Military planners have spent years working on proposals for expanded runways and housing at Marine Corps Air Station Iwakuni, where the relocation of units from other parts of Japan is expected to nearly double the base population by 2014.

Now, Navy health officials are taking on a different strategic task: Where will all the babies be born?

Currently, pregnant women at Iwakuni have two choices. They ride a train four hours north to Yokosuka Naval Base to stay in the Stork’s Nest, a common system of facilities near military hospitals where women can stay as their due dates near.

Or, the Marines, workers and family members at Iwakuni go off base to see Dr. Takashi Shoji, who has been delivering American babies since he started working at Iwakuni Byoin hospital in 1971.

Both options are still good for now. But Shoji, who is in his 70s, will likely retire in the next few years. And as the base population increases, there will come a need for a more permanent solution for certain health care options — including obstetrics — at Iwakuni, according to Capt. Kevin D. Moore, the commander of the Navy’s health care facilities in Japan, South Korea and Diego Garcia.

"We’re looking at what the population will support," Moore said last week during an interview in his office at U.S. Naval Hospital Yokosuka.

By 2014, a Navy carrier air wing from Naval Air Facility Atsugi and a refueling squadron from Marine Corps Air Station Futenma on Okinawa are scheduled to move to Iwakuni. To support those changes, Moore is looking at opening a family health center at Iwakuni that would focus on certain needs, such as obstetrics, pediatrics and orthopedics. The idea is in the early stages, and no proposed budget or timeline has been discussed, he said.

Last week, Moore held a town hall meeting at Iwakuni to discuss the current and future needs of the base, which is expected to grow from 5,400 personnel to an estimated 10,400 in five years. He said the group raised three main issues — births, mental health care and orthopedics.

Iwakuni has an outpatient clinic for medical checkups, but it doesn’t handle procedures or illnesses that involve overnight stays. Its staff has family practice physicians, who among other things provide prenatal care. Visiting specialists bolster that care, Moore said.

Still, the clinic has a months-long vacancy for a full-time civilian psychologist. The physical therapy technician and uniformed psychologist staffed at Iwakuni work primarily with school-age children to meet school guidelines, Moore said.

That leaves many at Iwakuni relying on referrals and visits to Yokosuka, said Moore, who took command last summer. He’s begun medical town hall meetings to get feedback from patients about the referral process. The next one is scheduled for Jan. 29 at Yokosuka.

For now, Moore said, the plan is to further improve the referral system — mainly ensuring that appointments don’t get canceled at the last minute.

And, Moore said, he’s going to continue to encourage Japanese health officials to consider more formal operating agreements for U.S. military patients. Similar arrangements exist in South Korea, where the agreements make it easier to receive patient care and get insurance coverage at off-base hospitals.

Japanese hospitals have been reluctant to sign on, preferring to adhere to their own medical standards rather than international ones, Moore said. Still, the Japanese often help the military communities, especially during emergencies, he said.

"They have been stellar in supporting us," he said.

Stars and Stripes reporter Hana Kusumoto contributed to this story.

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