The shortage of practicing obstetricians and the closing of maternity wards in Japan has led some rural cities to adopt a system that examines pregnant women remotely using real-time data transmitted to a physician's cell phone, the New York Times reports (Onishi, New York Times, 4/8). According to Japan's Ministry of Health, Labor and Welfare, the number of practicing obstetricians dropped by 40% from 1992 to 2004. Some physician groups attribute the decline in part to local and national governments' failure to address the leading causes of the shortage. Japan's medical system also does not allow obstetricians, who often work longer hours than other physicians, to receive additional compensation for their extra work (Kaiser Daily Women's Health Policy Report, 5/1/06). According to the Times, about half of the obstetricians in the country are age 50 or older, and the number of medical students choosing an obstetrics specialty has "plummeted" since 2004. Four cities last fall adopted a remote examination system, according to Eisai Kikuchi -- an official from Tono, Japan, one of the cities that is using the system. If a physician judges that a pregnant woman is about to go into labor using the system, the pregnant women is instructed to go to the nearest city with a maternity ward, the Times reports. Fourteen women in Tono have given birth using the system, and five pregnant women currently are using it. After a three-year evaluation of the system, it is expected to be expanded to other areas of Japan (New York Times, 4/8).

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