Key result
Targeted education and interdisciplinary cooperation remain essential to improve obstetric anesthesia management and perinatal safety.
Why the study?
Despite Japan's low maternal and neonatal mortality rates, increasing advanced maternal age and cesarean deliveries require efforts to maintain perinatal safety amid challenges in anesthetic management and low labor analgesia prevalence.
Highlights the critical need for improved obstetric anesthesia education and management systems in Japan to maintain perinatal safety amidst an aging maternal population and increasing cesarean deliveries.
Japan's small-clinic model without full-time anesthesiologists may strain safety amid rising cesareans; leaves open optimal staffing solutions for low-volume centers.
Japan is one of the most developed countries in the world, and perinatal care is safe, with low maternal and neonatal mortality rates. However, as birthrate declines, advanced maternal age and the number of cesarean deliveries increases, efforts must be made to maintain safety in the future. The characteristic of the delivery facilities is "many small clinics," and half of all facilities have fewer than 500 deliveries per year. Such clinics rarely have full-time anesthesiologists; therefore, anesthetic management, including cesarean deliveries and labor analgesia, is left to obstetricians' efforts. Furthermore, the prevalence of labor analgesia is very low compared with that in developed countries. In 2017, maternal deaths during labor analgesia were reported and became a social problem. The Ministry of Health, Labor, and Welfare (MHLW) appointed a research group to conduct a study on labor analgesia and issued recommendations for a safe delivery system in 2018. Even when recommendations are understood, changing the size and staffing of medical facilities is challenging, and the field needs specific interventions such as education and information sharing. Most maternal deaths related to anesthesia are preventable. Within the existing medical environment, a distinctive anesthetic management system is crucial to improve the safety of perinatal care, and cooperation among obstetricians, anesthesiologists, nurses, and midwives involved in perinatal care through education and management is essential. We review past perinatal safety initiatives in Japan and discuss the need to make obstetric anesthesia safer as future risks increase.
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Reiko Ohara (2025) conducted a review in Obstetric anesthesia and perinatal safety. Obstetric anesthesia management and education was evaluated. A review of perinatal safety in Japan emphasizes the need for specific interventions like education and interdisciplinary cooperation to improve obstetric anesthesia management.
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