Pregnancy and Birth in Japan: The Ultimate Guide
In this guide, we will cover all the information that you need to know about giving birth in Japan, as well as key vocabulary and information about costs at English-speaking hospitals in Tokyo.
This guide is a work in progress and we will consistently update it so check back often for new information.
Related article: Guide to Health Insurance in Japan
Last update: May 18 2021
Giving birth in Japan
Giving birth in Japan should be a joyful experience. And with this guide, we want to share with you the necessary information that will make your birthing experience in Tokyo, or elsewhere in Japan more pleasant.
With National Health Insurance, a woman can receive assistance of 420,000JPY (Approx. US$ 4,200) for a delivery. Likewise, the same amount will be given if there is a certificate or proof of miscarriage and premature birth if the pregnancy period is beyond four months (85 days)
What are the major differences and considerations when giving birth in Japan at a Japanese hospital?
How is the coronavirus pandemic affecting the type of care? What are your options?
What happens when you give birth in Japan?
- Find out you’re pregnant with an at-home pregnancy test.
- Make an appointment to confirm the pregnancy with a gynecologist. You will need to be about 10 weeks, and in order to confirm the pregnancy, the doctor will have to confirm that your baby has a heartbeat.
- If your baby has a heartbeat – the doctor will formally confirm your pregnancy.
At this time they will offer to provide you with a hospital referral letter. The referral letter – 紹介状 (pronounced Shokai Jo) is used to register with the hospital of your choice. Without this – you will be unable to book a reservation for delivery at most hospitals.
The OBGYN may provide you with this on the spot, or they may ask you for a follow-up consultation.
Before you register at the hospital you will need to get the mother and child handbook and take it with you to the registration appointment – most people register their birth at city hall in order to obtain this.
- You will register your pregnancy with City Hall. At this point, you will receive the VERY important 母子健康手帳 or Maternal Mother and Child Handbook. This will be used to keep track of all of your child’s appointments up until the birth.
(If you’d like to buy one in preparation for your pregnancy to learn more or to have an extra copy, you can do so here: https://hanbai.mcfh.or.jp/material/detail/27)
They will also give you gift certificate vouchers that you can use to purchase necessary items for the birth, which can be used at different retailers.
These certificates can also be used to pay for taxis, or eating out. You will receive a list of the retailers and eateries that they can be used when you register.
Check your city hall website and there may be information about what type of vouchers will be provided – you may even receive a free gift or a choice of free gift such as a nursing pillow.
- After you have registered the birth with your city hall – you will then make a registration appointment with your hospital of choice and book your delivery stay. At this point you will make your requests for the type of birth – and they may ask you to submit a birth plan with preferences for the type of room you will have, shared vs private, and thins like painless delivery if it is available.
This is also the point where you can request to use the direct method payment system so make sure to ask for the direct payment system if you would like to use it.
Instead of having to pay all the costs in cash and ask for reimbursement from your city ward office, or city hall, you will be able to have the hospital take the 420,000 lump sum birth allowance directly.
This is very important for people that do not have the cash flow to put up 650,000 yen in collateral.
In Japanese it is called the 直接支払制度 or chokusetsu shiharai seido.
- Once you are registered with your hospital, depending on whether or not they have an open system – you will either need to find another OBGYN to attend regular appointments prior to the birth, or you will have to keep visiting your registered hospital for regular appointments. Typically – larger hospitals have a semi open system where you can visit your OBGYN Clinic of choice up until you go into labor and give birth.
The clinic that you visit will write all of your appointment data into your mother and child handbook so that your doctors at the delivery hospital can reference it.
In Japanese, this semi-open system of OBGYN is called either 産科オープン (sanka o-pin), or セミオープンシステム (semi o-pin shisutemu)
Aiku has this guidance on it: https://www.aiiku.net/cooperation/ and further reading here: https://www.aiiku.net/img/cooperation/index/opensystem.pdf
It’s generally the same for all hospitals that participate in this system. Your regular checkup visits prior to the birth will be handled at a participating nearby clinic – and if you’d like to request a doctor from the clinic to attend the delivery at the larger hospital you may be able to do so.
- You will feel contractions and start to go into labor. Generally, they will ask you to come to the hospital if your contractions are within 5 minutes apart.
(Except for cases where you have been determined to have an at-risk pregnancy. Then they may ask you to come in earlier.)
If you show up at the hospital prior to this window, they will likely ask you to return home and wait until contractions are more closely together.
If your partner cannot drive, you may not want to take public transportation.
In this case, we would recommend taking a baby taxi.
These specialist taxi services are a way to register your estimated delivery date and your address – this will give you priority in a queue for the hospital delivery and it will also alert the driver to your needs ahead of time.
Normally referred to as 陣痛タクシー (Jintsuu Takushii) or labor taxi, they can also sometimes be called by trade names
Here are several links to labor taxis that serve tokyo
We will include a more comprehensive list later in the article.
- You will be in labor. Your labor experience will vary widely depending on which hospital or clinic you register to give birth with. Depending on how long your labor is – it may require medical intervention. A common induction practice is to provide a dosage of oxytocin to help speed up contractions.
- You will stay 4-10 days at the hospital after giving birth depending on what type of labor you have. During this time the hospital staff will help consult with you to help to breastfeed, as well as to perform medical checks on your newborn such as a hearing exam.
The name of this is 耳検索 or ear exam.
- You will get discharged and go home.
As mentioned above – booking a labor taxi to take you to and from the hospital when giving birth is a nice way to prepare and make things smoother on the big day, here is a list of links to labor taxis in Tokyo that will help you.
https://www.seibuhire.co.jp/html/maternity.html <— has an easy to use the registration form, it’s in Japanese but you can use google translate.
Important Japanese Pregnancy Vocabulary
These are a sampling of vocabulary and phrases that are important to giving birth in Japan.
We have put together a comprehensive spreadsheet with even more terms.
Register your email to download it for free: – COMING SOON
|産婦人科||Sanfujinka||Obstetrics and Gynecology|
|自然分娩||Shizen Bunben||Natural Birth|
|無痛分娩||Mutsū bunben||Epidural Anesthesia (Painless Delivery)|
|紹介状||Shokai Jo||Hospital Referral Letter|
|母子健康手帳||Boshikenkō techō||Mother and Child Health Handbook|
|直接支払制度||Chokusetsu shiharai seido||Direct Payment System|
|訪問時間||Houmon jikan||Visiting hours|
|定期検診||Teiki Kenshin||Regular Checkup|
|血液型||Ketsueki Gata||Blood Type|
|陣痛||Jintsu||Labor Pains / Contractions|
Key Japanese Pregnancy Phrases
|赤ちゃんにあえますか。||Akachan ni aemasuka||‘May I see my baby?’|
|赤ちゃんを抱っこしてもいいですか。||Akachan o dakko shitemo iidesuka||‘May I hold my baby?’|
|母乳をあげたいです||Bonyuu o agetaidesu||‘I want to breast feed.’|
|授乳室はどこですか？||Jyunyushitsu wa doko desuka?||‘Where is the nursing room?’|
|よくわかりません。もう一度説明してください||Yoku wakarimasen. Mou ichido setsume shite kudasai.||I don’t understand. Could you please explain one more time.|
|パートナーも一緒でいいですか？||Pātonā mo isshode īdesu ka?||Can my partner come too?|
|英語のわかるスタッフはいますか?||Eigo no wakaru sutaffu wa imasu ka?||Is there a staff that understands English?|
Map of English Birth Hospitals in Tokyo
Here is a Map we have created of the hospitals that advertise English speaking birth support in central Tokyo
You’ve found out you’re pregnant, and you’re living in Japan.
You’re now probably wondering what comes next, and you might be feeling a mix of excitement, and worry.
If you do a quick google search – you will see that pregnancy in Japan isn’t covered by national health insurance.
Does this mean you will need to pay out of pocket for all of your medical visits?
Well, yes, technically pregnancy is not covered by health insurance, but you shouldn’t worry. Giving birth in Japan is relatively affordable.
There is a lump sum birth allowance that you will get for reimbursement – typically around 420,000 JPY
In addition to this – your local city hall will provide you with vouchers to subsidize the cost of your appointment visits. In effect, this subsidizes the same amount that regular insurance coverage would.
So in a sense – it is defacto covered, although not directly, and there are a limit on the amount of vouchers that are given to an expectant mother, whereas insurance coverage would not have this limitation.
You will also receive a lump sum of gift certificates that you can use towards purchasing necessary items for the baby. These gift certificates can be used at a variety of retailers and for a variety of different purposes. But they are generally accepted at major retailers related to babies – including Babies R Us.
Lump Sum Childbirth Allowance
Everyone who gives birth in a participating medical institution in Japan (99%) will be provided with a lump sum reimbursement of 420,000 Japanese yen.
The name of this in Japanese is 出産育児一時金 – Shussan ikuji ichi jikin.
This can either be applied for after paying out of pocket, and reimbursed in Japanese yen, or you can ask the hospital to take the lump sum directly, if you would like to use the direct payment system, you can ask for the 直接支払制度 or Choku setsu shiharai seido – which literally translates to direct payment system.
The majority of hospitals and clinics in Japan participate in this system, and most people elect to use this.
Deposit / Downpayment
Many hospitals require you to provide them with a deposit to secure your booking/reservation. This typically ranges anywhere from 150,000 – 200,000 yen.
You will get back whatever the difference is if any after the lump sum birth allowance is dispersed. So for example:
Your cash deposit: 200,000 JPY
Lump sum allowance paid directly to the hospital: 420,000 JPY
Total Balance: 620,000
Total Cost: 520,000 JPY
You will receive 100,000 JPY of your deposit back.
Your total cost (all charges include tax) for giving birth in Tokyo will depend largely on the hospital that you select for your hospitalization.
It will also vary depending on what sort of services you will need during and after the birth.
For example, getting an epidural or a C-Section delivery will be more expensive, because of both the service delivery and the extra time spent hospitalized.
In addition to this – you will need a 4-5 day stay in your hospital or clinic. And that will add another variable cost depending on the room and the meals / any incidentals including formula or added services.
Generally, most private hospitals and public hospitals will have a cost simulation available on the departmental section of their website.
As an example, here are several cost simulations from popular hospitals in Tokyo that offer English Speaking Support. The pages are in Japanese – but if you have google chrome you can right-click the page and google translate it.
Generally, most hospitals have more information on the Japanese version of their pages.
Another important point to keep in mind is that all of these costs are before the 420,000 JPY Lump-sum allowance, so take all of the totals and minus 420,000 JPY.
The average person will pay anywhere from 50,000 JPY – 200,000 JPY out of pocket depending on the hospitals and services.
Aikuu Cost Simulation:
An estimate for a 5-day stay would be around 650,000 Yen with a private room. This is one of the more popular clinics due to its convenience and service-oriented attitude.
In this case, you would need to deposit in cash and then pay the deposit difference after discharge.
You can see a full simulation by clicking through the link.
Japan Red Cross Hospital:
Around 710,000 Japanese Yen for a regular natural birth with a 5 day stay in a private room. http://www.med.jrc.or.jp/visit/tabid/325/Default.aspx#n4
Hiroo Hospital: Boshikenkō techōApproximately 450,000 JPY with a 6 day stay in a public room. For a private room, there is a surcharge of 16,000 Jpy / day.