San-ikukai Hospital in Tokyo’s Sumida Ward has introduced confidential births and a “baby hatch,” becoming the second medical facility in Japan to adopt such measures after Jikei Hospital in the city of Kumamoto. We hope this serves as an opportunity for deeper discussion on preventing baby abandonment and abuse-induced infant deaths by ensuring pregnant women don’t feel isolated or like they have no choices
The measure allows women facing unplanned pregnancies to deliver their babies confidentially, disclosing their identities solely to medical staff at the hospital, which also provides prenatal and childbirth care. The baby hatch provides a place where parents unable to raise their newborn babies can leave them safely at any time of the day.
If the parents’ willingness or ability to raise the child cannot be confirmed, a child welfare consultation center connects the infants with foster parents or individuals seeking special adoption arrangements.
Jikei Hospital first introduced Japan’s baby hatch, known as the “Konotori no Yurikago” (Stork’s Cradle), in 2007. Since then, 179 infants have been entrusted to Jikei’s baby hatch and 47 have been born through confidential birth arrangements. With a similar facility now operating in the Tokyo metropolitan area, these numbers are expected to increase.
For several years, San-ikukai Hospital has received pregnant women facing difficulties stemming from complex family situations. Two years ago, the hospital began examining the introduction of anonymous births and a baby hatch, coordinating with the Tokyo Metropolitan Government to determine appropriate maternal and child support approaches.
Underlying these measures is the isolation pregnant women can experience. There are women who have been forced to give birth without support from administrative bodies or even family members, including the child’s father.
According to data compiled by the central government, from fiscal 2003 through fiscal 2022, 228 infants less than a month old died due to abandonment or abuse. About 80% of them were born in high-risk environments outside medical institutions, such as in-home washrooms. Both hospitals emphasize that confidential births and baby hatches serve as “fortresses for protecting lives.”
Efforts by health care professionals reaching out to these vulnerable mothers deserve recognition and respect. Nevertheless, serious issues remain unresolved.
For instance, Japan currently has no clear legal framework covering birth registrations or handling of family registers in anonymous birth cases. Even where facilities lack sufficient preparation and resources to establish such arrangements, administrative bodies have no authority to halt their operation.
Another challenge is the absence of a state-guaranteed system securing the child’s right to know their origins.
Countries with laws permitting anonymous births — such as Germany, France and South Korea — have mechanisms whereby national agencies securely store information about the mother’s identity to allow disclosure under defined circumstances. In Japan, however, handling these sensitive situations remains the responsibility of the individual hospitals, prompting cities like Kumamoto and other parties to urge the national government to assume clear responsibility.
The Japanese government has begun examining overseas examples. It must expedite legislation establishing clear legal guidelines for anonymous births and baby hatches to ensure all women, regardless of circumstances, can deliver their children safely and securely.