Japan: Love, Creativity, and a Pioneer Spirit

This week Jim and I flew from Takamatsu, Japan, to Tokyo to meet new nursing colleagues at St. Luke's Hospital and International University (founded by American missionary and physician, Dr. Rudolf Bolling Teusler in 1920). In preparing for my visit to this campus with a 90-year history of nursing education, I was particularly inspired by the words of its president, Dr. Toshiko Ibe, who wrote that St. Lukes' wants "to welcome women and men full of love, creativity and a pioneer spirit."  With my presentation, "Innovative Nursing" having just been warmly received at Kagawa University, I knew I would feel at home here as well.

What a joy on Day One to visit the St. Luke's Birth Clinic with director, Shigeko Horiuchi, NM, Ph.D, and St. Luke's School of Nursing professor [photo] (and our host), Yoko Shimpuku, Ph.D (on Right). Dr. Horiuchi had visited a number of birth centers across the USA, gathering ideas to launch this model birth center in Tokyo. This Center is attached to a sprawling, state-of-the art hospital overlooking Tokyo's picturesque Sumida River. Just three years old, St. Luke's Birth Center now delivers about 20 mothers a month with a population growing steadily as local couples learn how midwifery care in a birth center is a safe and "homey" alternative to traditional hospital care.    

Birth Center mothers spend a minimum of 5-6 days postpartum here. The typical cost of birth and postpartum care here is about $6,000 USD, with insurance paying $4,000 USD and the balance paid by the mother and her family. (A typical delivery in the hospital costs $12,000 USD, with a similar postpartum stay, which is typical in Japan). 

At the birth center mothers learn how to breastfeed, visit with other moms, and eat healthy postpartum food (miso soup, root veggies with no oil, sugar or preservatives). 

The center offers its "graduates" a fun baby/mother yoga exercise class that stimulates a healthy lifestyle and helps to prevent the social isolation that some new Japanese mothers feel. Fathers typically work VERY long days, often leaving at 7 AM and returning at 10 PM, or later. Mothers with a year of maternity leave (the Japanese standard) can spend a lot of time in their high-rise apartments, alone with baby. 

How I laughed along with these babies (about five to nine months of age), who squealed with delight as their moms squatted down and then jumped straight up with their little ones!

I finished up my visit to the Birth Center just in time to accompany Yoko to meet a group of young mothers, students, and mothers-to-be for "A HUG." Four of the five women were nursing students and, as Yoko said, "wanted to learn all they could about The HUG." Two of the mothers arrived with their one-year-olds. 

My years of providing primary care services and teaching nursing students and resident physicians gave me the inspiration to create an approach which has become an essential part of HUG Your Baby teaching. Borrowing language from the sporting world, I teach professionals how to  "Broadcast and Commentate" on the baby's behavior. "Broadcasting" means just saying  EXACTLY what you see the baby doing. "Commentating" refers to describing the importance of the child's behavior you see. I, and other HUG trainees, have experienced time and time again that "Broadcasting BEFORE commentating" on a child's behavior improves connections with the family, emphasizes the positive capabilities of a baby, and enhances a professional's ability to see what is right before her eyes!

It was easy to describe these Japanese babies as they demonstrated initial hesitation with a stranger (completely normal and expected), showed off their pincer and early pointing abilities (emerging at nine and twelve months respectively), and exhibited a budding sense of independence (beginning, as anticipated, at the start of year two). 

One child eventually offered a remarkable example of "deep sleep," providing the opportunity to discuss two kinds of sleep and a baby's normal transition between these states. Later Yoko shared feedback similar to what I often hear from those watching "a HUG": "I would not have thought how important it could be to actually SAY what I was seeing!" But, observing the delight on the faces of these young mothers, Yoko, like many professionals practicing this skill, can imagine the transformative power of implementing this simple HUG technique into their care of young families.

After returning to our nearby hotel for only a moment's rest, Jim and I then took off for our scheduled presentation with 40 faculty and students interested in exploring HUG tools and techniques to help parents understand their baby's behavior. Participants were delighted with the newly-translated HUG DVD, which is ready for sharing with both pregnant and new mothers in Japan. 

Phrase-by-phrase translation by Yoko made it possible for these Japanese professionals to learn how to teach parents about newborn "Zones" and "SOSs" (Signs of Over-Stimulation), to use this information to address challenges around infant crying, breastfeeding and sleeping, and to enhance the satisfaction of those providing care.   

Let's Celebrate! Shigeko, Yoko, Jim and I celebrated the success of the St. Luke's School of Nursing workshop with a lovely traditional udon and soba dinner. But in addition to just being thankful that these two amazing nurses would spend time getting to know Jim and me and HUG Your Baby, there seems to be significant enthusiasm about incorporating these materials into routine teaching and services at St. Luke's. 

Today Yoko contacted the  journal, Japanese  Nurse Educator, about the possibility of publishing an article on HUG Your Baby. Delighted to learn that they are now gathering articles for an upcoming issue on the teaching of maternity care, Yoko and I are hoping to meet their September deadline, thus continuing to explore what HUG Your Baby may mean in a Japanese context.