Health September 2014

Having a baby in Japan

  • One of the lowest maternal and infant mortality rates worldwide
  • Caesarean section rates low and access to epidurals limited
  • Hospital stay common and midwives on hand to help

When living overseas, the initial excitement upon discovering that you are pregnant can quickly be replaced by the uncertainty and apprehension of giving birth in a foreign country.

But, be assured; Japan has one of the lowest maternal and infant mortality rates in the world, and most non-Japanese are happy with the care they receive during their pregnancy and delivery.

In Tokyo, there are many English-speaking obstetricians, although in small towns and cities, access to one may be an issue. In some ways, childbirth here is quite “medicalised” compared with that in many European countries.

For example, at every antenatal appointment in Japan, you will be seen by an obstetrician and an ultrasound will be carried out. By comparison, in the UK the majority of appointments are with only a midwife, and an ultrasound is done a maximum of two or three times throughout a pregnancy.

Many women in Japan report actually quite liking the opportunity to see the growth of their baby on each occasion.

Early in your pregnancy, you will receive the Maternal and Child Health Handbook (Boshi Kenko Techo), some versions of which contain an English translation and so are easy for non-Japanese speakers to use.

The aim of this book is to have a record of the pregnancy, delivery and subsequent child development and immunisations all in one place. It was first developed in Japan in 1947, and has since been adopted by several countries.

In the UK, all mothers receive the Personal Child Health Record—which usually has a red cover and is often called “the red book”—although it has nowhere to record information about the mother’s pregnancy and delivery.

In Japan, most women deliver their baby in hospital. Home births and water births are uncommon, and the requisite facilities limited. There are some childbirth centres run by midwives, but these also are not common, and only a small number of them have staff with English-language ability.

In Japan, natural deliveries are always encouraged. The caesarean section rate is low compared with many European countries and the US.

This brings us to commonly asked questions regarding pain relief during labour. Many women are extremely anxious about the pain they will need to endure, and how quickly someone will respond to their requests for medication.

Epidurals are definitely not as widely available as in the UK. Even in hospitals that do offer epidurals, they may only be available from 9am to 5pm, which isn’t going to be much help to you if you go into labour at midnight.

This issue is certainly something to consider when deciding on a hospital, or on an obstetrician with whom you will feel comfortable.

After delivery, a hospital stay of four or five nights is common, even after a completely normal delivery. Midwives are always on hand to help with breastfeeding, any concerns you may have about your post-partum body, and care for your new baby.

The first few weeks following discharge from hospital—especially with your first baby—are often the hardest, and a time when one can feel very isolated in Tokyo.

In the UK, a community midwife and a breastfeeding advisor visit on a regular basis over the first few weeks to ensure that both mother and baby are doing well. However, these services are rarely available in Tokyo.

Small problems and anxieties can quickly escalate when you combine post-partum hormones with extreme sleep deprivation. Therefore it is important to accept as much help as possible.

If your partner is unable to have a significant period of leave from work, it is even more crucial to accept friends’ offers of help, no matter how small. Just having someone to watch the baby for 30 minutes means that you can have a relaxing shower or brief nap.

Overall, most women’s experience of childbirth in Tokyo is very positive. The most important thing, regardless of where you give birth, is to keep a flexible outlook at all stages of the process.

Even if you have a very definite birth plan, situations in obstetrics can change very rapidly, so be prepared to completely abandon your plan at the last minute.