Lessons Learned from the Great East Japan Earthquake: Birth Outcomes in a Catastrophe in a Highly Aged Society (SpringerBriefs in Population Studies)

Maternal and Child Health \((\mathrm{MCH})\) is one of the pillars of a country. In order to understand \(\mathrm{MCH}\) during a disaster, it is necessary to know about the state of public health, sanitary conditions, and living standards in the country. The history of MCH tells us the details. In the period between 1868 and 1944, Japan's MCH policies dramatically developed facing two major World Wars. In the postwar era (1945-1948), MCH was designated as an important field of public health, under the direction and with the assistance of the General Headquarters of the United States Army (GHQ). The Children and Families Bureau was established in 1947 as part of the Ministry of Health and Welfare responsible for preparing MCH policy including mother and child handbooks. Recently, a new trend in \(\mathrm{MCH}\) was reviewed based on the statistical analysis of national databases including the national census data. The key findings of the statistics were decreased infant mortality rate (IMR), decreased perinatal mortality rate (PMR), and decreased total fertility rates, while low birth weight babies, intellectually handicapped children, and the number of babies conceived through artificial fertilization therapy have increased. Foreword 6 Contents 9 1 Maternal and Child Health History and Public Health System at the Time of Disasters in Japan 12 1.1 Introduction 13 1.2 MCH in the Period Between the Prewar and Wartime Eras Including the Meiji Era (1868–1912), Taisho Era (1912–1926), and Showa Era (1926–1945) 15 1.3 Postwar Era (1945–1980) 17 1.4 Change in MCH Systems and Healthcare Policy (1980–Present) 19 References 22 2 Support System of Maternal and Child Care on Great East Japan Earthquake 24 2.1 Introduction 25 2.2 The Disaster-Risk Prevention System in Japan and Medical Care for Perinatal Infants 26 2.3 The Legal Basis for Providing Support in Times of Disaster 27 2.3.1 The Disaster Relief Act (Act No. 118 of 1947) 27 2.3.2 Disaster Countermeasures Basic Act (Act No. 223 of 1961) 28 2.3.3 Act on Special Measures Concerning Earthquake Disaster Management (Act No. 111, Established in 1995) 28 2.3.4 Natural Disaster Victims Relief Law (Act No. 66 of 1998) 29 2.4 Evacuation Sites and Evacuation Process for Maternal and Child Healthcare System 29 2.4.1 Shortage of Maternal and Child Healthcare System on the Great East Japan Earthquake (GEJE) 29 2.4.2 Disaster Effects for Prenatal Care System and Neonatal Mortality in the GEJE-Affected Area 31 2.4.3 Evacuation Site for MCH Care 35 2.5 Preparations for Disaster and Use of International Models to Provide Safe Milk 37 2.6 Mother and Child Support and Management of Evacuation Sites 38 2.7 MCH Care and the Growth of a Friendly Society for Mother and Child 39 2.8 Conclusion 40 References 41 3 Importance of Cross-Organizational Collaboration for Disaster Preparedness for Maternal and Child Health Care 43 3.1 Introduction 44 3.2 Initiatives for Personnel Development Research 44 3.2.1 Progress in a Nationally Applicable Manual for the Operation of Welfare Evacuation Sites and Techniques for Personnel Training 44 3.2.2 Development of Training Programs for the Operation of Evacuation Shelters in the Community 45 3.3 Establishing a Collaborative System for the Operation of Next-Generation Evacuation Shelters in the Community 51 3.3.1 Establishment of a Liaison for Pediatric and Perinatal Care During Disasters 51 3.3.2 Future Plan 53 3.4 Conclusion 53 References 54 4 Preparations for Maternal and Child Protection in Times of Disaster: Practical Tools for Regional and Multi-Occupational Collaboration 55 4.1 Introduction 56 4.2 Report on Situation of Expectant and Nursing Mothers in the GEJE 56 4.3 The Role of Administrators Within Governments During Times of Disaster in Providing MCH Care 59 4.3.1 Specific Processes for Establishing Disaster Relief Centers for Mothers and Children 59 4.3.2 Creating an Emergency Response System to Meet the Regional Situation 62 4.4 Conclusion 74 References 77 5 Issues to be Solved on Mother and Child Health Care in the Disaster 79 5.1 Introduction 80 5.2 Insufficient Support System for Evacuees at Home 80 5.3 Issues on Perinatal Medical Support in Disaster Area 81 5.3.1 Medical Support by Medical Team in Foreign Countries 81 5.3.2 Difficulty on Medical Support for Pregnant Women in the Disaster Area 82 5.4 Population Dynamics in the Disaster Area: The Role of Local Governments 82 5.5 Oral History of Mothers Survived from Disasters 83 5.5.1 Difficulty of Families with Children Under Elementary School-Going Age Staying in Refugee Facilities 84 5.5.2 Difficulties in Obtaining Supplies and Information for People Who Stayed at Home 85 5.5.3 Case of Single Parent Families 86 5.6 Equal Support for MCH Care in the Disasters 86 5.7 Conclusion 87 References 88 6 Personal Health Record (PHR) System for Maternal and Child Health Care in Disaster 89 6.1 Introduction 90 6.2 The Necessity of Constructing a PHR System for MCH Care in Disaster Preparedness 91 6.3 The Future of PHR—Establishment of Information and Communication Technology (ICT) System 94 6.4 Conclusion 97 References 98 This book provides insights into the enormous impact of fetal and newborn loss in the aftermath of the natural disasters that Japanese society constantly has to face. It first reveals effect of the Great East Japan Earthquake in 2011 on the next generation and reproductive attitudes and shows that prenatal care strategies for emergencies had not been established by any local government in Japan. With continuing research on birth outcomes in the area surrounding the catastrophe, the authors emphasize the importance of the pre-hospital obstetric care team in disaster response and highlight the inequality in health care in a highly aging society like Japan, where perinatal health care is given lower priority than elderly care. Following the creation of a specialized project for pre and postnatal care the authors conducted surveys on how community preparedness in maternal and child health for post-disaster areas impacted population changes. This book is a valuable resource for researchers who are interested in the association between rapid population decline and the disaster management system for maternal and child health, as well as the effect of culture, gender bias, and family traditions.