For the comfort of the family

Support for anxiety expressed during pregnancy and delivery

Concerns are endless from pregnancy to parenthood.
What systems and professions exist worldwide to support pregnancy, childbirth, and child-rearing?

Examples of support for mothers and children

Doula

Worldwide

This profession gained momentum after 1990, mainly in highly developed countries in Europe and the United States, and is now being trained for and registered across the world. It provides ongoing physical, psychological, and other kinds of support to women and their families from pregnancy to delivery. Many studies have shown that expectant mothers who receive such support have safe deliveries and are satisfied with their results. Postpartum women, who make home visits after delivery, have also been trained in Japan and are expanding their field of activities.

Neuvola

Finland

A Neuvola is a pregnancy and childcare support facility that provides seamless support for mothers, children, and families from pregnancy through delivery and before the child starts school. When a woman visits Neuvola after finding out that she is pregnant, a public health nurse certified as a midwife is assigned to her. The public health nurse issues a maternity health handbook and is in charge of medical checkups for pregnant women, infants, women’s partners, and siblings.

Kraamzorg

The Netherlands

Kraamzorg (postpartum helper) is a support system for delivery and postpartum care, the costs of which are covered by medical insurance. They assist midwives during home delivery, maternity hotels, or hospital delivery, and make daily home visits for eight days after delivery to care for the mother and child. They teach the mother and family about the knowledge needed after birth, how to care for the baby, and if there is time, they assist with household chores, such as cleaning and laundry.

What about in Japan?

Japan

The Maternal and Child Health Act is a law designed to protect the health of mothers and children. It stipulates that public health nurses and midwives in municipalities visit pregnant women and families where children are born in the community, to provide counseling and support for their daily lives and childcare. A system of seamless support from pregnancy to child rearing has been established, centering on Inclusive Support Center for the Childcaring Generation (maternal and child health) and the Comprehensive Support Center for Children and Families (child welfare).

Three kinds of support by Doula
for a peaceful mind

What kind of care during pregnancy, delivery, and the postpartum period would make you feel happy and comfortable to say that you had a baby and that you would like to repeat the experience?

Physical Support

They assist the mothers in taking care of their bodies. During delivery, they rub the lower back, hold hands, support the body, and take care of personal needs, such as eating, drinking, and changing clothes. After delivery, they may assist with childcare that constitutes breastfeeding, changing diapers, and helping with household chores. They also apply acupressure and other treatments to relieve postnatal body aches and pain.

Psychological Support

They provide emotional care while respecting expectant mothers’ wishes and preferences. During pregnancy, they listen to the mothers’ concerns about delivery and help them prepare for delivery. During delivery, they accept the mother's feelings while encouraging and praising her. After delivery, they reflect on the birth experience and sympathize with her worries and anxieties about childcare while staying close to her.

Social Support

They help the mother connect with their surroundings from conception to the postpartum period. They ensure that the mother does not feel alone, help the family communicate with medical personnel, explain and interpret medical terminology in an easy-to-understand manner, connect them to local services and specialists, and care for their older child.

Having and raising a baby is not only a joyous experience, but also comes with its own anxieties and burdens. Doulas, also known as "mothering,” are not medical professionals and do not perform medical examinations or assist with deliveries. However, they use their own experiences to support expectant mothers and their families using a non-medical approach. For example, they accompany the expectant mother, provide attentive care for minor consultations, help her communicate with the medical personnel, and rub her back to help her through labor. They do their best to ease the anxiety of the expectant mother and her family and help her have a better delivery experience. After the delivery, they make home visits to help the mother with her anxiety and isolation. They also provide her family with childcare tips and inform them of ways they can be there for her.

Written by Fukuzawa, Rieko
Fukuzawa, Rieko. Doula Sapouto no Kousei Youso: Bunken Kentou. (Structural Components of Doula Support: Literature Review) Doula Kenkyuushitsu (Doula Laboratory). 2018 http://www.blog.crn.or.jp/lab/03/43.html

“I am committed to helping pregnant women
get the care they need at the moment of delivery!”
Ludmilla Hirata

Attendance at a midwifery clinic in Shizuoka. On the far left is Ms. Ludmilla.

Ludmilla Hirata, who works as a doula,
helps expectant Brazilian mothers who give birth in Japan.

Profile of Ludmilla Hirata

Lives in Hamamatsu-city, Shizuoka Prefecture.
GAMA (Grupo de A poio à Maternidade Ativa: Support Group for Active Maternity) certified delivery Doula. Breastfeeding consultant. Prenatal and postpartum educator. Mother of two children.

My work usually begins with prenatal care for the pregnant women. During the first meeting, I ask the mother about her past pregnancy and childbirth experiences and build trust by understanding her expectations, desires, fears, and traumas regarding childbirth. I also provide information on the delivery procedure, an overview of obstetric care in Japan, and how to choose a birth location. Once labor begins, I explain what is happening during birth, provide emotional support, and offer a variety of ways to help ease the pain. At the same time, I communicate with the medical team to help ensure that the care matches the needs of the mother, including environmental aspects and privacy. Even when a cesarean section is performed, I am mindful of the environment and the rights and wishes of the woman to ensure that the process is smooth and respectful to the mother and child. For example, I lower the surgical coverings so that the mother can see the moment when her baby is born, allow for skin contact between the baby and mother, and allow breastfeeding within the first hour of delivery. The COVID-19 pandemic has made face-to-face birth companions and holding of parent’s childbirth classes difficult, but it has also opened up online possibilities. I began remotely accompanying births online around 2016, and since the pandemic, that number has grown significantly. Now I attend to the delivery processes of people from various countries.

Attending and supporting a Brazilian couple giving birth in Japan.

Written by Fukuzawa, Rieko
Fukuzawa, Rieko. Nihon ni sumu Burajiru-jin ninsanpu to sono Kazoku o sien suru Doula no komyunitei: Hirata Ludmilla-shi (A community of doulas supporting Brazilian expectant and nursing mothers and their families living in Japan: Ms. Ludmilla Hirata) Doula Kenkyuushitsu (Doula Laboratory). 2021 https://www.blog.crn.or.jp/lab/03/50.html

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