Being pregnant is a life-changing event. And being pregnant in Japan? You’ll discover that you knew absolutely nothing about Japan and Japanese culture by the time your tenth month is up! (Just kidding…kind of.) Take comfort the fact that you can eat all the sushi that you want, because everything else is dame.
Wanna wear cute flat sandals when it’s 32C out? Dame.
Wanna go to driving school? Dame. (Seriously. I think it’s an insurance issue mixed in with a heaping of “women are more emotional when pregnant.” Here’s more about my experience going to driving school in Japan.)
Welcome to being pregnant in Japan.
Since this post was first published, it’s become of the most popular posts here on The Wagamama Diaries. I’ve since updated it to add useful items, clothing, and books that I used throughout my pregnancy.
Confirming Your Pregnancy in Japan
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. If there is no pharmacist on duty at the moment, you will not be able to make your purchase at the time. This is because these type of pregnancy tests are classified as “pharmacy drugs” (薬局医薬品) in Japan.
HOWEVER, you can order them online. Most Japanese women avoid them (or are advised to avoid them) as the directions are not in Japanese and they are not manufactured in Japan therefore BAD.
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) A Shrine Visit for Pregnant Women
Maternal and Child Health Handbook
After confirming your pregnancy, it’s time 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.
They are available in English (other languages may vary by city), but as each book/child is assigned a number, you can’t have a Japanese one and English one.
The boshi techou is also used to record your vitals/tests results throughout your hospital stay and 1 month postpartum checkup.
Clinics and hopsitals in Japan record the results of your child’s physicals and dental checkups in the Maternal and Child Health Handbook.
The stickers on vaccine vials are affixed to the appropriate page so you’ll instantly know that vaccines your child has already taken.
Your child’s very first health entry will be the birth weight and length, and this book will be used up until your child is 6 years old. It’s a really fantastic journal of your child’s development which also has pages that parents can fill out.
I was a bit nervous having all of my child’s vital information in one place (what if I lose it?) but now I appreciate the convenience. I even carry my daughter’s boshi techo when we travel abroad as it contains all of her health information.
Japanese mothers often purchase special boshi techou holders to hold their handbook, hospital cards, insurance cards, cash, and other relevant items.
Pregnant in Japan — Maternity Badges
You’ll get one maternity badge when you register your pregnancy at city hall. I liked having extras so I didn’t have to worry about switching my badge when changing handbags.
They’re 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!
I don’t know if it’s people pretending not to see a pregnant lady or that they’re really just that oblivious to their surroundings. But please don’t make yourself suffer! For tips on getting around town see this post: Navigating Tokyo While Pregnant Or With A Baby.
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. You can also get them when checking in at airlines, and of course on Amazon Japan.
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.
Pregnant in Japan — Checkup Schedule
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
Pregnant in Japan — Weight Gain
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!
My advice is: don’t let the doctors bully you or make you feel bad for the “excess” weight you again. I worked while pregnant, up until going on maternity leave in December. My appointments were always in the afternoon, after work. I’d be there, 2 meals full, dressed in winter clothes, without a single care. I knew what the scale said in the morning, anyway!
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). I have a list of 10 Japanese Drinks Rich in Iron if you need the extra boost!
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. Seems excessive, but popular places “book out.” I’ve heard of women booking their stay as soon as they received their boshi techo!
Keep in mind that some places may charge a deposit at the time of reservation, 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. You may prefer a doctor who can speak English/your native language, as well as your level of comfort around staff. Your reasons for choosing your birth clinic/hospital are the only ones that matter.
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 your desires.
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.
Pregnant in Japan – Useful Items
Here’s a very basic list of items that I found useful during my pregnancy and after giving birth:
Folic Acid/Iron Supplements
I’m anemic, but the nutritionist at my OB/GYN swore up and down that I could meet the necessary daily intake of iron with a balanced diet. (She also told me to stay away from fruit because of all the sugar content, but anyway… #pregnantinjapan ね!) Well, I ended up needing to take iron tablets and even then, it wasn’t enough. I took 2 of these Pigeon iron-calcium-folic acid tabletsdaily, and I also kept these citrus lozenges in my desk at school.
These compression socks are designed with the needs of pregnant women in mind. Wear at home or in the office to soothe your legs of tension, restlessness and to prevent/relieve swelling. Available on Amazon Japan.
Kyusoku Jikan Leg Sheets
I add these herbal scented leg sheets on nearly every beauty/self-care list that I write because they work! I’ve used them since I was pregnant and still use them after a long day or when traveling by air. I apply them on my calves and on the soles of my feet. They have a cooling sensation and a wonderful lavender-ish scent that is so relaxing. Available on Amazon Japan.
I wasn’t sure if I would breastfeed or not, but purchased several of these tops just in case (and also because regular bras just weren’t cutting it any more!). I found these useful in the summer because I could layer them with jeans or a midi skirt and cardigan and be out the door. Available on Amazon Japan.
I didn’t pay heed to the “keep your belly covered!” superstition, but as my bump grew in the winter months, so I really appreciated these high-waisted panties. I continued to wear them even after giving birth, too! Available on Amazon Japan.
I liked these maternity bras because they are simple and provide support without irritating sensitive breasts. I tended to wear nursing bras instead of nursing camisoles when sleeping. Available on Amazon Japan.
Maternity Girdle Set
As I discovered, maternity girdles are less about looking slim and all about helping you maintain correct posture and realign your body’s center of gravity. The girdle can be used by itself in the first trimester and combined with the girdle belt in the thrid trimester to support the growing weight of your bump. Available on Amazon Japan.
My sister-in-law had some of her maternity clothes in storage and she gave me a pair of these stretchy maternity jeans! I worked up until going on maternity leave, and these held up well in the classroom and on field trips (like potato digging!) Available on Amazon Japan. Winter version (with a warm, fuzzy lining) available here.
These look like regular high-waisted maternity panties at first glance. But, these have a Velcro crotch so you’ll be able to change your maternity pads and go to the toilet with ease. Definitely worth having a few pairs of these in the weeks after delivery! Available on Amazon Japan.
Postpartum Sanitary Napkins
I got several packages of these Dacco postpartum sanitary napkins from my hospital. They measure 41cm long, are very absorbent and have large wings to keep them in place Normal sanitary napkins are not enough for the postpartum discharge, not even the extra flow ones, so do yourself a favor and stock up accordingly! Available on Amazon Japan.
Along with the Dacco postpartum sanitary napkins, I also got a package of Dacco nursing pads, but I eventually switched to these fluffy, “silky touch ones” by Pigeon. After 6 months of childcare leave, I went back to work and continued breastfeeding. I tried cloth pads, but I preferred to have these in my bag and in my desk to replace when I had any leaks in public. I continued breastfeeding/comfort nursing until last summer and still used these! Available on Amazon Japan.
These look super intimidating, and I clearly remember the midwife strapping me into one after delivery. This belt has several roles: to ease the uterus, organs and muscles back into place; to relieve back pain; to ease postpartum discomfort. Available on Amazon Japan.
Pregnant in Japan Resources
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! Please check out the following related posts on being pregnant in Japan, giving birth in Japan and taking maternity leave.
And, take a peek at some of the Japanese celebrations that await your little one:
Pregnant In Japan? Here’s What You Should Know