We conducted a questionnaire survey targeting the Tokyo remote islands area（11 islands）. Only two large remote islands, Izu-Oshima and Hachijo-jima, have obstetricians permanently stationed and are capable of birth control. Prenatal checkups on small and medium-sized remote islands where obstetricians are not stationed are mainly performed by clinic doctors （general physician）.Also, pregnant women who give birth outside the island are forced to leave the island early （28 to 36 weeks gestation）, and there are various support systems related to childbirth. Of the two islands that have been delivered on the island, the number of deliveries on the Izu-Oshima has been decreasing year by year, whereas the deliveries on the island, including homecoming deliveries, has increased on the Hachijo-jima. 　Maternal transport cases from the island area were 60 cases in recent 10 years, and 70% of which were from Izu-Oshima. Tokyo Metropolitan Ohtsuka Hospital was the most common institution with 14 cases, accounting for 20% of the total and 40% of early pregnancy and preterm births. Eight out of the 14 maternal transport cases to the Tokyo Metropolitan Ohtsuka Hospital were delivered as they were, 3 were delivered prematurely（ ＜28 weeks） and 3 were delivered prematurely（ ＜37 weeks）. 　It should be noted that the number of newborn babies transported from the island area to the Tokyo Metropolitan Ohtsuka hospital was as small as 9 cases in past 31 years, but 3 serious cases（Fatal or cerebral palsy cases） were also included. It is important for medical staff in the field to acquire appropriate skills for neonatal resuscitation and to prepare emergency drugs. 　The perinatal medical care system in the island area is an issue of concern whether it should shift to the delivery outside the island with an emphasis on safety and risk, or whether it should maintain the delivery in the island based on it.

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