We surveyed the actual conditions of the activities of Midwives in 13 clinical facilities, a hospital and a neonatal intensive care unit in Gunma Prefecture in order to investigate the feasability of establishing concrete policies aimed, at changing and expanding the role of hospital midwives in the fields of regional perinatal care including puerperal care. The following conclusions were drawn: 1) Innovations and efforts to improve puerperal care were made in correspondence with the situation of each facility but the actual plan and how the care was provided in terms of the post-hospitalization state was left to the hospital midwives themselves so as to maximize the efficiency of the innovations and efforts to be made. 2) Post-hospitalization problems had generally be stabilized approximaterly 3 weeks after discharge thanks to phone calls from a hospital midwive made since shortly after discharge. 3) For post-hospitalization care of mothers and infants at high risk, an instructional visiting system in which a hospital midwife who is closely involved in correspondence and medical care, at least from the time of delivery, should be arranged
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