Jishoji temple monk Washin Akiyama, left, and his wife, Michiko, are seen in front of their temple in the Yuracho district of Takamatsu, Kagawa Prefecture, on Aug. 25, 2021. (Mainichi/Sahomi Nishimoto)

       TAKAMATSU -- Miscarriages and stillbirths are called "officially unrecognized deaths" in Japan. Local governments do not know how many there are in their jurisdictions, and society's understanding of the deep sense of loss people feel when they miscarry or have stillbirths is wanting. Now, a Buddhist monk and his wife in this city whose son was stillborn are trying to help others get information and grieve.

       Washin Akiyama, 47, the head monk at Jishoji temple in the Yuracho district of this city in Kagawa Prefecture, and his wife, Michiko, 44, were shocked when they were told at a hospital in the prefecture that there was an abnormality with the fetus. It was October 2020, and Michiko had entered the so-called "stable period" of her pregnancy.

       Michiko had passed the 20th week of pregnancy, so labor was induced, and she gave birth to a baby boy weighing less than 500 grams. It was a stillbirth. When she held the baby in her arms, she could clearly see his eyes, nose and mouth. "I don't want to make it seem as though he never existed in this world," she thought. The couple named the boy Chishin, and had a funeral for him at their temple.

       At the end of 2020, an incident poured salt into the wound. The Japanese government was distributing masks to pregnant women through local governments, and a set arrived at their home. The couple had already submitted a stillbirth certificate to the Takamatsu Municipal Government, but apparently the information had not reached the officials in charge of maternal health.

       According to the Ministry of Health, Labor and Welfare, in 2020 around 17,000 women miscarried at or after the 12th week of pregnancy but before the 22nd week, or had a stillborn baby at or after the 22nd week of pregnancy. But support for those who go through these experiences is paltry at best.

       A nationwide survey carried out online in 2021 by a support group called the Shusanki Grief Care Hachidori Project -- or the perinatal and neonatal grief care hummingbird project -- found that at least 20% of the approximately 900 people who responded said they "were hurt due to notices about maternal and child health-related information that was sent to them after they had already submitted their stillbirth or death certificates." Multiple people said that they received the masks distributed to pregnant women from the Japanese government.

       Starting in August, the Akiyamas started using social media to link up with others who were going through the same kind of loss they were experiencing, because they felt that there was not enough information out there. "When I was wracked with grief, I didn't know whom to reach out to," Michiko said. "If at least the hospital where I gave birth had given me a pamphlet or something."

       Jishoji temple monk Washin Akiyama, left, and his wife, Michiko, are seen by a statue representing a mother who lost her child, in the Yuracho district of Takamatsu, Kagawa Prefecture, on Aug. 25, 2021. (Mainichi/Sahomi Nishimoto)

       Through social media, Washin and Michiko introduced the pink and blue ribbon child loss awareness campaign and other programs and projects related to child loss. Gradually, they began to receive messages, from people asking advice to those asking about holding funerals or other services.

       "There's a tendency in society to make miscarriages and stillbirths a taboo topic. As a monk, I want to think about the different kinds of struggles people are having together with them," Washin said. Meanwhile, Michiko remarked, "Mothers tend to blame themselves for what happened. I want to tell them, 'It's all right to forgive yourself.'"

       The national government is rushing to establish a support system for people facing miscarriages and stillbirths. According to a 2020 health ministry investigation, information about stillbirth and death certificates were being shared between the departments that accepted the certificates and the sections responsible for maternal and children's health at only 38.5% of local governments.

       According to an online health ministry survey, 92.7% of women who experienced miscarriages or stillbirths in the past five years said they had "never consulted a local government office or public health nurse." There are cases in which the women are suspected to have depression or anxiety disorders, and the health ministry sent out a notice nationwide in May 2021 that psychological and social support be promoted.

       Mikiya Nakatsuka, a professor at Okayama University's Graduate School of Health Sciences, has set up a consultation practice where he cares for women who have had miscarriages or stillbirths. "Immediately afterward, many women don't have the mental energy to consult anyone. But after a little bit of time passes, the sadness builds up, and that's when they need a lot of support," he said.

       (Japanese original by Sahomi Nishimoto, Takamatsu Bureau)

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