PURPOSE:
The objective of this study was clarify transitions and issues in postnatal care services as Japan faces a declining birth rate.

DISCUSSION:
Japan’s birth rate continues to decline. The total fertility rate for 2024 was 1.22; in Tokyo for the same year, it was 0.99. As the birth rate declines, acceptance of postnatal care for mothers and their babies is increasing, and postnatal care services are garnering attention. These services were initiated as a model project in 2014 and legislated in 2019. In 2021, local municipalities were obligated to make an effort to provide such services under the revised Maternal and Child Health Act 2021. Various reforms had been implemented until this point, including the creation and revision of guidelines, changes to those eligible for such care, and the period of coverage. The usage rate was 6.1% in 2021 and 15.8% in 2023. Care services related to breastfeeding and childcare accounted for 98.6% of the cases. Local municipalities implementing such services experienced an increase from 29 facilities in 2014 to 1,543 facilities in 2023, and the budget also increased. However, a diverse range of issues has emerged and includes low usage rates, differences by municipality in the frameworks for offering systems, and postnatal mental health responses and coordination.

EVIDENCE WHERE RELEVANT:
An investigation of reports by corporations and government agencies (e.g., Ministry of Health, Labour and Welfare and the Children and Families Agency) and manuscripts by midwives related to postnatal care was conducted.

KEY MESSAGE:
Many mothers and children require postnatal care. Enhancing support systems to enable mothers and children to select the care that they require is important so that they can spend the postnatal period in peace—psychologically, physically, and socially—as a result of meeting with and forming a continuous relationship with a midwife before the birth of their children. Poster session 1 (Group A)