Giving birth in Japan

By Amy Kelly Golden

If you think living in Tokyo is tough, try having a baby here. I recently did, and though the experience was challenging, I learned a host of useful tips that I can pass along.

Finding a strong support network was almost as important as finding the right health care provider. I highly recommend The Tokyo Pregnancy Group, which holds meetings every two weeks, featuring guest speakers that include doctors, nurses and other experts. Even if you do not go to the meetings, you can stay connected by simply being on the email list and checking the website for notices about events, services and secondhand goods.

The process of getting information often felt like a scavenger hunt. I would research topics prior to doctor appointments and compare notes with friends to find out what I was missing. Half the battle is figuring out what you don’t know. Do not expect to be spoon-fed information — it’s up to you to be proactive and seek it out. I asked other friends what tests, booklets, info they received during hospital visits at various weeks, and made sure I was getting the same.

Do your own research and be educated on the standards of your home country, and compare that to your experience here. Take a birth education class to get a big picture perspective on what you can expect and what you need to learn more about.

I found it hard to reconcile clearly contrasting opinions on topics such as diet. For instance, it’s widely accepted in Japan that pregnant women can eat certain foods like raw fish, but in the US that is a major pregnancy taboo. The bottom line is that there are variances in cultural norms and it is up to you to decide what is best.

Another of these cultural differences is in the standards of weight gain in mothers and average birth weight in babies. If my growing belly wasn’t reminder enough that I was pregnant, the comments about my increased size from coworkers certainly were. Despite falling into the average range of weight gain according to American standards, my increased girth seemed extreme compared to standards for Japanese women. In my last week of pregnancy, I received bewildered looks from people on the elevator in my office building and would be asked by women in the bathroom what I was still doing there in my “condition.”

Also, it’s almost cliché to point out, but don’t expect salarymen to give up their courtesy seats for you even if your bump is visible and even if you are wearing one of the pregnancy badges issued by rail companies.

In my nine months of riding the subway pregnant, the only people who ever gave up their seat were older ladies — probably mothers themselves who knew what it was like and wanted to make a stretch of the journey a little easier.

When it finally came time to spend my six days at the hospital (one day for labor and five days for recovery is standard), I found myself settling for one-word explanations like “Daijobu” when trying to understand important information such as the results of a test or condition of my baby — and then later referring to baby books to get deeper explanations, or making lists of questions to ask my doctor.

I made a few mistakes, such as opting out of a newborn screening test that was required in the United States, but in the end, I felt like my needs were met. The post-delivery recovery period in the hospital was like boot camp for new moms — preparing us for life outside the hospital.

This commentary originally appeared in Metropolis magazine (www.metropolis.co.jp).

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Latest 15 of 24 Total Comments Show All

VoXman at 04:35 AM JST - 20th May

Dealing with Doctors in Japan:

One huge difference. In Japan, Doctors are accepted as some kind of god and their word is bond. They don't explain things well to Japanese either. In the US, its the opposite. Funny thing is many of Japan's Doctors were trained in the US under the same system of bed side manner.
USB at 11:33 AM JST - 20th May

To sushi, or not to sushi

I always thought the debate over whether to eat sushi or not had to do with the high levels of mercury and other heavy metal toxins found in certain species of fish ESPECIALLY maguro and other tuna
Ultradude at 12:03 PM JST - 20th May

We've used (and will use again soon) Ikuryo Clinic in Naka-Meguro - quite good, all private rooms, clean and very flexible (I coached/filmed the birth). Regarding fish, restrictions have to do with mercury in larger/older predatory fish and also parasites in raw fish. However, the benefits of Omega-3s, etc to the embryos neurological development can't be dimissed either. My wife ate a decent amount of fish during her first pregancy but kept the maguro and kajiki to a few times a month & our boy seems fine with no dain bramage at all.
yasukuni at 01:20 PM JST - 20th May

First of all, experiences will differ widely according to the hospital. They range from very similar to the US, to others where husbands are still not welcome. Also, in general a lot has changed in the last 10 years, and continues to change.

re giving up seats, yes it is bad. But wannabe John Waynes like voxman irritate me. Why do gaijin come here and instantly become Mr Tough Guy. Yeah, I can probably beat up 99% of people on the train too, but I have never felt the need to get in anyone's face like that. Doubt whether you would do that in your own country - or if you did you would probably be careful who you did it too. Probably not as bad as romulus "dragging a person off their seat and Dumping them on the floor". One day of you clowns will pick the wrong person - maybe a skinny looking guy who happens to be a boxer or something and learn your lesson. Japanese young people who don't give up their seat for pregnant woman give a bad impression of Japanese, but gaijin who go around yelling at little Japanese and dragging them around give gaijin a bad name. Go home and do it a subway in a rough area , then tell us what a hero you were.
illsayit at 02:16 PM JST - 20th May

I think more research needs to be done, there is lots of various practioners for child-birth. Midwifery is very much available. Information is there.

Mostly I agree with cleo, when it comes down to it, when the crunch comes, the support that is there is helpful, but ultimately you do it alone.

How bout not riding trains. Never have in any of my births.
USAkuma at 12:42 AM JST - 21st May

I feel for Ms. Golden, but one thing that seems unclear here is her ability to use the Japanese language or her access to people who do. My wife found an abundance of help in as lowly and powdunk place as Shizuoka, and when we came to Saitama, the local government went so far as to pay us to have our child.

During her pregnancy, my wife received tons of offers for classes and support groups. But yes, they were all in Japanese, so it may be true that everything would be less than perfect if we couldn't speak the local tango, or had friends who did.

About the trains.

I agree with Yasukuni to an extent. Its a sorry state of society that young men and women take the priority seats without consideration of other people who need it, but that doesn't make vigilantism acceptable. In the example case above, were there no other priority seats available on the train? or were they all filled with young punks. If so, maybe you are on the wrong train. In Tokyo/Saitama area, there are women-only cars, I think it would be more possible to find a seat there than in the middle.

But that's just me and my wife...
Bizarro at 08:19 AM JST - 21st May

Historically low C-section rates in Japan seems to me a plus compared with the US, where malpractice fears probably play a role in the high rates of surgical births. Our hospital here in Japan has a philosophy more on the natural side, and we have been happy with the care.

Just curious about this one...

How bout not riding trains. Never have in any of my births.

You do realize that in cities many people don't have cars and can't afford the luxury of riding in taxis for several months, right? What is the recommendation, exactly?

Cheers,
ren_doi at 08:26 AM JST - 21st May

*We all have mouths so instead of simply complaining about how rude people are do the brave thing and open your mouth. *

Yes, I agree with that. If you need a seat, ask for one, especially if the occupied seat is one of the reserved ones.

On the other hand, I do see many instances of people giving up seats for those who need it more. Just yesterday, I saw a young punk with weird hair and very baggy trousers on the train. When an elderly woman got on, he immediately stood up and offered her the seat. I've seen similar scenes a number of times. This however is in a medium-size conservative city. Maybe in the big cities, people are afraid of getting their butts gang-kicked.
Bizarro at 12:40 PM JST - 21st May

This however is in a medium-size conservative city. Maybe in the big cities, people are afraid of getting their butts gang-kicked.

Having lived in a small Japanese city in addition to Tokyo, I have found the opposite. I saw more "gangs" and overall rudeness from young people (including smoking on the trains) in the small city, and relatively very little here in Tokyo. Japanese friends have also said that there are more such problems with youths in the smaller cities and countryside. Maybe not enough constructive things for them to do; I don't know.

I'd better get back on topic, though. I was surprised to see the author write that eating raw fish is "widely accepted" for pregnant women here. My (Japanese) wife knew from the beginning that she should generally avoid it during her pregnancy. She didn't go completely cold turkey, but probably cut back more than 90% on raw fish (not that we ate it so often before anyway) and basically 100% on tuna.

On a separate note, when a pregnant woman wants to go out for a meal it can be a challenge to find a non-smoking place here. And if you settle for a place that is not non-smoking but at least has nobody there actually smoking, sometimes a group will come in and make no hesitation about lighting up next to an obviously pregnant woman. But that's their right, and I think some people simply aren't aware of the danger. So we just ate at home much more.

Cheers,
Fair dinkum! at 12:43 PM JST - 22nd May

The lack of obstetricians and trained mid-wife staff at most public hospitals is alarming. We have had both our kids at private maternity hospitals. I can't complain about the treatment although, due to my previous experiences with Jpese hospitals and doctors I was ready to take over at any given point!
illsayit at 08:55 AM JST - 23rd May

Riding trains answer.

Lets face it, most of Japan is serviced for necessities. You can climb a mountain and find a drinking machine at the top. If you are pregnant, and the situation I dont deny that there are rude train riders, obviously it is common knowledge, why choose to get on a train, what is the dire need of riding it? The rude riders have a purpose. The preganat womans purpose is what? To get food? I doubt. Doesnt sound like a mother who would be concerned about the child's welfare. And supposing there were a necessity of riding the train, like to the hospital, knowing how it is, you could have someone go with you, or as mentioned, ask to sit down.
timorborder at 02:52 PM JST - 23rd May

In more than 18 years in Japan, I have only lost my temper (with the locals) on 1 or 2 occasions. One of these occasions was when my wife was expectant with my older son. She was about 7 months gone and we had to travel somewhere by train. On the way home, despite the "Silver Seat" stickers on the train (old folks, pregnant women, disabled persons, etc), these two young clowns decided to not give up their seats. I let it go for about 5 minutes with my blood pressure slowly rising. In the end, because my wife was getting more and more tired, I asked these two young chaps the following questions: 1. "Are you disabled?" 2. "Would you like to be disabled?" Despite being of minimal intelligence they both got the message rather quickly and gave up their seats.
Nessie at 03:30 PM JST - 23rd May

Tomor, LOL!
Bizarro at 11:51 AM JST - 24th May

Funny one, timorborder!

Got your message, illsayit. To all pregnant women - JUST STAY HOME (or within walking distance of home. And if one of you would like to have at least some semblance of her normal life and go somewhere that requires a train once in a while, you're a BAD MOTHER.

I'm curious to know if you would say the same to the elderly or handicapped, that they should just stay off the trains because, after all, "what is the dire need or riding it?" and "rude riders have a purpose." If not, then why are pregnant women different?
illsayit at 02:59 PM JST - 24th May

No. You are the one saying that. I pointed to discrepency of choice.

And I said, you can ask. I dont like rude riders either. The topic is about giving birth in Japan, how that leads everybodies comments to train riding is off topic.