Rush to raise childbirth costs Pregnant women's confusion and hospital anguishSeptember 9 27:11

She was about to give birth next year and was receiving an explanation from the hospital. As a reporter, I involuntarily asked, "What?"

I was told, "We have raised [maternity costs] this spring." The total cost was expected to be more than 50,<> yen.

Currently, childbirth costs are being raised one after another across the country. Why? (NHK Matsuyama Broadcasting Station Maho Arakawa)

"Childbirth is not cheap."

I found out I was pregnant with my second child in early spring. At the same time that I was happy, at the beginning I also thought, "The timing is good!"

In principle, childbirth expenses are paid by the child, but the "Childbirth and Childcare Lump-sum Grant" paid by public medical insurance will be increased from this April. This is because it was raised to 4,50 yen as part of the country's measures to address the declining birthrate.

When I gave birth to my first child, I was paid 1,42 yen, but I have experienced that this lump-sum payment alone could not cover it.

The cost of childbirth has risen year by year, and now the national average exceeds 48,2022 yen (FY10, Ministry of Health, Labor and Welfare survey). The cost varies depending on the region, but I often heard from friends who live in central Tokyo that they paid 20,<> or <>,<> yen themselves.

I was keenly aware that childbirth is not cheap. I thought that if the lump-sum payment was increased, the burden would be reduced.

However, as mentioned at the beginning, the hospital explained that the cost of childbirth would be raised. The price increase was about 5,<> yen, but I was disappointed that there was no point in increasing the lump-sum payment.

Price increase in one month until childbirth

When I interviewed them, it seems that there are many people who feel the same way as me.

It was my 25-year-old mother who told me the story. This April, I gave birth to my first daughter at a medical institution in Ehime Prefecture.

With just over a month left until her due date, the hospital suddenly announced an increase in the cost of childbirth. The price increase was about 4,1 yen.

: "When I was in the waiting room of the hospital, a staff member handed me a small piece of paper with the words 'Price increase' written on it. It wasn't time to be transferred, and I could only accept the hospital's explanation and say, 'I understand.'"

After that, a woman who gave birth safely. When I was discharged from the hospital, the final bill was 55,5 yen. It is said that the "lump-sum childbirth and childcare allowance" alone could not cover it, and he paid <>,<> yen himself. The hospital did not provide a detailed explanation of the price increase until the end, and said that "questions remained."

: "I am grateful to the hospital for being able to finish the birth safely, but I thought it would cost so much money. The name of the lump-sum payment includes 'childcare,' but it all disappears into the childbirth expenses, so I felt that the reality was different."

Price increases nationwide

I sympathized with the woman's story. These increases in childbirth costs seem to be occurring one after another across the country.

As a result of a survey conducted by the Ministry of Health, Labour and Welfare targeting medical institutions, 4 facilities raised their prices between April last year and this April. It accounts for 4% of the total.

In addition, 457 facilities responded that they plan to raise prices in the future, and 479 are considering it.

The detailed amount of the increase of medical institutions that have already raised the price has not been investigated, but when I looked at the website, there were many places that indicated an increase of 3,5 yen to <>,<> yen.

On "X (formerly Twitter)", there were many voices such as "It is a piggyback price increase" referring to the increase in the lump-sum childbirth and childcare allowance.

Hospitals in distress

What is the reason for the price increase? As we proceeded with the interview, the director of an obstetrics and gynecology clinic in Matsuyama City, Ehime Prefecture, told us a story.

"Some people say that the price increase is a piggyback, but what about it?" he asked frankly, and the director said with a sigh.

"I know there's been criticism, but to be honest, we're screaming administratively."

What does that mean? The director said that the biggest reason is the rapid decline in births.

of the Obstetrics and Gynecology Clinic: "Until about 15 years ago, our clinic had more than 800 births a year, but last year it dropped to the 600 range. However, it is not possible to reduce the manpower and system of hospitals. You never know when the baby will come, and you need to be prepared 24 hours a day for sudden changes in your newborn. Nurses and midwives have to be assigned as before. And now, the childbearing age is aging. In order to prepare for various risks before and after childbirth, testing and labor are increasing."

In addition, the director said, "In the past few years, there have been new responses that have been required." That is the enhancement of "postpartum care".

In recent years, demand for postpartum support has been increasing for mothers, such as leaving their children with midwives with overnight stays, allowing them to take temporary rest and receive childcare advice.

When I got permission to visit for an interview...

At the hospital, there was a woman in her 3s holding a three-month-old boy. In an interview with the midwife, she said, "I was able to sleep comfortably after staying at the hospital for one night," but she also confided her worries, "I am most worried about whether she will be able to breastfeed properly from now on."

In response, the midwife responded with a smile, saying, "When I measured the amount of that the baby was drinking, it was drinking very well.

After the interview, the midwife says:

"There are quite a few postpartum women who are struggling alone without asking anyone around them for help.

Certainly, when I gave birth to my first child, I relied on "postpartum care" at a nearby obstetrics and gynecology department. I was unable to go back and forth between relatives due to the Corona disaster, and I felt confused and lonely about raising children for the first time, so it helped me a lot.

As the shape of the family becomes more complex, the role required of maternity facilities may be greater than before.

Hospitals are working to cut costs...

Under these circumstances, the director says that he has also been focusing on cost reduction.

Since labor costs cannot be reduced, in addition to saving electricity, the staff themselves clean and care for the air conditioners ordered from contractors and clean the curtains in the hospital rooms.

However, expenses have nearly doubled in the past 1 years due to the combination of equipment renewal of medical equipment that costs 10 million units every year, as well as soaring electricity bills and prices. Recently, there have been years when the company has turned into a deficit.

We have been considering childbirth expenses so that the burden on pregnant women does not become heavier, but in April we decided to raise the price by about 4,5 yen due to the increase in the lump-sum childbirth and childcare allowance. The director drops his shoulders and says:

of the Obstetrics and Gynecology Clinic: "The decrease in the number of births and the increase in expenses have almost no positive effects. I'm sorry for the pregnant woman, but I just raised the cost."

At this clinic, it is said that consideration was given to making the final self-payment after the price increase about 2,<> yen less than before, but in interviews with other medical institutions, serious voices such as "management is a fire car" and "there is no future prospect" were heard, and it seemed that many places decided to raise the price.

Finally, the director spoke calmly:

of the Obstetrics and Gynecology Clinic: "Considering that the declining birthrate will not be stopped anytime soon, I think we can only temporarily stop this time.

Expert: "It is necessary to review the existing system"

The director's clinic has been in business for more than 60 years. It is one of the famous obstetrics and gynecology departments that everyone knows in the local area, and I was very surprised when he often said, "Obstetrics and gynecology may be the toughest department right now."

In addition, due to the acceleration of the declining birthrate due to the corona disaster, some medical institutions do not have the physical strength to manage and are stopping or closing their services for childbirth.

On the other hand, if the price of childbirth costs continues to rise, it will be the end of the world for pregnant women. I'm in trouble.

How do experts view this situation? Professor Tomoyuki Takura of the University of Japan School of Medicine, who has been conducting research on childbirth costs, says that it is time to review the way the support system for childbirth costs has been used in Japan.

Professor Tomoyuki Takura of the University of Japan School of Medicine:
"When the lump-sum childbirth and childcare allowance was increased, hospitals with difficult management no longer felt resistance to price increases, and as a result, childbirth costs have been raised again.

On top of that, Professor Takura mentioned "insurance coverage of childbirth expenses."

In principle, public insurance does not apply to childbirth because it is "not a disease or injury," but the government is currently considering whether childbirth expenses can be covered by insurance in the same way as ordinary medical care.

If it is applied, it is expected that price increases will be stopped and that the cost of 20,<> yen, which varies by as much as <>,<> yen depending on the region, will be uniform throughout the country, and Professor Takura said the following based on these developments.

Professor Tomoyuki Takura of the University of Japan School of Medicine:
"If it is covered by insurance, it will send a message that the entire nation should support childbirth fairly from the perspective of public interest. It is necessary to thoroughly discuss the advantages and disadvantages of the system, such as the economic burden on the public and the management stability of hospitals. On top of that, childbirth is just a "gateway" to child-rearing. Without child-rearing support over the long period thereafter, it may not be possible to expect a reversal in the declining birthrate. It is necessary to discuss measures for childbirth and their effects within a large policy package, and now is a major turning point. It will take a long time to reverse the declining birthrate, and it is necessary to have a considerable sense of crisis."

Can the declining birthrate be reversed?

More than 1,77 children were born to Japan children last year, the lowest number since the country began keeping statistics.

As the declining birthrate becomes more serious, as Professor Takura points out, I felt that we have reached a point where the conventional framework of systems and ways of thinking cannot deal with the problem of childbirth costs or the way each medical institution should be.

Will Prime Minister Kishida's "measures to address the declining birthrate in a different dimension" really become a "different dimension"? As one of the parties concerned, I will continue to pay close attention to its developments.

Matsuyama Broadcasting Station reporter
ArakawaFrom Joetsu City, Niigata Prefecture Joined the Nagasaki Bureau
, Osaka Bureau, Social Affairs Department, etc. in 08, and is in charge
of the education field such as the Ministry of Education, Culture, Sports, Science and Technology, where she currently belongs
, as well as the "work style" of the Kasumigaseki bureaucracyMother of a child