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< INTERVIEW >
The Theme for Japanese Women That Came Through Work

Miki City, with a population of eighty thousand, is situated to the north-west of Kobe City in Hyogo Prefecture, an area greatly damaged by the Great Hanshin Earthquake in 1995. Ms. Akiko Akamatsu, a midwife, opened Sato-no-Ie (regional home) in the city in 1990, where women can think about their way of living through solving their health problems. Ms. Akamatsu, who has served in the counseling room of an obstetric and gynecological clinic for over 25 years, talks about the status quo and future themes involving women and their reproductive health.

Profile:
Akiko Akamatsu is one of the pioneers in the field of reproductive health counseling. She spends her busy days in counseling at a hospital, running "Sato-no-Ie," teaching at a nursing technical school, and giving counseling or lectures at various public and private women's centers around Japan. Among her books are Women: Mind and Body Analysis from 5000 charts of a Counseling Room at an Obstetric and Gynecological Clinic, published by Sogensha, and A Breakthrough of Menopause, published by Kamogawa Press.

One out of two women worries about pregnancy
I graduated from a nurses' training school, then went on to a public health nurses' school. I worked for a city hall as a public health nurse for ten years

In the meantime, I got married and gave birth to three children. I quit my job to care for my children, then entered a midwives' school.

After graduation, I got a job at an obstetric and gynecological clinic as a counselor for pregnant women. I was shocked to find out that I couldn't say "Congratulations!" to half of the women who turned out to be pregnant.

The women whom I had met at the city hall counseling room were those who had decided to "have babies," while half of the women who came to a practitioner to check their pregnancy were worried or sad about their unwanted pregnancy. In the background, there existed problems that meant the women couldn't make decisions about their own reproductive health; for they couldn't talk about birth control or pregnancy with their partners; they were ordered to "have babies" or "not to have babies."

In the course of counseling, in order to solve this problem, the necessity to establish a Kakekomidera (refuge or shelter) came to be realized, a place where we could give consulting and counseling to women, and help support a gender-free way of life and child-rearing through considering women's reproductive health involving pregnancy, childbirth, sexuality, birth control, abortion, or menopause.

As a place to practice that, I turned my house into "Sato-no-Ie" and opened it to the public. It is run by voluntary workers. Midwives and health nurses give telephone counseling. We set out to make a childrearing support network as well.

Middle-aged women must also be "self-dependent"
One of the great themes about women's reproductive health and mental well-being is the relationship between women in their fifties or sixties and their daughters. In the past, it was men who ordered women to "have babies" or "not to have babies," but nowadays more and more mothers meddle in their daughters' pregnancy or childbirth. Their energy, interest, and economic power is focused upon their daughters and grandchildren. Daughters also expect and rely on their mothers' economic power.

Women should find lives worth living beyond childrearing to be self-dependent from their parents and from their children. Now we are entering into an aged society, so middle-aged and elderly people should have networks beyond the framework of the family system. "Sato-no-Ie" is going to play a central role in such activities from now on, too."(Interviwed by Haneko Inoue)

***Nursing professions in Japan***
Nurses=In charge of bedside care and home-visit nursing
Public health nurse, midwife=Can get a license when a qualified nurse, after studying at a technical school and passing the state examination.

Public health nurses engage in health and hygienic services in the region at both offices and schools.
Midwives, having licenses of practitioners, work for hospitals or open clinics to help support childbirth and take care of pregnant women and newborn babies.



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