Being pregnant is a life-changing event. Being pregnant abroad is certainly nerve-racking, especially when you have to deal with linguistic and cultural barriers. Here’s a simple guide to help you navigate the very basics of being pregnant in Japan.
Confirming Your Pregnancy
As in the US, at-home pregnancy tests (妊娠検査薬 | ninshin kensa yaku) are sold in Japanese drugstores.
There are two types, the First Response-type tests used the day of an expected period and tests that can be used a week after a missed period.
The tests that can be used a week after a missed period provide discretion as you simply take the box off the shelf, go to the register, pay, and leave.
On the other hand, First Response-type tests (早期妊娠検査薬 | shouki ninshin kensa yaku) while also found on the shelves, are merely a display of an empty box.
You must take the empty box to the pharmacy, fill out your name and address(!) to receive the pregnancy test.
Blood tests (血液検査 | ketsueki kensa) and urine tests (尿検査 | nyou kensa) to confirm a pregnancy can be done at a hospital or clinic.
Pregnant For 10 Months
Pregnancy in Japan is a 10 month affair. As in the West, it’s a 40 week long event.
Yet here, those 40 weeks become 10 months of 4 weeks each. Those ten months are further divided into three trimesters:
First trimester: 0 to 15 weeks (初期 | shoki)
Second trimester:16 to 27 weeks (中期 | chuuki)
Third trimester: 28 to 40 weeks (後期 | kouki).
Anteiki (安定期) is a special word for the second trimester. It has no direct English equivalent but signifies the period in which the risk of miscarriage is less.
In the US, this period is after 12 weeks, but in Japan, it is at 16 weeks. Thus, pregnancy announcements in Japan are often made at the 16th week/5th month mark, which also coincides with Inu no Hi (戌の日).
Maternal and Child Health Handbook
After confirming, to go to city hall to register your pregnancy. Only then will you receive your 母子健康手帳 boshi kenkou techou (boshi techou for short, Maternal and Child Health Handbook) to be used throughout your entire pregnancy to record your vitals.
The boshi techou is also used to record your vitals/tests results throughout your hospital stay and 1 month postpartum checkup.
You use the handbook for your child’s checkups and vaccines, starting with right after birth with birth weight and length, up until your child is 6 years old.
Japanese mothers often purchase special boshi techou holders to hold their handbook, hospital cards, insurance cards, cash, and other relevant items.
Maternity badges are given out to help pregnant women find seats on public transportation. They go on handbags etc. with the idea that persons sitting will notice the pregnant woman and kindly offer her a seat.
The badges also serve as a means of communication for women who are too nervous or shy to speak up and request a seat. My advice is, if you really want to sit down, don’t be afraid to ask!
景品 記念品 ノベルティ マタニティマーク Maternity Mark 反射板
Maternity badges are available for free at public health centers and some train stations. Pregnancy magazines often have specially designed maternity badges attached as a bonus gift with purchase.
After registering your birth at your local municipal office, you will receive a set of vouchers for every checkup until you give birth. Vouchers will help subsidize the cost of tests while vouchers for three ultrasounds free of charge are provided. Even with the vouchers you can expect to pay between 500 yen to 10,000 yen depending on the tests.
From 4 to 10 weeks, checkups are 2-3 weeks; From 12-23 weeks, checkups are every 4 weeks, then from 24 to 35 weeks, checkups are every 2 weeks, From the 36th week of pregnancy, checkups are weekly, and once you past the 40 week mark, check ups are twice weekly.
At every appointment, they’ll take your blood pressure and weight, and a urine sample. The doctor will check your ankles for swelling, measure your growing bump and check the baby’s heartbeat as well.
The following is my hospital schedule to use for guidance. Please consult with your healthcare provider in regards to your pregnancy and needs.
Month 2 (4-7 weeks)
- Confirmation of pregnancy
- Transvaginal ultrasound
Month 3 (8-11 weeks)
- Transvaginal ultrasound
- Blood test
- Cervical cancer screening
Month 4 (12-15 weeks)
- Ultrasound if necessary
Month 5 (16-19 weeks)
- Quad screen test (voluntary, done at 15 weeks)
Month 6 (20-23 weeks)
- 4D ultrasound
Month 7 (24-27 weeks)
- Glucose challenge test
Month 8 (28-31 weeks)
- 4D ultrasound
- Blood test for anemia
- ATLA screening
Month 9 (32-35 weeks)
- Gestational diabetes, chlamydia screening
- Medication and retest for those who tested positive for chlamydia
Month 10 (36-40 weeks)
- Ultrasound and fetal measurements
- Blood test for anemia
- HPL screening
- Non-stress test
There is an adage in Japan, 小さく生んで大きく育つ “Chiisaku unde, ookiku sodatsu,” which means to give birth to a small baby so that they will grow to adulthood. Perhaps this is why Japanese women don’t gain much weight. (Or because doctors can be a bit strict here!)
You can forget about “eating for two” in Japan, but at least you won’t have to give up sushi! Prenatal vitamins (プレナタルビタミン | purenataru bitamin) and folic acid (葉酸 | yousan) aren’t really suggested as doctors will encourage you to get nutrients through your diet.
However, if you have anemia (貧血 | hinketsu) like me, you’ll likely be prescribed iron suppliments (鉄剤 | tetsuzai).
Pregnancy weight gain in Japan is based on BMI. For reference, please look at the following guidelines, which are from a handbook provided by my hospital. Please check with your healthcare provider on their weight gain guidelines.
Underweight/BMI 18.5 and under: Suggested weight gain- 10-12kg
Average/BMI 18.5-25: Suggested weight gain- 7-10kg
Overweight/BMI 25 and over: Suggested weight gain – 0-5kg
After confirming your pregnancy, look for a hospital or clinic where you want to give birth and reserve a spot as quickly as possible. Some places may charge a depost which can be used towards the final balance of your hospital stay.
There are many factors to consider when choosing a hospital. For example, distance and ease of attending appointments is a major factor, a doctor who can speak English/your native language, as well as your level of comfort around staff.
In my case, I was already a patient at the OB/GYN where I gave birth, but I briefly considered changing hospitals.
What prompted me to stay was familiarity with the staff and facilities. Also, I planned to work up until maternity leave, so I needed a hospital within commuting distance from my home and kindergarten, as well as open on Saturdays.
Think about your birth plan (バースプラン |ba–su puran) but be aware that hospitals and clinics may be unable to accommodate yoir desired. Other questions to consider are:
Will my partner and/or children be able to attend the birth? (立ち会い出産 | tachi ai shussan)
Does the hospital give epidurals? (無痛分娩 | mutsuu bunmen)
Does the hospital provide private rooms? (個室 | koshitsu)
Will my partner and/or children be able to stay with me? (お泊り | otomari)
As it will be your birth, think about the facilities and services that best match your needs.
Don’t let any doctors or nurses push you around. Be the best advocate that you can be for you and your child.
These are the English and Japanese books that I used throughout my pregnancy:
What To Expect When You’re Expecting
Ina May’s Guide to Childbirth
Good luck on your journey, and if you have any questions or concerns, or just need someone to talk to, feel free to contact me! I’m also on Twitter and Instagram.
Pregnant In Japan: The Basics