The hospitalization assistance policy system in Japan.

In Japan, the hospitalization assistance policy (HAP) system helps pregnant women who, for financial reasons, cannot give birth at medical institutions. The HAP system allows these women to deliver at specified midwifery institutions. We compared women with singleton pregnancies who gave birth with the HAP system (n=150) or without (control; n=2,869) . Although the percentage of women younger than 20 years was significantly greater in the HAP system group than in the control group, the parity number in the HAP system group was significantly greater than that in the control group. The percentage of non-Japanese was significantly higher in the HAP system group than in the control. The rates of preterm delivery and of low birth weight (<2,000 g) were significantly greater in the HAP system group than in the control group. From the perspective of perinatal medicine, social risks, such as poverty, present some perinatal problems, even in Japan.