Japan to drop term ‘abnormal delivery’ to ease emotional burden on parents

Japan will no longer use the term “abnormal delivery” to describe births involving medical procedures such as caesarean sections, following concerns that the wording could cause psychological distress to expectant parents.

The Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists decided to generally discontinue the use of the term, effective immediately, when explaining childbirth to pregnant people and their families, according to a statement released Tuesday.

Representatives of both medical associations met with health minister Kenichiro Ueno on Tuesday to outline the changes, and the government agreed to adopt them.

Currently, births involving medical interventions, including C-sections and vacuum-assisted deliveries, are often referred to as “abnormal deliveries” to distinguish them from births that do not require such procedures.

The term has been used for classifications in the government’s health insurance system because nonurgent deliveries — termed “normal deliveries” — are currently not covered by public health insurance. A healthcare reform bill was passed in parliament in May to make such deliveries fully covered by public health insurance, with it likely to be implemented within two years.

However, medical professionals have been raising concerns that the terminology could lead pregnant people to believe their childbirth experience was or will be abnormal or inferior, potentially causing them emotional distress. According to the Japan Society of Obstetrics and Gynecology, a survey of its members conducted in July found widespread support for discontinuing the expression.

Under the new approach, medical institutions will be encouraged to avoid both the terms “normal delivery” and “abnormal delivery” when communicating with patients and instead use terminology that describes the specific procedure performed, such as “vaginal delivery,” “vacuum-assisted delivery” or “emergency caesarean section.”

The association also said medical institutions are encouraged to avoid using the term “natural delivery” — commonly used to describe nonurgent deliveries — as a synonym for vaginal delivery because it may lead to the impression that other deliveries are not natural.

The health ministry issued a notice to local health authorities on Tuesday saying that the changes apply to the language used in administrative documents and notifications and will replace the existing terminology with descriptions such as “delivery involving treatment covered by health insurance.”

The changes will initially focus on notifications concerning the government’s lump-sum childbirth payment and childcare allowance, with existing documents to be reviewed and revised gradually.

The government also plans to encourage private insurance companies to adopt the new terminology and ask local governments to review wording used on health checkup and vaccination screening forms.