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Saitama Pref. city sets up support net for new moms based on Finnish model

A care manager talks with a woman at a municipal "childrearing generation comprehensive support center" in Wako, Saitama Prefecture, on Aug. 8, 2018. (Mainichi)

WAKO, Saitama -- "My son got an ear infection," a 35-year-old working mother tells a female "care manager" at this city's municipal "childrearing generation comprehensive support center" on a day in early August.

"You can't put him in day care, but do you have anyone who can offer you a helping hand if you can't take time off of work?" asks the care manager, carefully listening to each word to see if there is a need to offer the woman support services.

When the woman gave birth to her son, now 2, she ended up seriously hemorrhaging and losing a large amount of blood, and developed an intractable disease. This prompted worries if she would be able to properly raise her child. But now that things have settled down, their lives have been peaceful. She even returned to her job at a company this spring. The woman and her husband are even discussing a second child.

In the city of Wako, Saitama Prefecture, just north of Tokyo, municipal childrearing support begins from the moment a mother receives her maternal and child health record book from the government. A care manager will then interview all the new mothers for 20 to 30 minutes about their lifestyle situation. Along with the condition of the mother's health, the center also confirms the mental health and financial situation of the family. This is to quickly nip any possibilities at the "bud" that the situation might lead to postnatal depression, child abuse or other issues. This is risk prevention for issues surrounding childbirth and childrearing.

The population of Wako, being located on the southernmost edge of Saitama Prefecture, has grown as the city has developed into a bedroom community for workers in Tokyo. However, with the move to the suburban area, those of the generation raising children being isolated due to a lack of community connections has become an issue, and preventing any problems from occurring during child care has become an important focus for Wako.

Even after giving birth, the center makes a "birth phone call" to each new mother, making sure to once again tighten the ropes of the city's safety net. It was during that phone call that the woman who lost a large amount of blood during childbirth came to request support.

The support system is similar to that of Japan's nursing care insurance for the elderly. The care manager chooses the needed services from the city's child care repertoire and creates a care plan for the parent. The menu of services is quite varied, ranging from help with household chores, to babysitting services for infants and even short stays away from home to rest while sitting in on lectures about child care. Those tasked with offering support are a team of specialists such as caretakers, nurses, nutritionists and more.

The Wako Municipal Government calls these support policies "Wako edition neuvola," after the Finnish support system for new mothers and their child. "Neuvola" means "a place for advice" in Finnish. In Finland, comprehensive support for women from the time they become pregnant, to when they give birth, and even through the childrearing period, is provided by municipal facilities that offer continuous support.

Under the system, a new mother has a designated worker who offers continuous support and builds a trusting relationship in hopes of preventing child abuse, domestic violence and other risks that a new mother may encounter.

Pivotal in the construction of the support system in Wako was Kyoichi Tonai, 54, currently the head of the education department of the Wako Municipal Government, but who served as the head of the city's health and welfare department up until March 2018. He was also involved in laying the groundwork for the nursing care insurance system in Wako in 2000. Tonai felt keenly that if the municipal government did not offer physical, mental and economic support to the elderly in addition to nursing care, then their dignity could not be protected. He then realized that the same idea was also applicable to childrearing.

The central government has praised efforts like those in Wako, and in an outline of declining birthrate countermeasures adopted by the Cabinet in March 2015, and in other announcements, the goal has been set to establish "childrearing generation comprehensive support centers" all over Japan by the end of fiscal 2020, or March 2021.

If the preventative measures work to reduce risks, then it is hoped that there will also be a positive influence on public finances. Still, "Focusing on preventative measures is so that families, just like in nursing care situations, can live independently in terms of physical and mental health and economic circumstances," Tonai explained. "If we do not consider the dignity of the childrearing generation above all else, then we will not gain proper understanding from our residents, and more than anything else, the motivation of workers is not being protected."

This is Part 4 in a series.

(Japanese original by Kaoru Yamadera, Saitama Bureau)

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