This study aims to analyze the perinatal care provided to non-Japanese speakers in one hospital in Tokyo from 1990 to 2001. It attempts to identify critical issues in perinatal care services and to recommend measures which should be taken to improve them.
Two major problems were identified: firstly, communication difficulties between health-care providers and the women and, secondly, a severe lack of information available to the women regarding health, medical and welfare services in Japan.
In particular, communication difficulties were a big burden for health care providers in that they presented an obstacle to collecting medical histories, to finding out about symptoms, to establishing good rapport with the patients and to providing spiritual support. It also made it difficult to provide health care based on informed consent.
Systematic assistance from medical interpreters is urgently needed in order to provide foreign women with the same level of care as that provided to Japanese patients.

Introduction
Recently, an increasing number of registered foreigners get married and bear children in Japan. At the same time, a variety of needs for maternal and child health (MCH) impose burden for medical practitioners. A questionnaire survey was conducted to clarify the situation of MCH service for foreign residents.
Method
Self-report questionnaires developed by “The study group for MCH in a multiethnic and multicultural society” were sent by mail to the pediatricians registered in the Gunma medical association or Gunma pediatric association. In total, target number was 299. The survey period was between 2003/10/6-11/3.
Result
The number of valid response was 167. Out of 167, 155 doctors replied to have experience of caring foreigners. 75% of them had the experience of trouble in communication. For the question of the need of translator, 76.8% of doctors answered “absolutely necessary” or “necessary if the quality of translation is high enough”. Desired competencies for translators were “Accurate translation of diagnosis, hands on of treatment strategy” or “To help taking detailed patient's history”.
For the experience of using MCH handbook in foreign languages, 52.9% of doctors answered “Never used it”.
Discussion
We found that the majority of doctors had difficulty in communicating with foreigners.
To meet the doctors' requirement for the competency of translator, two strategies should be considered. One is to develop professional medical translator through education of basic medical knowledge or Japan's health care system. The other is to train foreigners already engaging in translation.
For communication tools development, user friendly concept should be reflected including 1) adscript of foreign and Japanese languages, 2) illustration usage and 3) eye-friendly materials for elderly. Contents should have explanations including 1) diagnosis and treatment policy for common disease, 2) ways of coping with common symptoms, and 3) the information of a variety of Japan's welfare services.