In 2007, Jikei Hospital in Kumamoto installed a “baby hatch” where infants could be deposited anonymously, presumably by parents who are unable to raise them for whatever reason. Since then, the hospital has received about a dozen babies every year through the system. The purpose has always been to give new mothers who feel they cannot have the child they are carrying an option other than abortion, but, more significantly, it allows the mother (or father, for that matter) to remain anonymous, since one of the reasons mothers don’t give their babies up for adoption is that they don’t want to be identified in official documents, such as the family register (koseki). The baby hatch has always been controversial.

In an interview with the Asahi Shimbun that appeared Feb. 21, the head of the hospital, Dr. Takeshi Hasuda, who came up with the idea for the baby hatch, talked at length about “isolation births” (koritsu shussan), meaning those instances when a woman gives birth alone and, usually, in secret. As with infants dropped off at the baby hatch, the reason a woman may have a child in isolation is to keep it hidden from others, and, as Hasuda points out, giving birth is often dangerous, even when done in a medical institution. Isolated births are thus doubly dangerous to both the mother and the child. In recent decades, the practice of isolated births has become more of a problem as parents found it ore difficult to sidestep bureaucratic requirements. When births happened at home and were assisted by midwives, a woman could manipulate the birth registration with the help of the midwife. So if the mother was, say, unmarried or underage, the child could be registered as the issue of an older married sister or even the birth mother’s own mother. In some cases, the baby chould be given to a third party without the authorities knowing. However, nowadays almost all births take place in hospitals, so such subterfuges are much more difficult, if not impossible. Consequently, many teen pregnancies end with mothers giving birth in isolation. 

This phenomenon was broadly discussed in the media after a Vietnamese technical trainee, who believed she would be deported from Japan if it were known she was pregnant, gave birth to twins in 2020 in secret and the twins died. (We have already written about this story here.) Though the trainee’s circumstances were different from those of most Japanese women who opt to give birth in isolation, the dangers are the same. More to the point, medical institutions that want to address the problem have to contend with its main cause—the registration of the child’s birth, which is mandated by law and requires the name of the mother. As Hasuda told the Asahi reporter, there are no laws in Japan that even acknowledge such a phenomenon. All births in Japan must be reported to the relevant local government within 14 days, and if the required documents are not filled out “properly,” they can be “rejected.” What Hasuda meant was those situations when documents are submitted without a mother’s name. In that case, the baby cannot be placed in a family register and, for all intents and purposes, does not exist as far as the authorities are concerned. 

So Hasuda is trying to force the issue. In December, according to the Asahi article, a teenage girl in “western Japan” gave birth in a hospital. She didn’t want her name disclosed on the birth record. The hospital improvised a system wherein only one employee would know the birth mother’s name and keep it confidential. The mother’s wish is that her child go through the process of a “special adoption,” which means the child would be adopted by a couple as an infant. (In Japan, “adoption” usually refers to a person being registered as the legal heir of someone they are not necessarily related to by blood.) According to Hasuda, the hospital and the local government are now devising a way to create a family register solely for the baby. Usually, the name of the baby goes into the family register of the parents or just the mother, if she is not married. 

A Feb. 18 article in the Kumamoto Nichinichi Shimbun went into more detail, revealing that the Dec. birth mentioned in the Asahi article took place at Jikei Hospital, but the mother refused to submit a birth report to the city office. At first, the mayor of Kumamoto, Kazufumi Onishi, refused to cooperate, saying that isolated or “secret” births should not be legally recognized. However, on Feb. 9 he changed his mind and announced he had already been involved in discussions on “how to support the mother and the child.” He met with social services personnel at the hospital, along with Hasuda, and the result was to create a family register for the child that included the date and place of birth. Though Onishi has asked the hospital in turn to ask the birth mother to “submit” a birth report, at this point he doesn’t seem to be requiring she identify herself on the report, but discussions at the time were ongoing.

Though Kumamoto’s actions sound like a bureaucratic one-off, the consequences of those actions could be significant if it is accepted as a precedent, since it poses yet another challenge to the primacy of Japan’s family register system. In this case, the mayor of the city where the baby is registered makes an exception to the rules that apply to birth reports. The koseki system is already being compromised by other exceptions to the “conventional family” it envisions as posed by transgender people, children born via surrogates or in vitro fertilization, and same sex unions. (The system will be challenged yet again if separate names for married couples are ever legalized.) What’s problematic about this exception, as some experts have pointed out, is that it shortchanges the rights of the child, who could grow up never knowing who their biological parents are. Other countries that have tried to address the problem of unwanted pregnancies with programs similar to the baby hatch idea have already discussed this aspect, especially in Europe, where a child’s right-to-know is guaranteed. In the U.S., “safe havens,” which exist in all 50 states to some legal degree, are championed by anti-abortion groups since they allow mothers to leave babies at designated locations anonymously and with no questions asked, which means the child may never know who their biological parents are. This fundamental right-to-know could be why the Kumamoto hospital gave at least one person involved in the delivery of the child in December the name of the mother. The implication is that sometime in the future, perhaps after the child becomes an adult, they will be able to access this name, at least. Between now and then, however, the law will have to be clarified. 

Of course, the real solution to this issue is to create an environment where women do not need to deliver a child in isolation. For many of these women, better birth control education and availability is vital. Also, Hasuda told Asahi that his experience with the baby hatch has taught him that many girls and women who abandon babies are from broken homes and/or are victims of abuse. These women do not want to bring children into the world for a variety of reasons, one of which is that they are afraid of perpetuating the cycle of violence. It’s an old story, but one that people still don’t want to talk about.