The rising caesarean section rate is an important public health concern that in turn increases maternal and perinatal risks of adverse effects, unnecessary medical consumption, and inequities in worldwide access. The aim of this study was to investigate caesarean section indications by maternal age group and examine the association between age and caesarean section in primiparous Japanese women with singleton births. We analyzed the Japanese data of primiparous women with singleton births from the WHO Global Survey on Maternal and Perinatal Health to compare maternal and neonatal characteristics and outcomes between groups with and without caesarean section. Women were divided into 3 maternal age groups (≤29, 30 to 34 and ≥35 years). We performed multivariable logistic-regression analysis to identify characteristics associated with caesarean section. Of the 3245 women with singleton births were included in the Japanese data, 610 women (18.8 %) delivered by caesarean section, half of whom (n = 305) were nulliparous. We included singleton nulliparous women (1747 deliveries) in our analysis. The maternal age 35 years old was associated with higher risks for all caesarean section (adjusted odds ratio [AOR] 1.89, 95 % CI 1.28–2.78) and emergency antepartum caesarean section (AOR 2.26, 95 % CI 1.49–3.40). Intrapartum caesarean section, which is mainly performed for obstetric indications, was not higher among the older maternal age group. In Japan, advanced maternal age significantly increased the risk for caesarean section; however, intrapartum caesarean section was not higher risk among the older age group. Management of maternal complications would help to reduce the rate of caesarean sections and associated unnecessary medical consumption.

With the outbreak of COVID‐19, maintaining the healthcare system is a crucial issue. In Japan, the number of COVID‐19 cases is increasing rapidly day by day with a risk of overshooting initial estimations (WHO, 2020a). Public health nurses (PHNs) working in public health centers in prefectures and designated centers in cities or core cities, play a critical role in controlling COVID‐19 (Yoshioka‐Maeda, Honda, Iwasaki‐Motegi, 2020). Providing care for COVID‐19 patients, their families, and the community, the workload of PHNs has been reaching the maximum limit.

Objective: To identify characteristics of mothers who face difficulties with childrearing.Design and Sample: Cross‐sectional study. During 2014, 221 mothers and 248 children living in City A within the Tokyo metropolis were registered as requiring help with childrearing. Nursing records of 205 mothers (92.8%) and their 227 children (91.5%) were available. We excluded 29 mothers and children owing to incomplete data for a final sample of 176 mothers (79.6%) and 198 children (79.8%).Measures: Difficulties with childrearing were assessed by self‐reported questionnaires at the newborn child's 4‐month health checkups. Data on maternal and child variables were collected from nursing records.Results: The “Difficulties group” included 59 mothers (35.4%) and their 70 children. Logistic regression analysis showed that mothers who were aged 40 years or older, who had a total score on the Edinburgh Postnatal Depression Scale of 9 or greater, who used more child‐care support services, and who were monitored more frequently by public health nurses had a high risk of facing difficulties with childrearing.Conclusions: Periodic monitoring by PHNs is a key strategy to improve the impact of the difficulties of childrearing for mothers of yoshien jido and their children.