How and why Japan is improving its perinatal support

Having a safe and healthy childbirth, and a supported postpartum period, is every woman’s right. From pregnancy through postpartum recovery, childbirth poses risks that make medical care and other forms of support essential for protecting the health of mother and child.

In Japan, suicide has remained the leading cause of death among expectant and postpartum mothers since 2020. According to data from the Japan Society of Obstetricians and Gynaecologists and the Japan Suicide Countermeasures Promotion Centre, more than half of these suicides occurred after childbirth, accounting for 66% of all cases between 2022 and 2023. The primary factors behind these tragedies include family-related issues and health concerns, particularly postpartum depression.

Postpartum depression affects 10% to 15% of women, and is often triggered by hormonal imbalances and other factors after childbirth. Symptoms such as anxiety, agitation and insomnia can emerge within the first three months, making it challenging for mothers to care for their newborns. A physician in the field of women's health, Dr. Miho Takao, notes, "the problem with postpartum depression is that during this period, it’s easy for women to become isolated and no one realizes they are struggling."

In Japan, it is common for women to return to their family homes before and after childbirth to receive support. These stays are often short, however. A 2024 survey by the Nomura Research Institute found that while 47.1% of women stayed with their parents during the perinatal period, 45% returned to their own homes within a month after delivery. Additionally, many women lack nearby family members to rely on. Given these challenges, there is an urgent need to establish a comprehensive support system to assist women during pregnancy and the postpartum period in Japan.

The Child and Families Agency in Japan is establishing Children and Families Centres, designed to provide comprehensive consultation and support for expectant and postpartum mothers, families and children. The goal is to open these centres nationwide, covering every city, ward, town and village in Japan. As of May 2024, they had already been set up in half of the municipalities across the country. The facilities serve as key contact points, offering support for issuing pregnancy notifications, prenatal and postnatal care, childcare consultations, and referrals to appropriate services when necessary.

Recognizing the physical and mental challenges of raising a child, the Japanese government has emphasized the importance of expanding postnatal care services. In a recent statement, the government noted that reducing the postpartum burden on families is a priority – and pledged to accelerate nationwide efforts to improve support systems. As part of this initiative, postnatal care services are being expanded to provide mothers with physical and emotional support after childbirth.

These services cover a range of needs including physical recovery, mental health support, and guidance on breastfeeding and childcare. Midwives and healthcare professionals lead these in collaboration with local medical institutions. There are efforts to foster social connections as well, helping mothers build relationships with family members and support networks, while also introducing community resources for childcare.

To support these initiatives, the postnatal care budget was increased from approximately 5.72 billion yen in 2023 to 6.05 billion yen in 2024. The government is also working to remove financial caps on assistance for municipalities and enhance support for facilities that provide care for mothers in need.

Some private companies are also beginning to integrate postnatal care into their employee welfare programmes. In November 2023, Shiseido launched KANGAROOM+, a postnatal care programme for employees with children under three months old. Through this initiative, trained postpartum care specialists visit employees' homes to assist with household chores and childcare, offering much-needed support during the early months of parenthood.

The non-profit organization Machinowa, based in Tokushima Prefecture in western Japan, supports parents by fostering community connections. It was founded by Satomi Shiramomo, who experienced postnatal depression herself and found healing through medical treatment and relationships within her community. Drawing from her own experience, she established an online community in 2021, providing a space where parents facing similar challenges could connect and support one another.

In 2023, Machinowa expanded its efforts by creating an in-person support space within a prefectural facility, where expectant and postpartum mothers can share their concerns about pregnancy, childbirth and childcare. By offering a safe and welcoming environment, this initiative helps prevent social isolation and provides essential emotional and psychological support for women during this critical period.

Another initiative, the Kizunamail Project, helps reduce isolation by providing informational and supportive emails to expectant and postpartum mothers. Subscribers receive personalized messages based on their pregnancy stage or their child's age, from conception until the child reaches three years old. These emails, supervised by doctors and dietitians, contain valuable advice on maternal and child health and messages of encouragement to provide emotional support. Additionally, emails include local resources and information, helping parents access the services they need more easily. Surveys indicate that 90% of subscribers read these emails immediately upon receipt, highlighting their effectiveness in engaging and supporting mothers during pregnancy and early parenthood.

Research is underway to develop a simple test that can predict the risk of postnatal depression during pregnancy, enabling early intervention and appropriate support. A research team led by Kenta Matsumura, a lecturer at the University of Toyama, has developed a system that assesses the likelihood of postpartum depression based on responses to three questions. Using data from the Japan Environment and Children’s Study and machine learning, the system has achieved an accuracy rate of over 70% in identifying women at risk. These findings have been published in an academic journal. By identifying potential risks during pregnancy, healthcare providers can establish effective support systems and ensure timely care after childbirth.

Providing appropriate postnatal support plays a crucial role in ensuring a safe and healthy childbirth and postpartum experience, both physically and emotionally. These efforts align with the objectives of the Global Alliance for Women's Health, an initiative by the World Economic Forum aimed at promoting women's health on a global scale. A society-wide commitment, including initiatives from governments, private organizations, and communities to support pregnant and postpartum women is essential. Strengthening these support systems improves maternal mental and physical health, and enhances the overall well-being of women.