The Japanese Midwifery Model of Care

The Japanese Midwifery Model of Care

This was originally written for an assignment in my Introduction to Midwifery course at the Midwives College of Utah. 

Midwifery Models of Care Vary across the world

Several different impactful midwifery models around the world are covered in the book, ‘Birth Models That Work”, which have similarities in reducing cesarean sections, trauma, and increased parent-centered care. The Japanese midwifery model was especially noteworthy because Japanese culture supports the midwifery model. Japan puts a high value on the specific gendered role of pregnancy and childbirth and sees the intensity of birth as an opportunity for a person to become a proper parent. While the Japanese midwifery model prioritizes vaginal birth, low medical intervention, and family at the center of childbirth, the culture’s heavy value on gender roles and its negative view against cesarean section and pain relief in pregnancy could harm parents emotionally.

Values of the Japanese Midwifery Model

The Japanese model of care believes deeply in the importance of patiently waiting for a baby to be born, values the pain of labor, mothering the mother, and birth is a family event (Davis-Floyd et al., 2009). Japanese midwives believe that a baby chooses the time it wants to be born and they do not intervene in the process unless an emergent situation arises (Davis-Floyd et al., 2009). Using analgesia in labor is not viewed positively in Japan because most Japanese care providers and families see birth as a tremendous cultural event where birthing people are fulfilling the most essential role of their specific gender (Davis-Floyd et al., 2009). 

Furthermore, Japanese midwives and families deeply value the importance of birth being a family event. Because of these deeply held beliefs around birth, “Japan continues to promote physiologic birth without complications, at lower rates than many other developed nations” (Shorten et al., 2014, p. 1). They also have one of the world’s lowest maternal mortality rates and a cesarean rate of only 18.6% in 2014 (Shorten et al., 2014). 

This rate is less than 1% higher than the cesarean rate in 2005 of 17.4% that “Birth Models That Work” cited (Davis-Floyd et al., 2009). The beliefs that care providers should respect when a baby wants to be born, involving the family in pregnancy and birth, and mothering the mother during their childbearing year are contributed to Japan’s low rate of cesarean section and maternal mortality rate (Shorten et al., 2014).

Possible Negative Side Effects of This Midwifery Model

While Japan has maintained a low rate of cesarean section, maternal mortality, and analgesia intervention, placing heavy importance on the gendered roles of parents could be harmful to the mental health of parents who need cesarean sections and those who do not identify with gendered roles. The opposing view on analgesia use and method of delivery may also be unsupportive of women and birthing people’s right to choose what happens to their bodies and how they deliver their babies. This model seems to be more centered on the Japanese culture than the mother or birthing person compared to the other midwifery models of care presented in “Birth Models That Work” (Davis-Floyd et al., 2009).

Has the Japanese Midwifery Model Changed since the Book Birth Models that Work was released?

Since the “Birth Models That Work” book was published, “Japan continues to promote physiologic birth without complications, at lower rates than many other developed nations” (Shorten et al., 2014, p. 1). There has not been a deviation from Japanese midwifery care’s deep value placed on women and birthing people’s ability to give birth, compassion, non-medical pain relief, and the presence of an educated midwife (Shorten et al., 2014). The continuation of these values is most likely why Japan still has such a low maternal mortality rate, cesarean rate, and use of analgesia during labor (Shorten et al., 2014). While the effects of the Japanese culture and Japanese midwifery model of care continue to be beneficial for keeping medical interventions and surgical births low, they could also be mentally damaging for parents who need or want medical interventions, as well as for those who do not identify with Japan’s strict gender roles.


 Shorten, A., Torigoe, Ikuyo., Weinstein, L., Muto, A. (2014). Continuity, confidence, compassion, and culture: Lessons learned from Japanese midwives. Journal of Midwifery and Women’s Health, 59(5),  551.


Davis-Floyd, R. E., Barclay, L., Daviss, B., Tritten, J. (2009). Birth Models That Work. The Regents of the University of California.

Jenni Jenkins Sekine Student Midwife

Jenni Jenkins – Sekine is an Oklahoma Student Midwife, Midwives Assistant, Birth & Postpartum Doula, and Child Birth Educator who serves her Central Oklahoma  community. She began her journey as a student midwife in 2022 at the Midwives College of Utah.

To learn more about Jenni, please click here.

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