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CONFERENCE PROCEEDING
Barriers to implementing in-hospital midwife-led births in Japan
1
St. Luke’s International University, Women’s Health/Midwifery- Graduate School of Nursing Science, Tokyo, Japan
2
Japanese Red Cross Toyota College of Nursing, Maternity Nursing- Faculty of Nursing, Aichi, Japan
Eur J Midwifery 2026;10(Supplement 1):A706
ABSTRACT
BACKGROUND:
Japan has been promoting establishment of in-hospital midwife-led birth since 2008. However, as of 2023 only approximately 20% of institutions providing maternity services had established in-hospital midwife-led births, a low level.
OBJECTIVES:
We aimed to identify barriers to establishing in-hospital midwife-led births in Japan.
METHODS:
We conducted a cross-sectional study using the Ministry of Health, Labour and Welfare online database "Shussan Navi." We identified 1,859 delivery facilities and sent them study invitations. Data were collected via Google Forms from September to November 2024. The survey addressed willingness toward and concerns regarding implementation, barriers, required support, anticipated challenges, motivation, and confidence. Descriptive statistics were used. The Ethics Review Committee of St. Luke's International University in Tokyo, Japan, approved this study (Approval No: 24-A024).
RESULTS:
In total, 267 facilities responded (response rate: 14.4%). Of 263 participating institutions, 53 (20.2%) wished to establish in-hospital midwife-led births but had not yet done so; 77.4% of these operated mixed wards. Most (94.3%) desired implementation, and midwives were the most frequent advocates (88.0%) but also the most concerned (80.0%). Barriers were identified by 98.1%, with the most common being a lack of midwives with appropriate skills (75.0%) and concerns about profitability (86.3%). Key support needed comprised external training for midwives (96.2%) and admission criteria for mixed wards (100%). Facilities also reported potential operational issues such as shift scheduling (78.3%). Although 52.8% were highly motivated, only 18.9% felt over 60% confident in implementation.
CONCLUSIONS:
Although midwives expressed a desire to lead in-hospital midwife-led births, they also voiced strong concerns. Key issues included training, system development, and institutional alignment, especially in mixed-ward settings.
KEY MESSAGE:
Establishing in-hospital midwife-led births requires addressing staff training, financial concerns, and system readiness, especially in facilities with mixed wards. Poster session 2 (Group A)
Japan has been promoting establishment of in-hospital midwife-led birth since 2008. However, as of 2023 only approximately 20% of institutions providing maternity services had established in-hospital midwife-led births, a low level.
OBJECTIVES:
We aimed to identify barriers to establishing in-hospital midwife-led births in Japan.
METHODS:
We conducted a cross-sectional study using the Ministry of Health, Labour and Welfare online database "Shussan Navi." We identified 1,859 delivery facilities and sent them study invitations. Data were collected via Google Forms from September to November 2024. The survey addressed willingness toward and concerns regarding implementation, barriers, required support, anticipated challenges, motivation, and confidence. Descriptive statistics were used. The Ethics Review Committee of St. Luke's International University in Tokyo, Japan, approved this study (Approval No: 24-A024).
RESULTS:
In total, 267 facilities responded (response rate: 14.4%). Of 263 participating institutions, 53 (20.2%) wished to establish in-hospital midwife-led births but had not yet done so; 77.4% of these operated mixed wards. Most (94.3%) desired implementation, and midwives were the most frequent advocates (88.0%) but also the most concerned (80.0%). Barriers were identified by 98.1%, with the most common being a lack of midwives with appropriate skills (75.0%) and concerns about profitability (86.3%). Key support needed comprised external training for midwives (96.2%) and admission criteria for mixed wards (100%). Facilities also reported potential operational issues such as shift scheduling (78.3%). Although 52.8% were highly motivated, only 18.9% felt over 60% confident in implementation.
CONCLUSIONS:
Although midwives expressed a desire to lead in-hospital midwife-led births, they also voiced strong concerns. Key issues included training, system development, and institutional alignment, especially in mixed-ward settings.
KEY MESSAGE:
Establishing in-hospital midwife-led births requires addressing staff training, financial concerns, and system readiness, especially in facilities with mixed wards. Poster session 2 (Group A)
| eISSN: | 2585-2906 |
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