In Japan, the field of obstetrics focuses on the importance of perinatal mental health and carries out actual activities. In the revision of medical fees in 2016, an additional obstetrical benefit was approved, based on the importance of managing pregnant women with psychotic disorders with cooperation between psychiatrists and obstetricians. This was regarded as major progress in mental health activities during the perinatal period. However, due to this addition, not only psychiatric departments in general hospitals but also psychiatric institutions are required to provide active cooperation and information relevant to obstetrical treatments. They are also required to establish a system to immediately respond to requests from obstetricians. Moreover, in the documents issued by the Ministry of Health, Labour and Welfare on March 31, 2017 regarding the health check-ups for pregnant women project, some items were thought to require liaison with psychiatrists. Thus, further increases in requests for cooperation from obstetrical institutes and their administration are anticipated to be important realistic issues. In the questionnaire sent to psychiatric clinics, psychiatric hospitals, and medical institutions providing obstetrical services in Tokyo in 2015, several items were indicated to be necessary:educational campaign for psychiatrists on drug therapy for pregnant women, collaboration with obstetricians, establishment of the guidelines for pregnant women with psychotic disorders, and medical fees covered by the national health insurance. The guidelines and medical fees have already been put into practice. A general hospital is a valuable place where a broad range of healthcare professionals can gather together and evaluate the conditions of pregnant women from various angles. However, their responses have limits, such as the issue of how to use limited resources effectively. To be specific, the following are indicated:information sharing among various healthcare professionals, educational efforts aimed at staff members of obstetrical departments, psychiatrists' understanding of the child-rearing assistance system, improvements of screening techniques, and standardization of responses.
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