A Japanese physician’s experience as an inpatient in the United States and Japan

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I have had the unique experience of being an inpatient and a physician in both the United States and Japan. To deliver my three children, I stayed in three different hospitals: a university hospital in Tokyo, a university hospital in Florida, and a private institution in Florida. Although my labor was induced for all three deliveries, my experiences varied widely in both medical and cultural ways. I delivered my first child at a university hospital in Tokyo where I was working as a physician. Because I was already 2 weeks overdue, my doctors decided to induce labor. I was admitted in the afternoon because they were planning to use Laminaria to expand my cervix before starting the drip infusion for induction. They explained that if the Laminaria did not work, they would start the drip infusion the following morning. This would ensure there was adequate medical coverage should something go wrong. The hospital was beautiful and brand new. Medical care in Japan is cheap, so a hospital has to give a good impression in order to attract more patients if they want to stay in business. Although, as a physician, I had the option to stay in a single room (with no roommate), I requested to stay in a six-person room, which did not cost any extra. When I was admitted to the hospital, the nurse gave me a bag with all the supplies I would need during my stay, including brand-new pink pyjamas, a tea cup, a post-partum pelvic support band, sanitary pads, and formula and diaper samples. It seemed my every need was anticipated. Labor and delivery were done in different beds. There was a labor area separated by a curtain from the delivery bed. There was no privacy. You could hear and be heard. And because there was no option to have an epidural, you could hear all of the women screaming. (Actually, there were very few hospitals in Japan that offered the epidural. One reason is the shortage of anesthesiologists, but another is the cultural avoidance of pain control. Though things have changed in recent years, asking for pain relief is generally regarded as a weakness.) Once you were ready to deliver, you moved to the delivery area. If your husband wanted to be with you during the delivery, he had to take classes (many husbands choose to wait outside). This rule was very strict. My husband could not attend the classes and was not allowed to be with me during the delivery— even though he was a physician himself and had already attended other births during medical school. During labor, my nurse taught me that if I pressed or massaged a particular pain pressure point, the labor pains would weaken, which really worked. Because of the Laminaria, my labor was very smooth. After 2 h of induction my water broke and shortly after that, I felt the baby’s head. She checked me and exclaimed, ‘‘Run to the next room!’’ Before I knew it, the baby was out. They briefly cleaned and checked the baby, then brought him to me right away. They told me that this was called ‘‘kangaroo care’’ and was very important for the baby. I stayed in the hospital for 5 days after delivery, wherein I had a chance to rest and learn how to take care of the baby. For my second child, I delivered at a Florida academic hospital where I worked. For the 2 months leading up to my due date, nurses did a 20-min biophysical profile. During one of my tests, the baby’s heart rate dropped. My physician explained that there could be an umbilical cord problem with my baby and sent me to the main hospital to be induced right away, without doing an ultrasound examination. In retrospect, I should have insisted on an A. I. Saito (&) Department of Radiology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, Japan e-mail: anyusaike@yahoo.co.jp