about their work environment, their education and their relationships with other hospital staff.
After the focus group, we took a little break and then came back to the school to listen to Allison’s presentation on shared-decision making. It was the first time that I had ever heard Allison speak on the topic and it was wonderful to sit in the room and learn about her research, but also to watch her skillfully present it. It’s such a gift to be on this trip with such a positive role model and mentor. After Allison’s presentation, we went to sushi at Sushi Dai (which is apparently very famous) with two of St. Luke’s teachers. It was Lisa’s second time to sushi and Allison’s first, so it was a bit of an adventure for them. After sushi, we were pretty stuffed and pretty exhausted and so we were quite content to return to our hotel for a good night’s sleep.