Nursing Degree Programs Advanced Midwifery
Faculty of Comprehensive Development Nursing
Graduate School of Health Sciences
Hokkaido University

What We Focus On
We conduct research on a broad spectrum of topics related to perinatal care and women’s health. Our current themes include perceptions of menstruation and menstrual hygiene and health (MHH), as well as family issues and access to obstetric care from a midwifery perspective. Drawing on my background, I am also interested in the influence of life-science technologies on perinatal care. Advanced technologies underpin non-invasive prenatal testing (NIPT) and future infertility treatments; although these have been partially adopted in society, their ethical implications still warrant further discussion.
Perceptions of menstruation among groups that tend to delay childbearing
University students, having already invested in their education and exhibiting strong career aspirations, tend to postpone childbearing. We conducted a qualitative study to elucidate how Japanese women in this demographic perceive menstruation. Although previous research has focused on nursing and medical students, our study excluded participants with professional medical knowledge.
Among Japanese female undergraduates, menstrual symptoms were openly acknowledged but rarely discussed in depth; consequently, having symptoms was normalized. Participants even tended to conceal the absence of symptoms—adopting a humble attitude that it was unnecessary to announce when one was not in pain. They also judged themselves “normal” so long as they followed usage guidelines for menstrual products and experienced no leakage. Given the high performance of Japanese menstrual products, there is a risk that assessment may become biased toward those with more severe symptoms.
Moreover, because symptoms are regarded as commonplace, help-seeking behavior is often delayed, and the idea of taking early action to preserve fertility does not arise. While menstrual hygiene and health (MHH) research is generally robust in low- and middle-income countries, menstrual management must be approached within each society’s specific stigmas and cultural contexts. Even in high-income settings, further research is needed to help women maintain both healthy menstrual lives and sustained fertility.
In high-income countries, access to menstrual products is generally good, yet formal education about menstruation remains insufficient, and many young women rely solely on peer-to-peer information. When women enter nursing school at university, they study menstruation in courses such as Maternal Nursing, general education, and Physiology, and often reflect on how little they knew in high school. To investigate this, we administered an anonymous questionnaire to Japanese high school students, measuring: (1) their knowledge of menstrual management, and (2) their perceived menstrual burden using a Japanese-developed scale. In applying the scale, we specifically asked about burden on “important days”—for example, college-entrance exams or sports competitions—that occur only once or a few times per year.
Although we found no statistically significant differences overall, there was a tendency for greater menstrual knowledge to be associated with higher perceived burden. We had hypothesized that more knowledge would increase confidence on important days and thus reduce burden; instead, the opposite correlation emerged. This suggests that students who experience greater discomfort actively seek out information, accumulating knowledge through their own suffering rather than in advance. We also used a simple measure of menstrual-management knowledge (number of coping methods known) and discovered that awareness of options such as menstrual cups and discs remains very low.
These findings imply that, even as menstrual cycles stabilize in adolescence, coping behaviors remain unstable, and high-stakes days loom large. There remains a clear need for comprehensive menstrual education so that young women can approach key life events—and life planning in general—with greater confidence and peace of mind.
Knowledge of Menstruation and Perceived Menstrual Burden Among High School Students
Discrepancies Between Spouses’ Perceptions of Household and Childcare Responsibilities Are Associated With Women’s Mental Health
Few studies have treated married couples as dyads when examining the division of household and childcare duties; most have surveyed husbands and wives separately. In our study, we anonymously asked each partner in a couple two questions: (1) the share of household and childcare tasks they consider ideal, and (2) the share they feel they—or their spouse—actually perform. We then measured the magnitude and direction of each couple’s perceived discrepancy and analyzed its correlation with quality of life (QOL).
Our results showed that larger discrepancies, particularly in the direction of dissatisfaction, were associated with poorer mental QOL among wives. No such correlation was found for wives’ physical QOL or for husbands’ QOL. These findings indicate that how spouses perceive and misalign in the division of household and childcare responsibilities is especially important for women’s mental health.
In Japan, fathers’ participation in childcare has improved dramatically in recent years thanks to efforts by both government and private sectors. However, our study suggests that it is not merely participation itself, but mutual recognition and appreciation—being able to say “you’re doing a great job”—that truly benefits couples’ well-being.
The obstetric care system in Japan has long been characterized by numerous small clinics spread across the country, providing high accessibility. However, in recent years, nationwide population decline and a falling birth rate have made it increasingly difficult for these small clinics to remain financially viable, prompting a wave of closures and mergers of birthing facilities. In many of these clinics, deliveries were sustained by just a few obstetricians and midwives—a staffing model that has become unsustainable and further compromises accessibility. This issue is particularly acute in Hokkaido, where large areas have low population density.
Until now, Japanese research on pregnant women living “far” from delivery facilities has focused on how to transport them safely once labor begins. Going forward, however, we anticipate a rise in women who, much like in expansive countries such as Canada and Australia, relocate to urban centers in advance and stay nearby to await delivery. While such pre-delivery stays are common in low- and middle-income countries, high-income countries—with their already advanced, medicalized systems—may encounter different challenges. It is these emerging challenges that we currently focus on.
Women’s experiences of traveling long distances and staying nearby before giving birth
The Relationship Between Foundational Scientific Knowledge in Reproductive Medicine and the Development of Ethical Awareness
Developments in iPS cell technology and CRISPR systems have introduced new ethical dimensions to reproductive medicine. At the same time, assisted reproductive technologies (ART) have become so commonplace that undergoing ART when natural conception fails is increasingly viewed as the norm. Decisions about whether to pursue these treatments therefore require robust decision-support, and students training to become physicians, nurses, and other healthcare professionals will one day be present in those counseling contexts. Their personal beliefs and values can directly influence patients’ choices. Indeed, research has shown that providers’ values can shape shared decision-making. In a relational culture like Japan’s—where decisions are often made within close interpersonal networks—this influence cannot be ignored, yet students rarely reflect on how their own values affect others.
Conceptions of life and values also encompass attitudes toward the clinical application of basic scientific technologies. With this in mind, we surveyed future physicians, nurses, and life-science students (who regularly engage with biotechnologies) about their knowledge of scientific techniques, their awareness of ART, and their perceptions of emerging possibilities such as gamete formation from somatic cells and genetic modification. All groups expressed generally positive views of technological progress. However, many nursing students reported that their opinions would shift depending on whom they were advising—indicating that their values are more malleable in relational contexts than absolute. Life-science students, by contrast, voiced particular concern about the potential loss of biodiversity. We believe that educational programs—and the foundational research that underpins them—lack sufficient emphasis on helping students critically examine their own value frameworks. We therefore plan to investigate how values fluctuate across different decision-making scenarios.