The current studies were carried out with the objective of clarifying the contents, methodology and the term during which midwifery capabilities are developed during the career development of a midwife, the capabilities obtained as a result of personal independent learning and development at the workplace through individual independent effort. The following were categorized and are summarily reported as follows:
(1) Confidence in working ability was established through the learning of basic principles through the actual practice of the work involved.
(2) Contact with effective superiors and senior peers triggered personal growth.
(3) The transfer of rights and responsibilities to oneself in order to take charge of tasks and shoulder the responsibilities on hand.
(4) Through work and research both inside and outside the hospital, to gain a clear understanding of what had been learned.
(5) The ability to improve routines and the pursuit of all round work practices.
(6) Activities of networking outside the hospital.
(7) Learning the role of the educating of and directing of other midwives.
(8) Comprehension of the significance of the tasks in hand through the transfer of the scene of activity.
(9) Coping with and overcoming everyday events in areas affecting midwifery.
(10) Adjusting to the role of an administrator.
From these results, we were able to realize the necessity of promoting the development of midwives through the provision of, by management and organizations, problems and opportunities to meet the career requirements of the respective midwives.

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The purpose of this research showed clearly how the women who experienced the delivery are evaluating the service about a delivery with institution, and aimed at obtaining an effective measure for institution management. The self-question paper investigation by the researcher creation which referred to the measurement tools “SERVQUAL” of service quality was requested from the women who experienced the delivery using the technique of service marketing, and 354 persons' reply was obtained. A result is as follows.
1. The service about a delivery was classified into the pregnancy time three factors, :“per-sonal trust factor”.“cost factor”“option factor” delivery time 4 factor:“personal trust factor”.“cost factor”“continuity of care factor”“factor of safety” and childcare time 4 factor, :“personal trust factor”, “hospitality factor”, “cost factor”, and “safety factor.”
2. As for the factor extracted with the degree of satisfaction of each time, significant relation accepted except for the “delivery time continuity of care factor.”
3. Factor Which Influences the Whole Degree of Satisfaction is “the delivery time factor: personal trust”, “the delivery time factor: cost”, “the childcare factor: personal trust”“the childcare time factor: hospitality” and “the childcare time factor: safety.”
4. In the service about a delivery, significant correlation was accepted in “the degree of satisfaction”, and “introduction to the others” and a “reuse intention.”

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The aim of this research was to identify major sources of stress and coping mechanisms of nurses caring for patients undergoing treatment for infertility. All 963 nurses (registered nurses, public health nurses, and nurse-midwives) working in centers providing treatment for infertility in Japan received questionnaires; 409 of the 963 identified and describes sources of stress; of these, 365 described their coping mechanisms.
Sources of stress were classified into five categories and 19 sub-categories. The most frequently identified stressor was the system for providing infertility treatment. Other frequently mentioned stressors were problems in the immaturity of the field, and ethical problems.
Six coping strategies with 28 sub-categories were identified. Fifty-one nurses said that they simply denied their stress or were unable to cope with it. From the responses it seems that nurses appear to cope best with natural treatments for infertility. Many indicated that their coping was supported by being able to engage in nursing activities and behavior.

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Management of maternity homes is built on three factors: persons, goods, and finance. This paper discusses the main characteristics of management of maternity homes from financial point of view, and aims at obtaining basic data for exploring a specific direction for a better management.
The object for investigation consists of six sample cases which were randomly selected from annual delivery cases at maternity homes. This investigation, while utilizing the breakeven point analysis as a mode of approach, drew on hearings on fourteen items relating to the financial management of maternity homes and on the past financial data. The investigation was conducted during October-December, 2000.
1. Breakdown of Expenditure
It now turned out that fixed costs far exceeded movable ones. Of the fixed costs, the personal costs occupied the highest rate. This was in order followed by lease, rental, and depreciation expenses.
2. Breakdown of Income
It was also made clear even if, in the case of 50 delivery cases per year, the income was under 5 million yen, it would be possible to keep the nursery in the black.
3. Relationships among Necessary Sales, the Number of Delivery Cases and the Operation Rate of Using Bet
It was suggested that supposing there were 50-60 delivery cases per year with three beds available in a nursery, the operation rate of beds would need to be over 30%-35%. If there were approximately 90 delivery cases per year with four beds available, its operation rate would need to be 37%. If five beds were available with the same number of delivery cases, its operation rate would require 30%.
The research stated above has revealed that a serious financial problem produces impeding factors for sound management, because the sales of maternity homes at present do not increase satisfactorily and running a maternity home assumes a family-like-business character due to the management scale. Maternity homes should be managed after business plans are made and certain profits are estimated from the same viewpoint as other ordinary busineses.

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90% of pregnant women in Japan prefer to breastfeed their babies and midwives give them guidance on how to start and keep the cycle of their breastfeeding. However, only insufficient investigation has been done into the last stage of the cycle, especially mothers' feelings when they are going to stop breastfeeding.
This study is based on the observation of midwives' care and guidance for 8 mothers in a municipal hospital in Tokyo who tried to stop breastfeeding. This observation was done 22 times and the mothers' complaints were analyzed into 356 topics according to their contents.
These were roughly classified into 3 categories: 1) the mothers felt perplexed with stopping breastfeeding, 2) they came to terms with such completion of breastfeeding and 3) they again became more and more aware of being a woman.
The feelings of the women who tries to put an end to breastfeeding changes as time passes. Such changes are processes in which mothers accommodate themselves to such termination. This is an important period for both mothers and children in which they have to create a new and appropriate relationship with each other.
Therefore the study suggests that mothers accept the last stages of breastfeeding, feeling various ambiguities. The process also establishes a new mother-child relationship.

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In this talk I will describe three paradigms of health care that heavily influence contemporary childbirth, most particularly in industrialized nations, but now increasingly all over the globe.‹SUP›1‹/SUP› I call these three paradigms the technocratic, humanistic, ‹I›and holistic models of medicine‹/I›. I will also speak about the importance of preserving midwifery around the world and most especially in Japan.

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