Nurse Ayumi Tsukasa

Becoming a midwife:

Could you tell us what inspired you to pursue a career as a midwife?

I wanted to obtain a qualification and work in a field that involves children, so becoming a midwife was my goal from the start. For that reason, I enrolled in a school that offered a midwifery program, with the prerequisite of having a nursing qualification.

Do you need a nursing qualification to become a midwife?

Yes, you need a nursing qualification to become a midwife. After obtaining my nursing qualification, I studied midwifery. During my practical training, I had to assist with 10 births over the course of one year. I remember feeling completely nervous the first time I delivered a baby… Honestly, I don't remember much about it, like whether it was a boy or a girl. In the beginning, it was a constant state of nervousness.

Current job and motivation:

Are you currently working as a nurse rather than a midwife?

Yes. Although I no longer directly assist with births, I find great fulfillment in supporting patients who are trying to conceive. While I feel a bit sad not being able to witness the moment a baby is born, I truly believe that helping ease the anxieties of patients who wish to have a child is an incredibly important job. I experience immense joy when I receive reports like "I’m pregnant" or "The baby was born." These moments are a major source of motivation for me

What exactly does your job entail?

I primarily work in the call center, handling patient inquiries and consultations over the phone. Since treatment can be mentally and physically demanding, I focus on supporting patients to ensure they feel comfortable and secure throughout their treatment. Additionally, I provide free counseling to those who are not currently patients, making sure to explain infertility treatments in an easy-to-understand manner.

Providing care with empathy for patients:

What kind of inquiries do patients commonly make?

During free counseling sessions, which are mainly for individuals who are not currently visiting the clinic or who have never undergone fertility treatment, common questions include inquiries about treatment methods and whether pregnancy might be challenging due to age. For patients currently receiving treatment, questions often pertain to how to take medications, how to administer injections, or what to do if they forget to take a dose. Additionally, some patients call when they have doubts or are dissatisfied with their treatment. In such cases, I carefully review their medical records while discussing their concerns. Sometimes, patients understand the explanations given during their consultations with the doctor but become unsure or have questions after returning home. They may also feel uncertain or develop doubts later, prompting them to reach out by phone. For issues that can be explained immediately, I provide answers on the spot. For matters requiring confirmation with the doctor, I follow up and call the patient back after verifying the details. Acting as a bridge between patients and doctors, I strive to ensure that patients fully understand and feel confident about their treatment through clear explanations and thoughtful interactions.

Struggles with taking a break from treatment and offering support:

Emotional care is crucial in fertility treatment. What are your thoughts on this?

Yes, it is. When treatment doesn’t progress well or fails to yield positive results, some patients become overwhelmed and express feelings like “I want to quit” or “I want to take a break.” However, we can’t fully understand whether they truly want to stop or take a break, or if they actually wish to continue, without carefully listening to them. Ultimately, it is the patient’s decision whether to pause or continue treatment, but I feel that supporting them through this process is my role.
I believe that even a temporary break from treatment can be a valuable period for achieving the goal of having a baby, so I make sure to communicate the benefits of taking a break. Refreshing oneself and then resuming treatment is also important.
For instance, when I say, “It’s okay to take a short break,” some patients feel relieved and decide to take a break, returning with a refreshed mindset to continue their treatment. Others may think, “If that’s the case, I’ll try a little harder,” and choose to continue without a break. I try to respond by understanding whether the patient is looking for encouragement to take a break or motivation to keep going.

What do you focus on when listening to patients?

No matter the inquiry, I prioritize listening carefully to the patient’s concerns. Sometimes, patients struggle to find the words to express themselves or feel unsure of how to explain their thoughts. In such cases, I avoid rushing them and gently say, “Take your time; it’s okay.” Additionally, while patients are speaking, I make sure to acknowledge their words with small responses to show I am actively listening. Continuous silence can make patients wonder, “Did the call get disconnected?” so I take care to reassure them by letting them know I’m attentively listening throughout the conversation.

Conveying Harsh Realities:

When patients express a desire to take a break from treatment, do you sometimes have to deliver difficult news?

Yes, that’s correct. For example, I may need to explain situations like being unable to retrieve eggs during a cycle or the risks associated with taking a break from treatment. This includes discussing the possibility of missing cycles where egg retrieval could have been possible during the rest period. However, I can’t say “You should take a break” or “You should continue” myself. Regardless of the choice the patient makes, I strive to clearly explain the realities and provide support based on their decision. Even when it’s necessary to communicate a difficult situation, I think it’s essential to maintain an environment where patients feel comfortable reaching out. I always make sure to say, “Please don’t hesitate to contact me anytime,” to foster a sense of approachability and reassurance.

As a Support for Patients’ Choices:

It’s clear that you deeply empathize with patients’ doubts and anxieties in your approach.

Thank you. Both taking a break from treatment and continuing with it have their own risks and benefits. For example, as I mentioned earlier, during a break, a favorable cycle for egg development may come. This is particularly concerning for older patients. However, taking a break can also allow patients to forget about treatment for a while and refresh their minds, which may reignite their desire to have a baby. Our role is to support patients in a way that ensures they won’t regret whichever choice they make. I hope to continue standing by patients so they can approach their treatment with confidence and peace of mind.

Work Stress, Coping Methods, and Health Tips:

While supporting patients, I’m sure you experience stress yourself. How do you relieve it?

My way to relieve stress is “sleeping.” Sometimes I tell my husband, “I can’t do anything today,” and skip making dinner to just go to bed. Sleeping helps me reset my mind, and I feel ready to take on challenges again.

With your busy work schedule, what do you do to maintain your health?

Eating well and sleeping well are key. I especially love eating meat. It helps me stay energized. In Osaka, beef is often used in curry, but I prefer minced meat keema curry.

The Fulfillment of Supporting Patients Daily:

What challenges and fulfillment do you experience working in the field of fertility treatment?

Fertility treatment is complex and doesn’t always go as planned. I constantly feel the weight of the responsibility to empathize with each patient’s hopes, but that also gives me a sense of fulfillment. We strive daily to alleviate patients’ anxieties and help them feel at ease during treatment. Hearing their voices turn brighter by the end of a call and being told, “I’m glad I consulted with you,” is the greatest joy. Receiving pregnancy announcements or letters about successful childbirth is incredibly rewarding.

I’ve heard consultations about egg freezing are also increasing.

Yes. For women, it becomes increasingly challenging to conceive after around age 35. We carefully explain the benefits and drawbacks of egg freezing to help patients prepare for future pregnancies and make informed decisions.

A Message to Patients and Those Considering Fertility Treatment:

Finally, do you have a message for patients or those considering fertility treatment?

Fertility treatment can bring many questions and uncertainties, so please don’t hesitate to consult with us. We are fully committed to helping you receive treatment that you can be confident in and pursue it without regret. It’s also essential to maintain both physical and mental health while striving for pregnancy. Reassessing the basics, such as your diet, exercise, and sleep, is more important than you might think. Eat well, sleep well, and find healthy ways to relieve stress—for me, it’s sleeping! It’s not about doing anything extraordinary but ensuring your daily life is in good order. I wholeheartedly support everyone on their journey toward welcoming a baby into their lives.