Aiiku Hospital, too, feeling pinch

Staff shortage hits perinatal care center known for its English-speaking obstetricians

by Mariko Kato

Aiiku Hospital, a perinatal care center in Tokyo for high-risk pregnancies widely considered one of the best for expectant mothers, recently applied to the metropolitan government to end its emergency 24-hour status, underlining the serious shortage of doctors to treat pregnant women.

Aiiku is so highly thought of that Princess Kiko stayed there in 2006 to deliver Prince Hisahito, the long-awaited, now third-in-line, male heir to the Imperial throne.

The hospital has also stood out among local foreign residents as being particularly accommodative of non-Japanese speakers.

The hospital, reputed for having English-speaking obstetricians available for delivering babies, is in Minato Ward, where more than 22,000 foreign residents are registered, according to government statistics.

“We have many foreigners coming here to give birth,” said a spokeswoman for the hospital. “We’re not particular about whether a patient is foreign or not, and our doctors are used to treating foreigners, so our reputation must have spread by word of mouth.”

The hospital is one of only eight comprehensive perinatal care centers for high-risk pregnancies in the Tokyo area. Many of the centers are creaking under a shortage of doctors and English-speaking staff.

Although four of the five other perinatal care centers that responded to a survey by The Japan Times said they have obstetricians who speak English, Tokyo Women’s Medical University Hospital in Shinjuku Ward said it does not oversee births in English “in principle,” and none said it had a notable number of staff who could speak any other foreign language.

Aiiku Hospital was urged last month by the Tokyo Labor Bureau to improve the working conditions of its obstetricians, who were on duty longer hours than allowed under the Labor Standards Law.

The hospital, however, was only making its doctors work overtime to keep up the 24-hour rotation necessary as an emergency perinatal care center.

Two obstetricians, as well as one pediatrician, are required to be on duty at all times at a perinatal care center. But at Aiiku Hospital only five of 13 obstetricians can work night shifts.

To reduce the doctors’ workload in accordance with the law, the hospital asked the metro government to downgrade its “comprehensive” perinatal care center status to “regional,” thus avoiding the need to have multiple obstetricians on 24-hour duty.

“At the moment, the situation is tough even with some general practitioners helping out part time,” said a PR spokesman for the hospital.

The metro government has asked the hospital to reconsider its request. While agreeing to reassess its position, the hospital is waiting for further analysis from the metro government’s conference for perinatal care centers, of which Aiiku Hospital is a member, the spokesman said.

Aiiku Hospital is only one of many hospitals suffering from staff shortages across the country. Long working hours, insufficient pay and an increase in lawsuits are discouraging people from specializing in OB-GYN and pediatrics, according to a report by the Japan Society of Obstetrics and Gynecology. Obstetricians spend more than 300 hours a month on average at hospitals, according to a study by the group.

The severe lack of doctors in the medical system has recently been in the spotlight due to tragic events as a result of hospitals’ refusal to accept emergency patients. Last October, a 36-year-old woman, although not in labor, was turned away from eight Tokyo hospitals and died of a brain hemorrhage after her baby was delivered prematurely birth by Caesarean section in order for a neurosurgeon to finally operate on her.

The first hospital that turned her away was Tokyo Metropolitan Bokutoh Hospital in Sumida Ward, a comprehensive perinatal care center, which claimed it did not have enough staff at the time to accept her.

Since then, the hospital has managed to maintain a sufficient number of obstetricians on rotation, but remains wary about doctors’ working conditions across the country.

“Every hospital in Japan is suffering from a shortage of doctors,” said a spokesman for the hospital.

He also expressed caution about doctors’ language ability. “Although some doctors here can speak English, it’s difficult to say what standard is sufficient,” he said.