Lessons Learned from Great East Japan Earthquake - Birth Outcomes in the Catastrophe of Highly Aged Country

The Great East Japan Earthquake and Tsunami occurred in 2011/3/11 and this disaster revealed health care issues that Japan already had. One is the lack of attention for maternal health care in the highly aged society and the other is decreasing OB/GYN providers in the Tohoku area.  It was hard to see pregnant people and babies in the highly aged country like Japan, however, there were a few expecting mothers left in the in the cold, hungry and anxious shelter with another people. They were not prioritized as a vulnerable population.Continuing research of 11 hospitals and 37 clinics in one prefecture in the devastated area showed that most of pregnant mothers stayed more than 3 evacuation shelters to find a safer place to live and half of the pregnant patients could not find a way to go out from the Tsunami area to have birth. With more than 200 patients who could succeed to transport to another prefecture, their average delivery time (weeks of gestation), weight of baby, preterm birth rate, low birth weight rate, amount of blood loss and another birth outcomes of this catastrophic area tells us the importance of the pre-hospital OB/GYN care team in disaster response and safety confirmation system for mothers and babies. We should strengthen the perinatal care in highly aged society where mothers are “minority”.There is a generation inequality in health care of highly aging society like Japan - perinatal health care is less concern than elder care. 10 obstetricians set up a project specialized for pre- and postnatal care, and carried out medical activities in these disaster-stricken areas by taking care of pregnant and postpartum patients from April 1st until September 3rd, 2011. With dispatched specialist after natural disaster and built the visiting system and correct birth outcomes and neonatal health outcomes.