Ultimate Guide to Pregnancy, Childbirth, and Baby Care in Japan for Foreigners

Navigating pregnancy and childbirth in a foreign country can feel overwhelming, especially when facing language barriers, unfamiliar medical systems, and complex paperwork procedures. If you're expecting a baby in Japan as a foreign resident, you're embarking on a journey through one of the world's most thorough and well-organized maternal healthcare systems—but understanding how it all works requires careful preparation.

This comprehensive guide walks you through every stage of having a baby in Japan, from confirming your pregnancy to raising your newborn through their first year. Whether you're concerned about finding English-speaking doctors, understanding the costs involved, securing your baby's visa, or simply wondering what the Maternal and Child Health Handbook is, we've compiled everything you need to know in one place. With proper knowledge and preparation, thousands of foreign parents have successfully navigated this system, and you can too.

Japanese Pregnancy Test

Confirming Your Pregnancy in Japan

Home Pregnancy Tests and First Steps

When you suspect you might be pregnant in Japan, your first step is typically the same as anywhere else: taking a home pregnancy test. These are readily available at any Japanese drugstore (like Matsumoto Kiyoshi or Welcia), convenience stores, or through Amazon Japan. Popular brands include Clearblue and Japanese brands like Check One, which function identically to tests in other countries.

Once you receive a positive result, don't wait too long to schedule a doctor's appointment. Japanese medical practice recommends visiting an OB-GYN (産婦人科 sanfujinka) relatively soon after your positive test, typically around 5-6 weeks from your last menstrual period. Unlike some countries where you might wait until 8-10 weeks for your first appointment, Japanese doctors prefer to see patients early to monitor the pregnancy from the beginning.

Visiting a Doctor for Confirmation

At your first OB-GYN visit, the doctor will confirm your pregnancy through a transvaginal ultrasound, typically performed around 6-8 weeks of gestation. The primary objective during this initial examination is to detect the fetal heartbeat and confirm the pregnancy is developing in the uterus (not ectopic). This early ultrasound practice is standard in Japan, and many expectant mothers find it exciting to see their baby so early, even though it may just appear as a tiny flicker on the screen.

It's important to understand that this first visit is usually paid out-of-pocket. The cost typically ranges from ¥5,000 to ¥10,000, depending on the clinic and what tests are performed. This is because Japanese national health insurance doesn't fully cover prenatal care—pregnancy is not classified as an illness or medical condition requiring treatment. However, the government provides substantial support through other means, which we'll discuss shortly.

Language considerations: If you don't speak Japanese fluently, consider bringing a Japanese-speaking friend or partner to this appointment. Some clinics in major cities have English-speaking staff, but this varies greatly by location. Having someone who can help communicate your medical history and understand the doctor's instructions will make the experience much smoother.

Pregnancy Confirmation Document

Once the doctor confirms a viable pregnancy with a detectable heartbeat (usually around 6-8 weeks), they will issue a pregnancy confirmation certificate or notification form (妊娠届出書 ninshin todokesho). This official document is crucial—you'll need it to register your pregnancy at your municipal office and receive your Maternal and Child Health Handbook.

The doctor will typically provide this document around your second or third visit once they've confirmed everything is progressing normally. This certificate includes important information like your expected due date, which the city office will need for their records.

Registering the pregnancy to the city office

Registering the Pregnancy at the City Office

Submitting the Ninshin Todoke

With your pregnancy confirmation document in hand, your next step is visiting your local municipal office (市役所 shiyakusho or 区役所 kuyakusho) to officially register your pregnancy. This registration process, called submitting the Ninshin Todoke (妊娠届 pregnancy notification), should be done as soon as you receive your confirmation from the doctor, typically around 8-12 weeks of pregnancy.

What to bring to the city office:

Pregnancy confirmation certificate from your doctor
Your residence card (在留カード zairyū kādo) or passport
Your health insurance card
Personal seal (印鑑 inkan/hanko) if you have one (not always required)
Your My Number card if you have it

The registration process is usually handled at the health or welfare division of your ward office. The staff will record your information, confirm your expected due date, and process your registration on the spot. The entire procedure typically takes 30-60 minutes.

Receiving the Maternal and Child Health Handbook

Upon registering your pregnancy, you'll receive the Maternal and Child Health Handbook (母子健康手帳 Boshi Kenko Techo), arguably the most important document you'll carry throughout your pregnancy and your child's early years. This comprehensive booklet serves as a complete health record, tracking:

All prenatal checkups and test results
The birth record and delivery details
Your baby's growth measurements
Vaccination records
Health checkups from birth through age 6

The handbook is available in multiple languages including English, Chinese, Korean, Portuguese, Spanish, Tagalog, Thai, and Indonesian. However, availability of foreign language versions varies by municipality. Larger cities and wards with significant foreign populations typically stock English versions, but smaller cities may only have Japanese versions readily available. If your local office doesn't have an English handbook, ask if they can order one or direct you to a larger office that stocks them. You can also download PDF versions from the Ministry of Health, Labour and Welfare website.

Critical importance: Bring this handbook to every single prenatal appointment and pediatric visit. Doctors will record information directly in it, and having a complete record ensures continuity of care, especially important if you change doctors or need emergency care.

Maternity Badge (Mataniti Maaku)

Along with your handbook, you'll receive a Maternity Mark (マタニティマーク maternity mark) keychain or badge. This distinctive pink and blue badge featuring a mother and baby symbol serves an important social function in Japan. It signals to others—particularly on crowded trains and buses—that you're pregnant and may need a seat or extra consideration.

Japanese society places significant emphasis on these visual indicators, and many commuters will offer their seat when they notice the maternity badge, even if your pregnancy isn't yet visibly obvious. Attaching it to your bag or wearing it as a strap can be especially helpful during the first trimester when morning sickness might be at its worst but you're not yet showing.

Coupons for Prenatal Checkups

One of the most valuable items you'll receive at registration is a booklet of prenatal checkup coupons (妊婦健診補助券 ninpu kenshin hojoken). These coupons substantially subsidize the cost of your prenatal care throughout pregnancy. Most municipalities provide approximately 14 coupons covering:

Regular prenatal examinations
Ultrasound scans
Blood tests (blood type, anemia, infectious disease screening)
Urine tests
Blood pressure monitoring
Gestational diabetes screening
Group B Streptococcus test

While the specific number and value of coupons varies by municipality (some provide up to 16 coupons worth ¥100,000 or more total), they're designed to cover the recommended prenatal visit schedule. You'll typically visit the doctor monthly until week 23, bi-weekly until week 35, then weekly until delivery—roughly 14 visits total.

Important notes about coupons:

They significantly reduce costs but don't always cover everything. Expect to pay ¥2,000-¥5,000 out-of-pocket per visit even with coupons
Some special tests or additional ultrasounds may not be covered
Coupons are municipality-specific; if you move during pregnancy, check with your new city office about transferring or exchanging them
Some cities include bonus coupons for services like dental checkups or prenatal classes

pregnancy checkup in Tokyo

Navigating Prenatal Care in Japan

Schedule of Prenatal Checkups

Japan's prenatal care system is notably thorough, with frequent monitoring throughout pregnancy. The standard schedule recommended by the Ministry of Health, Labour and Welfare follows this pattern:

Weeks 8-23: Monthly checkups (approximately every 4 weeks)
Weeks 24-35: Bi-weekly checkups (every 2 weeks)
Weeks 36-40: Weekly checkups (every week until delivery)

This schedule totals approximately 14 visits, which is more frequent than standard care in many Western countries. Each visit typically includes weight measurement, blood pressure check, urine test, and an ultrasound—yes, you'll usually get an ultrasound at nearly every appointment, which many foreign mothers find exciting but can also add to costs.

Prenatal Tests and Screenings

Throughout your pregnancy, you'll undergo various tests to monitor both your health and your baby's development:

First trimester screening (8-12 weeks):

Blood type and Rh factor
Complete blood count (anemia screening)
Infectious disease testing (syphilis, HIV, Hepatitis B and C, rubella antibodies)
Urine tests for protein and sugar

Second trimester (around 20 weeks):

Detailed anomaly scan (ultrasound to check baby's development)
Additional blood tests if needed
Gestational diabetes screening (typically around 24-28 weeks)

Third trimester:

Group B Streptococcus (GBS) test (around 35-37 weeks)
Non-stress tests in final weeks if recommended
Regular monitoring of baby's position and engagement

Optional testing: Non-Invasive Prenatal Testing (NIPT) for chromosomal abnormalities is available in Japan but not routinely offered unless you're 35+ or have other risk factors. It's not covered by insurance and costs approximately ¥100,000-¥200,000. If you're interested in NIPT or other optional screenings, discuss this with your doctor early in pregnancy.

Choosing an OB-GYN or Maternity Hospital

One of your most important decisions during pregnancy is selecting where you'll give birth. In Japan, you have several options:

Maternity clinics (産院 san'in): These are specialized birthing facilities, often smaller and more intimate than hospitals. They typically offer a more personalized, home-like atmosphere with private rooms and excellent amenities (some even provide elaborate celebration meals). However, they only accept low-risk pregnancies and transfer patients to hospitals if complications arise.

General hospitals with maternity wards: Larger hospitals can handle high-risk pregnancies, complications, and emergency C-sections. They have neonatal intensive care units (NICUs) and specialists on-site. The environment may feel more clinical, but they offer comprehensive medical support.

University hospitals: These tertiary care centers handle the most complex cases and are often research institutions. They're excellent for high-risk pregnancies but may involve longer wait times and teaching rounds.

Critical timing: Popular maternity facilities, especially private clinics in urban areas, fill up extremely quickly. Many require you to register or "reserve your spot" by 10-12 weeks of pregnancy—some even earlier. Don't delay this decision; start researching and calling facilities as soon as your pregnancy is confirmed.

Finding English-Speaking Doctors

For non-Japanese speakers, finding medical care with language support is a top priority. Here's how to locate English-friendly options:

Search online databases: Resources like the Japan Healthcare Info website, embassy listings, and expat forums maintain lists of English-speaking doctors
Ask in expat communities: Facebook groups like "Tokyo Pregnancy Group" or city-specific expat forums are invaluable for recommendations
Contact international clinics: Cities like Tokyo, Osaka, and Yokohama have dedicated international clinics (though they're often more expensive)
Check with your embassy: Many embassies maintain lists of English-speaking medical providers

Major cities with better English support: Tokyo (especially Minato, Shibuya, and Setagaya wards), Yokohama, Osaka, Kyoto, Fukuoka, and Sapporo typically have more options. In smaller cities, you may need to rely on translation apps, bringing a Japanese-speaking friend, or hiring a medical interpreter.

Tours and Orientation

Many hospitals and clinics offer facility tours for expectant parents, typically in the second or third trimester. These tours allow you to see the labor rooms, delivery rooms, recovery rooms, and nursery facilities. While most tours are conducted in Japanese, some international-focused facilities offer English tours.

During the tour or at a separate orientation session, the hospital will explain their policies regarding birth plans, visitor rules, what to bring, and their specific procedures. This is your opportunity to ask questions about pain relief options, partner presence during delivery, rooming-in policies, and any specific concerns you have.

Prenatal Classes and Resources

Japanese municipalities and hospitals widely offer prenatal classes (両親学級 ryōshin gakkyū or 母親学級 hahaoya gakkyū). These classes cover essential topics including:

Nutrition and exercise during pregnancy
What to expect during labor and delivery
Breathing and relaxation techniques
Breastfeeding basics
How to bathe and care for a newborn
Postpartum recovery

Participation: These classes are typically free or low-cost and highly recommended for first-time parents. Both parents are encouraged to attend—some classes are specifically designed as "couple's classes" where partners learn how to support during labor and care for the newborn.

Language barrier: Most classes are conducted in Japanese, which can be challenging for foreigners. However, some municipalities in areas with large foreign populations offer classes with interpretation or English-language sessions. Tokyo, Yokohama, and other major cities sometimes have dedicated programs for international residents. Additionally, private organizations and hospitals catering to foreign patients may offer English prenatal classes (though these usually require payment).

Nutrition, Exercise, and Cultural Tips

Japanese prenatal care emphasizes specific nutritional and lifestyle recommendations, some of which may differ from guidelines in your home country:

Weight management: Japanese doctors typically recommend lower total weight gain during pregnancy compared to Western guidelines—often 7-12 kg (15-26 lbs) depending on your pre-pregnancy BMI. Don't be surprised if your doctor monitors your weight closely and advises restricting calories if you gain too quickly. This cultural difference in weight recommendations is one of the most commonly mentioned by foreign mothers.

Dietary advice: You'll be encouraged to eat a balanced Japanese-style diet with rice, fish, vegetables, and fermented foods. Japanese guidelines are somewhat more permissive about eating sushi and sashimi during pregnancy (as long as it's from reputable sources), though raw liver and certain other items are still restricted. You may also be advised to avoid excessive caffeine and strictly avoid alcohol.

Folic acid supplementation: While folic acid supplements are recommended (especially in the first trimester), they're not as aggressively promoted as in some Western countries. You may need to specifically ask about or purchase prenatal vitamins (マタニティビタミン maternity vitamins), as they're not automatically prescribed.

Exercise: Moderate exercise like walking, swimming, and prenatal yoga is encouraged. Many pregnant women in Japan walk extensively and continue normal activities well into the third trimester, weather permitting.

Common Pregnancy Concerns for Foreigners

"What if I can't explain my symptoms in Japanese?"
Keep a translation app handy (Google Translate with the camera function works well for reading signs and forms). Write down symptoms in advance using translation tools, or bring a Japanese-speaking friend to important appointments. Many doctors understand basic English medical terms, and some clinics provide picture cards or symptom charts you can point to.

"The medication brands are different—what about prenatal vitamins?"
Japanese prenatal vitamins are available but may not be as comprehensive as Western brands. Many foreign residents order supplements from iHerb or Amazon that ship to Japan. Common Japanese brands include Pigeon supplements and Elevit, available at drugstores. Always inform your doctor about any supplements you're taking.

"How do I handle morning sickness while commuting to work?"
Wear your Maternity Mark badge prominently so commuters may offer you a seat. Consider adjusting your commute time to avoid peak crush hours if possible. Keep small snacks and water in your bag, and don't hesitate to take sick leave (有給休暇 yūkyū kyūka) if needed—pregnancy-related absence is generally accepted by employers.

"Can I request specific medical procedures common in my home country?"
Yes, but understand that Japanese medical practice may differ. For example, routine internal examinations at every visit are less common here than in some countries, while ultrasounds are more frequent. Epidurals aren't standard (see below). Discuss your expectations with your doctor early—most are willing to accommodate reasonable requests or explain why certain procedures aren't offered.

Baby delivery in Japan

Planning for Delivery

Choosing Natural Birth vs. Other Options

Japan has traditionally emphasized natural childbirth (自然分娩 shizen bunben), and this cultural preference significantly shapes the birthing experience here. Understanding your pain management options and the prevailing attitudes toward them is crucial for setting realistic expectations.

Natural childbirth approach: The Japanese medical system has historically operated under a philosophy of "gaman" (我慢)—endurance or perseverance—when it comes to labor pain. Many hospitals and clinics promote breathing techniques, position changes, and mental preparation rather than pharmaceutical pain relief. This approach is deeply rooted in cultural beliefs about the bonding experience of natural childbirth and concerns about medication effects.

Changing attitudes: However, perspectives are gradually shifting, especially in urban areas where exposure to international practices is greater. Younger Japanese women and foreign residents are increasingly seeking pain relief options, and the medical community is slowly responding to this demand.

Cost and Process of Getting an Epidural

Epidural anesthesia (無痛分娩 mutsū bunben, literally "painless delivery") remains relatively uncommon in Japan, with only approximately 6-12% of births using epidurals compared to 60-70% in countries like the United States and the United Kingdom. However, availability is increasing.

Finding an epidural-friendly hospital: Currently, approximately 480 medical facilities in Japan offer epidural anesthesia during labor. These are concentrated in major urban areas—Tokyo, Osaka, Yokohama, Fukuoka, and Sapporo have the most options. In smaller cities and rural areas, finding a facility that offers epidurals can be challenging or impossible.

Cost considerations: Epidural anesthesia costs approximately ¥100,000-¥150,000 extra on top of standard delivery fees. Since childbirth isn't covered by regular health insurance, this additional cost is typically paid entirely out-of-pocket. However, there's encouraging news for Tokyo residents: starting in 2025, Tokyo Metropolitan Government introduced a subsidy program providing up to ¥100,000 reimbursement for epidural costs, recognizing the importance of pain relief options for birthing mothers.

Booking process: If you want an epidural, you must:

Choose a hospital that offers them during your early pregnancy research (by 10-12 weeks ideally)
Inform your doctor of your intention early in pregnancy
Often attend an information session or consultation about epidural procedures (sometimes required by the hospital)
Some facilities require scheduling epidurals in advance, and availability may be limited to weekdays or specific hours when anesthesiologists are on duty
Confirm the hospital's policy on "backup plans"—what happens if the anesthesiologist isn't available when you go into labor

Medical considerations: Japanese protocols for epidural administration may differ slightly from other countries. Discuss timing (when it can be administered), type (continuous vs. intermittent), and what mobility restrictions exist during labor.

C-Sections and Complicated Births

Cesarean sections (帝王切開 teio sekkai) in Japan are typically performed only when medically necessary—elective C-sections for non-medical reasons are rare and generally not offered. Japan's C-section rate is approximately 20-25%, lower than many developed countries.

When C-sections are performed:

Medical complications (placenta previa, breech presentation that can't be turned, fetal distress)
Previous C-section (though VBAC—vaginal birth after cesarean—is possible at some hospitals)
Multiple births (twins, triplets)
Failure of labor to progress after extended time

Important financial note: Unlike natural childbirth, C-sections are covered by Japanese health insurance because they're classified as medical procedures. This means the costs are handled differently—insurance covers approximately 70% (or 80-90% depending on your coverage), and the lump-sum birth allowance can be applied to the remaining costs. If you've paid into insurance for a sufficient time, you may also qualify for the high medical expense system (高額療養費制度 kōgaku ryōyōhi seido), which caps your out-of-pocket costs.

Previous C-section abroad: If you had a C-section in your home country, inform your Japanese doctor immediately. Bring translated medical records if possible. The doctor will assess whether VBAC is an option or if a repeat C-section is recommended. Different hospitals have different policies on VBAC, so this may influence your choice of delivery facility.

Creating a Birth Plan

While comprehensive birth plans are not as common in Japan as in some Western countries, you can and should discuss your preferences with your medical team. A birth plan (バースプラン birth plan or 分娩計画 bunben keikaku) might include:

Pain management preferences
Position preferences during labor
Who you want present during delivery
Immediate skin-to-skin contact preferences
Cord blood banking wishes
Breastfeeding preferences
Photography/video preferences

Setting realistic expectations: Understand that Japanese hospitals may have firm policies that limit some choices. For example:

Some facilities don't allow partners in the delivery room throughout the entire labor or have restricted visiting hours
Immediate skin-to-skin contact may not be routine practice
Active labor management (walking, squatting, water birth) availability varies greatly
Photography restrictions may apply

Discuss your birth plan during the third trimester, ideally in writing (you can prepare it in English and have it translated). Approach the conversation with flexibility—Japanese medical staff prioritize safety and established protocols, so while they'll accommodate preferences when possible, they may have limitations based on facility policies or medical judgment.

Maternity Hospital Bag Checklist

Most Japanese hospitals provide a detailed packing list specific to their facility, usually given to you during your third-trimester appointments. However, here are essential items almost universally needed:

Documents (absolutely essential):

Maternal and Child Health Handbook (母子健康手帳)
Health insurance card
Hospital registration card
Residence card or passport
Personal seal (hanko/印鑑) if you use one
Birth plan (if prepared)

For mother:

Front-opening nightgowns or pajamas (2-3 sets for a 5-day stay)
Nursing bras (2-3)
Comfortable underwear (disposable postpartum underwear is recommended)
Slippers
Toiletries (toothbrush, toothpaste, shampoo, conditioner, body wash, lotion)
Towels (hand towels and bath towels)
Sanitary/maternity pads (extra-large for immediately postpartum; many hospitals provide some)
Breast pads
Hair ties
Glasses (if you wear contacts)
Phone charger
Snacks (Japanese hospital meals may seem small to some foreigners; having comfort snacks helps)

For baby:

Going-home outfit
Seasonal outerwear if needed (blanket, jacket)
Car seat (essential if you're driving home)

What hospitals typically provide:

Diapers during your stay
Some basic toiletries
Hospital gowns (though you may prefer your own)
Baby bathing supplies during demonstrations

Special notes: Japanese hospitals often require mothers to bring their own dishes, cups, and utensils, though this varies by facility. Some provide rental amenities for an additional fee. Luxury private clinics may provide almost everything, including postpartum care items and baby clothes, while public hospitals require you to bring more items yourself.

The cost of Childbirth

Understanding the Costs of Childbirth

The financial aspect of giving birth in Japan concerns many foreign residents, but the system is actually quite supportive once you understand how it works.

Average delivery costs nationwide:

Normal vaginal delivery with 4-5 night hospital stay: ¥500,000-¥600,000
In major cities (Tokyo, Osaka): ¥600,000-¥700,000 or higher
Private luxury clinics: ¥700,000-¥1,000,000+
Cesarean section: ¥800,000-¥1,000,000 (before insurance coverage)

Cost variables that increase the total:

Private room fees: ¥10,000-¥70,000 per night additional
Epidural: ¥100,000-¥150,000 additional
Delivery outside standard hours (nights, weekends, holidays): ¥20,000-¥50,000 surcharge
Extended hospital stay: ¥30,000-¥50,000 per additional night
Additional medical procedures or complications

Cost variables that might decrease the total:

Shared room (multi-bed room): often no extra charge
Delivery at a public hospital: generally less expensive than private clinics
Daytime weekday delivery: no surcharge

Lump-Sum Birth Allowance (Shussan Ikuji Ichijikin)

The Japanese government provides substantial financial support through the Lump-Sum Birth Allowance (出産育児一時金 shussan ikuji ichijikin), currently set at ¥500,000 per child as of 2024. This benefit is available to anyone enrolled in Japanese health insurance (National Health Insurance or employee health insurance) who reaches at least 85 days of pregnancy.

How the direct payment system works:
Most hospitals offer a "direct payment" arrangement (直接支払制度 chokusetsu shiharai seido), which is incredibly convenient:

Around 1-2 months before your due date, the hospital provides paperwork for the lump-sum allowance
You complete and sign the forms authorizing direct payment
The hospital submits these to your insurance provider
When you're discharged, you only pay the difference if your bill exceeds ¥500,000
If your bill is less than ¥500,000, you receive the difference as a refund within 1-2 months

Example calculation:

Total delivery cost: ¥650,000
Lump-sum allowance: ¥500,000
You pay at discharge: ¥150,000

If you pay upfront: Some hospitals (particularly smaller clinics) may not offer direct payment. In this case, you pay the full amount at discharge and then apply for reimbursement through your health insurance. You'll typically receive the ¥500,000 within 1-2 months.

Important eligibility notes:

You must have been enrolled in Japanese health insurance for the pregnancy
Miscarriage or stillbirth after 85 days (12 weeks) qualifies for a reduced allowance (typically ¥488,000)
For twins or multiple births, you receive ¥500,000 per child

Other Financial Support

High Medical Expense System (高額療養費制度 kōgaku ryōyōhi seido):
If you have a C-section or pregnancy complications requiring treatment, your medical costs are partially covered by insurance. If these costs exceed a certain threshold in a month (typically around ¥80,000-¥100,000 depending on income), you can apply for a refund of the excess through this system. This is separate from the lump-sum allowance.

Medical expense tax deduction:
If your total medical expenses (including pregnancy-related costs not covered by the lump-sum, such as prenatal vitamins, some prenatal visit copays, or transportation costs to medical appointments) exceed ¥100,000 per year, you can claim a tax deduction when filing your annual tax return.

Local municipality subsidies:
Some cities and wards offer additional financial support:

Extra birth grants (ranging from ¥50,000-¥100,000 for first or second children)
Subsidies for fertility treatments before pregnancy
Reduced costs for prenatal care beyond the standard coupons
Tokyo's new epidural subsidy (up to ¥100,000)

Check with your ward or city office about local programs, as these vary significantly and aren't widely advertised.

Maternity and Paternity Leave in Japan

For foreign workers in Japan, understanding your parental leave rights is crucial for family and financial planning.

After pregnancy

Maternity Leave (産前産後休業 Sanzen-sango Kyūgyō)

Prenatal leave: Women can take leave starting 6 weeks (42 days) before the expected due date. This is optional—you can work until closer to delivery if you choose and your employer agrees.

Postnatal leave: 8 weeks (56 days) of leave after giving birth is mandatory. Legally, you cannot work during this period (though after 6 weeks, you may return if a doctor certifies you're fit and you wish to do so).

Eligibility: All female employees are entitled to maternity leave regardless of employment duration, contract type, or nationality. This is a legal right, not a company benefit.

Compensation during maternity leave:

If your employer pays full salary during maternity leave, you receive normal pay
If the employer doesn't pay (which is common), you receive approximately 67% of your standard monthly salary from health insurance through the "Maternity Allowance" (出産手当金 shussan teate-kin)
This allowance is paid for both prenatal and postnatal leave periods
You must have been enrolled in employee health insurance for at least 1 year to qualify

Childcare Leave (育児休業 Ikuji Kyūgyō)

After maternity leave ends, both parents can take childcare leave (often called parental leave) until the child turns 1 year old, with possible extensions to 18 months or 2 years under certain circumstances (such as inability to secure daycare).

Eligibility requirements:

Employed under a labor contract (not independent contractors)
Have worked for the employer for at least 1 year
Enrolled in employment insurance (雇用保険 koyō hoken)
Plan to continue working after the leave

Foreign residents on work visas are generally eligible as long as they meet these criteria. Both parents employed by different companies can take leave simultaneously or sequentially.

Compensation during childcare leave:
Through employment insurance, you receive "Childcare Leave Benefits" (育児休業給付金 ikuji kyūgyō kyūfukin):

First 6 months: 67% of your average monthly salary
After 6 months: 50% of your average monthly salary
Paid approximately every 2 months during the leave period

Application process:

Notify your employer of your intention to take childcare leave (ideally 1 month before maternity leave ends)
Your employer submits the application to Hello Work (the public employment security office)
The employer typically handles most paperwork, but you'll need to provide necessary documents

Paternity Leave

Fathers can also take childcare leave, and Japan has recently strengthened paternity leave policies:

"Papa Leave" (パパ休暇): Fathers can take up to 4 weeks of leave within 8 weeks after birth in addition to standard childcare leave later. This is designed to allow fathers to support immediately after delivery.

Standard childcare leave: Fathers can take the full childcare leave (up to 1 year, extendable) just like mothers, with the same compensation rates.

Encouraging note: While Japanese workplace culture historically discouraged men from taking parental leave, government initiatives and changing attitudes are making it more acceptable. Foreign residents often find it easier to exercise these rights, as international companies and those employing foreigners tend to be more supportive.

in labor

The Delivery and Hospital Stay

Labor and Birth in a Japanese Hospital

When you go into labor, the first step is calling your hospital's delivery ward. Japanese hospitals typically ask you to wait at home during early labor until contractions are regular and intense (usually 5-10 minutes apart for first-time mothers, 10-15 minutes for second-time mothers, though guidelines vary).

When to call:

Regular contractions at the frequency your hospital specified
Water breaks (even without strong contractions)
Significant vaginal bleeding
Decreased fetal movement or any concerns

Checking in: When you arrive at the hospital, you'll be taken to an examination room where staff will check your dilation, monitor contractions, and assess the baby's heart rate. If you're in active labor, you'll be admitted to the labor room. If you're not sufficiently dilated, you might be sent home (yes, this can happen and can be frustrating—Japanese hospitals often wait for active labor before admission).

Labor room experience: Japanese labor rooms typically include:

A hospital bed with adjustable positions
Fetal monitoring equipment
Basic comfort items

During labor, Japanese hospitals have varying approaches. Some encourage movement and position changes; others prefer you remain primarily in bed with continuous monitoring. Pain management typically focuses on breathing techniques and mental focus unless you've pre-arranged for an epidural.

Language during labor: This is where language barriers can be most challenging. Key Japanese phrases to know:

"Itai" (痛い) - "It hurts"
"Mou sugu desu" (もうすぐです) - "Almost there/soon"
"Iki wo shite" (息をして) - "Breathe"
"Ikinaide" (いきないで) - "Don't push"
"Ikimu" (いきむ) - "Push"

If possible, having a Japanese-speaking support person with you can be immensely helpful for communicating with staff during critical moments.

Involving Your Partner or Birth Support

Japanese hospital policies regarding partner presence during labor and delivery vary significantly:

Most modern hospitals allow one support person (usually the partner) to be present during active labor and delivery
Some facilities require the partner to leave during certain procedures or examinations
Visiting hours for hospital rooms may be restrictive (some only allow visitors 2–3 hours daily)
During COVID‐19, many hospitals temporarily restricted partner presence, though most have relaxed these policies as of 2024–2025

What to confirm with your hospital:

Can your partner be present throughout labor?
Are there restrictions on when partners can be in the labor room?
Can partners stay overnight in the recovery room?
What happens if labor extends overnight — can partners return?
Are there waiting areas for support people?

Doula or birth coach: Professional doula services are not widespread in Japan. If you wish to have a doula, choose a hospital that allows outside birth attendants and arrange this well in advance. International hospitals and clinics are more likely to accommodate doulas.

After Delivery: Hospital Stay

Japanese postpartum hospital stays are notably longer than in many Western countries:

Standard stay duration:

Vaginal delivery: 5–6 days
Cesarean section: 7–8 days

What happens during your stay

The postpartum period in Japanese hospitals serves as an educational phase where you learn essential newborn care skills:

Mother’s recovery monitoring:

Daily checks of your vital signs
Monitoring uterine contraction and bleeding
Perineal tear or C‐section incision care
Breastfeeding support and instruction

Newborn care instruction:

Feeding methods (breastfeeding or formula)
Diaper changing
Baby bathing demonstrations and supervised practice
Umbilical cord care
Baby cues and comforting techniques
Safe sleep guidance

Rooming‐in practices

Many Japanese hospitals practice rooming‐in, meaning your baby stays in your room for most of the time. However, most also have nurseries available if you need rest, particularly at night. Policies vary:

Some hospitals automatically keep babies in the nursery at night and bring them to parents for feeding
Others encourage 24‐hour rooming‐in but allow nursery requests
First‐time mothers often appreciate having the nursery option early in recovery

Meals and amenities

Japanese maternity hospitals typically provide three meals and snacks daily. Meals are usually nutritionally balanced Japanese‐style menus designed to aid recovery and breastfeeding. Many private clinics offer special celebration meals (お祝い膳 oiwai‐zen) near the end of the stay — multi‐course meals presented beautifully for the parents.

Birth Certificate and Documents from Hospital

Before discharge, the hospital provides essential documents needed for registration:

Birth Certificate (出生証明書 shussei shōmeisho):
Includes:

Date, time, and place of birth
Baby’s sex
Birth weight and length
Mother’s name and age
Doctor’s signature and hospital seal

Important for foreign parents: Confirm name spellings carefully. The baby’s name will also appear in katakana — verify accuracy, as correcting later is extremely difficult.

Some hospitals additionally provide:

English‐language birth summaries (common in international hospitals)
Medical delivery records
Baby footprints or keepsake cards

If your embassy requires a certified English translation, ask the hospital first. If not available, certified translators (¥10,000–¥30,000) can produce accepted translations.

birthcertificate in japan

Post‐Birth Procedures and Newborn Documentation

Registering the Birth at City Hall (Shussei Todoke)

Deadline: Within 14 days of birth (legally required)

Where: Local city/ward office resident registration section

What to bring:

Birth certificate from hospital
Parents’ residence cards or passports
Marriage certificate (if applicable)
Personal seal (hanko/印鑑) if used
Mother‐Child Health Handbook (母子手帳 boshi techo)

Process time: 30–60 minutes

Once registered, you will receive a Residence Certificate (住民票 jūminhyō) including the baby’s details.

Special notes:

For unmarried foreign couples, paternity acknowledgment (認知 ninchi) may be required
If one parent is Japanese, the baby is automatically registered in the Japanese family register (戸籍 koseki)
Foreign parents must register the birth with their embassy separately

Getting Baby’s Residence Status (Visa)

If both parents are non‐Japanese, the baby does not automatically receive Japanese residency.

Deadline: Within 30 days of birth
Where: Regional Immigration Bureau
Visa type: Usually Dependent (家族滞在 kazoku‐taizai) unless parents hold Permanent Residence

Documents required:

Application form for status of residence
Baby’s birth certificate and residence registration
Parents’ passports and residence cards
Proof of employment/ability to support child
Baby’s passport (or application proof)
Photo (may be required depending on age)

Processing time: 2–4 weeks

Registering Baby in Health Insurance

Deadline: Within 30 days of birth

Two pathways:

National Health Insurance: Register at city/ward office with residence certificate
Employee Insurance: Submit application through employer HR

Coverage becomes retroactive if processed within deadline.

Applying for Child Allowance (児童手当 Jidō Teate)

Deadline: Within 15 days after birth

Monthly payments:

Ages 0–3: ¥15,000
Ages 3–12: ¥10,000 (¥15,000 for 3rd+ child)
Ages 12–15: ¥10,000

Paid quarterly (February, June, October).
If you miss the deadline, previous months are not paid retroactively.

Registering Birth with Embassy & Baby Passport

Foreign parents must register their baby’s birth with their home embassy.

Required documents typically include:

Japanese birth certificate (and translation if required)
Parents’ passports
Marriage certificate
Embassy registration forms
Infant passport photo

Processing usually takes 1–4 weeks depending on country.

Dual nationality: Children born to foreign parents may hold multiple citizenships until age 22, depending on national laws.

Newborn Care and Health in Japan

One‐Month Checkup (生後1ヶ月健診)

A combined checkup for both mother and baby, assessing:

Mother’s physical recovery
Baby’s weight, length, and head size
Feeding and breastfeeding
Developmental milestones
Screening for postpartum depression

Often covered fully or partially by municipal coupons.

Vaccinations and Routine Pediatric Health Checkups

Japan has a structured national immunization program, and most vaccinations for infants are free when using municipal coupons provided after birth registration. You’ll receive a vaccination schedule and coupon booklet from your ward or city office.

Standard Infant Vaccination Schedule (First Year)

Age	Vaccines
2 months	Hib, Pneumococcal, Rotavirus, Hepatitis B
3 months	Hib, Pneumococcal, Rotavirus, DPT‐IPV (Diphtheria, Pertussis, Tetanus, Polio)
4 months	Hib, Pneumococcal, Rotavirus, DPT‐IPV
5–6 months	BCG (Tuberculosis)
7–8 months	Hepatitis B (final dose)
12 months	Measles & Rubella (MR), Varicella (Chickenpox), Pneumococcal booster

Important notes:

Vaccinations require appointments at pediatric clinics — book early, especially for popular doctors
Bring your Maternal and Child Health Handbook and vaccination coupons to every appointment
If you miss a scheduled vaccine, ask for a catch-up plan; delays are common and manageable
Some vaccines recommended abroad (such as Flu, Meningococcal, RSV) may require payment or separate scheduling

Routine Public Health Checkups for Babies

These municipal checkups are mandatory health screenings where specialists check physical and developmental progress. They are free and included in the Maternal and Child Health Handbook schedule.

Standard Checkup Schedule

3–4 months: Early developmental check, hip joint assessment, feeding guidance
6–7 months / 9–10 months: Motor skills (rolling, sitting), hearing and vision checks
18 months: Walking, speech development, dental check, autism screening
3 years: Speech, behavior, eyesight, growth evaluation

Parents receive questionnaires to complete prior to the appointment, covering sleep, feeding, milestones, and behavior patterns.

Child Healthcare Costs and Subsidies

Japan provides generous medical subsidies for children. In many cities, hospital and clinic visits for children are free or very inexpensive.

Medical subsidy types vary by city, but commonly include:

Free pediatric care up to age 15 or 18
Small copays of ¥200–¥500 per visit in some regions
Free prescriptions in many municipalities

You will receive a Child Medical Certificate (医療証 iryō‐shō) that must be shown at every appointment and pharmacy visit.

Finding a Pediatrician in Japan

Most neighborhoods have multiple pediatric clinics (小児科 shōnika). You are free to choose any clinic and switch at any time.

How to choose a pediatrician:

Ask other foreign parents for recommendations (expat groups, parenting networks, Facebook communities)
Search maps using keyword 小児科
Look for clinics marked as international or English‐friendly
Consider distance from your home, especially for emergency visits

Large hospitals also have pediatric departments, but require referrals or appointments and often have longer wait times.

Emergency and After-Hours Care

Emergency Services

119 — ambulance and fire emergency number
#8000 — pediatric night emergency phone consultation (Japanese only)

Helpful resources

TELL Lifeline (English mental health support): 03-5774-0992
Japan Helpline (English general support): 0570-000-911

When to seek emergency help

Persistent high fever not responding to medication
Difficulty breathing or blue lips
Severe lethargy or unresponsiveness
Convulsions
Significant injury or uncontrolled bleeding

Japanese emergency rooms operate on a triage system — expect to wait unless life-threatening.

Postpartum Mental Health and Support

Postpartum depression is widely recognized in Japan, but support systems vary.

Signs to watch for:

Persistent sadness or anxiety
Intrusive thoughts
Difficulty bonding with baby
Extreme exhaustion not improving with rest
Feeling overwhelmed or hopeless

Support options

Municipal postpartum mental health consultations (free or low cost)
Home visit services from midwives or public health nurses (訪問指導 hōmon shidō)
Parenting groups and maternal support circles
English mental health counseling (private clinics in major cities)

If you feel mental health declining, speak to your doctor or city public health services immediately.

Parenting Support Resources in Japan

Common Municipal Resources

New parents’ support groups and classes
Breastfeeding consultations (助産師外来 josanshi gairai)
Home visit services for newborn care education
Baby weigh-in days at community centers
Play groups and public children’s playrooms (児童館 jidōkan)

Online support for foreign parents

Tokyo Pregnancy Group
Mothers’ groups on Facebook by city
Real-estate and relocation communities that share parenting resources

Final Thoughts

Having a baby in Japan as a foreigner can feel overwhelming at first, but with preparation and understanding of the system, the experience is extremely safe, supportive, and organized. Thousands of foreign families successfully navigate pregnancy, childbirth, and raising young children in Japan every year. With access to high-quality healthcare, financial support, and structured infant care systems, Japan provides a stable and nurturing environment for growing families.

The keys are:

Register early
Understand documentation timelines
Choose the right hospital and pediatrician for your needs
Use subsidies and support programs available
Ask questions and seek help whenever needed

With the right information and community support, you and your baby can thrive in Japan.

Frequently Asked Questions (FAQ)

Do I need to speak Japanese to give birth in Japan?

No, but it helps significantly. Many hospitals do not have fluent English speakers, particularly outside major cities. You can:

Bring a Japanese-speaking partner or friend to appointments
Use interpreter services at international hospitals
Use translation apps for symptoms and forms
Hire a birth interpreter (available in Tokyo, Yokohama, Osaka)

Can I get an epidural during labor in Japan?

Yes, but availability is limited. Only around 6–12% of hospitals nationwide offer epidurals. In major cities like Tokyo and Osaka, more facilities provide them, but you must register very early in pregnancy and expect an additional cost of around ¥100,000–¥150,000. Some cities such as Tokyo now offer subsidies.

How much does childbirth cost in Japan?

For a standard vaginal delivery with a 5–6 day hospital stay, expect ¥500,000–¥700,000. Private clinics can exceed ¥1,000,000. Cesarean deliveries are partially covered by insurance. The Lump-Sum Birth Allowance of ¥500,000 offsets most expenses.

Is water birth or home birth an option?

Water birth is available in some private clinics but uncommon. Home birth is rare and usually reserved for low-risk pregnancies with a midwife team. Insurance coverage varies and pediatric backup must be arranged.

Can my partner stay overnight in the hospital?

Some hospitals allow it, some don’t. Policies vary widely. Confirm during orientation or facility tour. Private rooms increase the chance but may add additional fees.

Can I choose a C-section if I want one?

Elective C-sections without medical necessity are rarely offered in Japan. C-sections are typically performed for medical reasons only. If you require a C-section based on previous complications, choose a hospital capable of surgical delivery and NICU support.

What happens if my baby is born prematurely or needs NICU care?

Japan has high-level neonatal intensive care support. University and large public hospitals have NICUs. Babies are transferred immediately if born at a clinic without NICU care. NICU treatment is covered by insurance under the high medical expense system.

How long can I stay in the hospital after birth?

5–6 days for vaginal birth; 7–8 days for C-section. Some private clinics offer extended postpartum recovery stays for extra fees.

Can I breastfeed in public?

Yes. Breastfeeding is widely accepted in Japan. Nursing rooms and facilities are available in nearly all malls, stations, parks, and airports.

Do newborns automatically get Japanese citizenship if born in Japan?

No. Citizenship is based on parents’ nationality, not place of birth. If one parent is Japanese, the baby is a Japanese citizen. If both parents are foreign nationals, you must apply for the baby’s residence status and register with your embassy.

Do I need a car seat in Japan?

Yes, by law a car seat is required to transport a baby in any motor vehicle. Taxis are exempt by law, but many parents bring portable infant carriers for safety.

Can I fly with a newborn?

Airlines generally allow domestic flights around 7 days after birth if mother and baby are healthy. International travel typically recommended after 1 month checkup.

Additional Tips for Foreign Parents

Book pediatric and vaccination appointments early
Always carry your Maternal and Child Health Handbook and child medical certificate
Confirm hospital policies early, especially regarding epidurals and partner attendance
Use public parenting spaces like 児童館 (jidōkan) for socialization and support
Join parenting groups to find baby gear second-hand — items like strollers and bassinets are expensive new
Know that bureaucracy in the first month is intense; make a checklist and calendar deadlines

Useful Japanese Terms for Pregnancy and Childbirth

Japanese	English
産婦人科 (sanfujinka)	OB-GYN / Maternity clinic
出産 (shussan)	Childbirth
分娩 (bunben)	Delivery
無痛分娩 (mutsū bunben)	Epidural / Pain relief birth
妊娠 (ninshin)	Pregnancy
予定日 (yoteibi)	Due date
陣痛 (jintsū)	Labor contractions
破水 (hasui)	Water breaking
帝王切開 (teio sekkai)	Cesarean section
母子手帳 (boshi techo)	Maternal and Child Health Handbook
乳児 (nyūji)	Infant
小児科 (shōnika)	Pediatrics
予防接種 (yobō sesshu)	Vaccination

Key Contacts and Resources in Japan

Service	Details
Emergency services	119
Pediatric after-hours hotline	#8000 (Japanese only)
TELL Lifeline	03-5774-0992 — English mental health support
Japan Helpline	0570-000-911 — English 24 hours

Having a baby in Japan as a foreigner comes with challenges — language barriers, cultural differences, and a lot of paperwork — but it is also one of the safest, most organized maternity systems in the world. With strong medical care, extensive assistance programs, and supportive community networks, many foreign parents find that giving birth in Japan is a positive and empowering experience.

Pregnancy & Childbirth in Japan for Foreigners (2025 Guide)