Anecdote: Childbirth experience in Tokyo

Yer a baby, Harry! — Hagrid shortly before the start of the series

Published in

the hai life

10 min readJun 22, 2024

This is a longer-form article than my usual ones, but there is a “Childbirth Expenses” section at the end if you’re here for that!

No matter how much you prepare, childbirth still brings surprises. Here’s our experience giving birth in Tokyo.

Prologue

We’re a week past due date now and while Baby is still healthy, her late check-out is getting a little late for comfort. The anticipation of “any time now!” soon turned into “any time now?” and later still into “please, now?”.

Since week 12 we’ve been going to pre-natal checks at the same hospital where we were planning to deliver, a major English-speaking hospital in Tokyo. We were scheduled in for a regular pre-natal check at week 41, with a slightly ominous note that we might be warded.

Checking in

Not long into the 9am pre-natal check, we were told that we will be warded starting now, and were assigned both an LDR (Labor, Delivery, and Recovery) room for the childbirth and a ward for the postpartum stay.

Birth induction would be performed, we were told, followed by a lengthy explanation of the procedures and what to expect. The induction was administered via drip for 12 hours.

Feeling surreal but slightly glad to have avoided the “rush to the hospital in a taxi” phase, Papa went back to grab the rest of the luggage for the stay, while Mama had hospital-provided lunch in the LDR.

It probably hasn’t sunk in yet then, because we asked whether we needed to takeout lunch and the nurse calmly replied, in a manner as if they had answered this many times before, that lunch was provided by the hospital for the patient, as they were in fact, warded.

Induction

The drip was taken away at 11pm. Contractions had began and monitors were attached to check on the contractions and Baby’s heartrate. Thinking birth was imminent, we got excited but alas, were told that induction typically takes 1–2 days.

The LDR doesn’t allow overnight visitors unless labour is in progress, so Papa went home for the night after making sure that they would be called up should labour start overnight. It’ll happen tonight or tomorrow, right?

Right?

Tomorrow came but Baby didn’t, so induction continued with a “balloon procedure”. Contractions continued throughout the day, increasing in intensity. Nurses checked in every so often to help with moving around, go to the toilet, rotate the drips and just answering our questions.

The “balloon” was taken out in the evening, with no sign of Baby coming with it. “Well, they said 1–2 days, so it has to happen tomorrow surely”, we thought. Papa made the trek back home again.

Another tomorrow came, this time with a flurry. Arriving from home to a LDR full of medical staff is a fairly scary sight, and the nurses were quick to explain that a c-section was being considered by the doctors. Baby didn’t like the contractions much it seems!

A variety of medical staff came and went, each bringing with them forms and explanation of the different procedures and possibilities, ranging from being “upgraded” to general anaesthesia, to the possibility of blood transfusion. With each form signed, the suggestion for c-section went from “being considered” to “might be better” to “is recommended” to “will be done”, and the jitters went up in tandem.

C-section

The c-section procedure in Japanese is named 帝王切開, a combination of the words for “emperor” and “incision”. Though similarly named in English (“c” refers to Caesar after all), seeing and hearing the Japanese name in full instead of the more abstract “c-section” probably upped the jitters more than expected.

Within an hour or so of hearing that a c-section is “being considered”, we were being wheeled to the operation room. Since it was considered an emergency c-section, accompanying visitors were allowed only up until the entrance where the surgical staff gathered in scrubs. After a last readout by nurses, kisses and “see you laters”, and a deep “yoroshiku onegaishimasu” to the staff, Mama was wheeled in, and Papa went to wait outside in the maternity ward waiting lobby.

Waiting

Hospitals in Japan typically close on weekends and holidays, except for the emergency and maternity departments. It was a Saturday morning, so other than the lights in the maternity ward and from the windows, the rest of the hospital was dark and there were no other patients or staff around the waiting lobby. It was in here that the 2 hour wait started.

We were told that the c-section happens in 2 steps: Baby comes out 15 minutes in, and Mama after that. 15 minutes came and went, with each staff and stray visitor passing by triggering an expectant glance. There was much pacing about and browsing of a nearby vending machine. Finally, after another 15 minutes came the distant-but-approaching sound of a baby crying.

Baby was wheeled out in a baby cot for quick “hi” and selfies, before being whisked away for a wash up. The nurse also explained that Mama had been awake during the c-section, had earlier seen and touched Baby and is now being stitched up. On for another hour-long wait.

At some point during the wait, another nurse came over to inform Baby’s weight and time of birth. More interestingly, the nurse brought along a small zipped bag containing a snipped section of Baby’s umbilical cord. Sensing some uncertainty of what to do with it, the nurse went on to explain about the custom in Japan of drying and storing the umbilical cord in a wooden box for keepsakes, a sort of “memory of being born”.

The distraction and intrigue lasted a while but did nothing to shorten the long wait. Finally, after almost exactly 2 hours since being wheeled in, Mama was wheeled out, conscious and able to talk, and off to the ward we went.

Postpartum

Day 1 of postpartum starts on the day of the c-section. Due to the anaesthesia, Mama still couldn’t feel her legs and so was bedridden. She also had difficulty eating and was still on drips for painkillers. Baby was brought in to the ward and this was the first time we both put a face to the little one kicking and hiccuping in the belly just a day before. After photos and a bit of family time, Baby was whisked back to the nursery.

Mama slept for the most part. We were expected to stay for another 6 days (for a total of 8 days of admission), and since the ward had a stricter visitor policy of only until 9pm, today starts Papa’s regular “working hours” of 8am to 9pm visits.

Day 2 began with breakfast at 8am. The ward had a large window, and though it was summertime and it was nice and bright outside, there was no other indication of time passing by. Mealtimes (8am for breakfast, 12 for lunch and 6 for dinner) helped countdown to discharge.

The goal of Day 2 was for Mama to be independent; be able to go to the toilet, eat, and breastfeed. Baby was brought in throughout the day for suckling, but for the most part was bottle fed either by Papa or back in the nursery. The nurse-in-charge set a goal of walking around the wards, about 450 metres, by 9pm (otherwise the distance resets). With great determination, Mama made the target just shy of 8pm. She was declared independent and had some tubes and the calf compression pads removed.

Rooming in

Day 3 marks the start of rooming in with Baby, which is when Baby sleeps in her cot with us in the ward. At 10am a nurse came with an interpreter for an hour’s “rooming class”; how to feed, carry and sooth Baby, how to change diapers, the distress signs to look out for, and what to do during earthquakes. From this point on, Baby sleeps in the room with Mama all day and overnight, only going back to the nursery for checks and when Mama had her own checks. Nurses came by once in a while and could be called on to help if needed, but we were strongly encouraged to DIY, so up our sleeves rolled! Bottle milk was provided on demand, and Baby still gets her daily bath at the nursery, but everything else was up to us — the feed sleep poop loop begins.

Day 4 is a rare “free day”. After blood test results came back looking good, the last of the drips were removed. We spent all day with Baby, a preview of sorts of a regular day with Baby.

Days 5 and 6 were lessons days. At 10am sharp, the nurse (and an interpreter) arrived for hour-long lessons. Day 5 was “discharge guidance”: what to do after discharging from the hospital and how to give Baby her weekly vitamin K dose. Day 6 was the “baby bathing guidance” class, where we gave Baby her daily bath that had been done by the nurses last few days.

Discharge

Discharge day came along with a sense of both anticipation and trepidation; happy to go home but yet knowing that we’ be on our own. The last checks on Mama and Baby were done to ensure they’re ready for discharge, prescriptions were filled, and a last tally done of necessary documents and forms.

The birth certificate had been given to us a few days back. And today the Mother and Baby handbook (母子手帳 boshi techo), which we had handed over to the hospital right as we were admitted, was returned to us, signifying that we were good to go. We were also given a bag of supplies for a few days — diapers, wipes and trash bags.

Home

After saying goodbyes to the nurses, home was a taxi ride away. Home, where Baby had lived her whole life except for the past 8 days, and which Baby was seeing and touching for the first time.

What a week it had been! A week that felt like a month. And now with Baby in arms and all hands on deck, it’s time for… the postpartum registrations at the ward office and immigration office!

Stray thoughts

The focus of the hospital stay seems to be on self-sufficiency. We left the hospital feeling a lot more confident to take care of baby basics.
The stay was incredibly hands-on. We expected 8 days of pure recovery except for the lessons, but that wasn’t the case. Even the lessons were conducted with Baby, not a dummy. We’d also roomed with Baby and were breastfeeding, bottle feeding, changing diapers and soothing tantrums from Day 3.
The nurses were unreservedly supportive and answered all our mundane questions, the most common of which was “X and Y happened, is that normal?”. They were always a button call away, and though they came to check on Mama and Baby every so often, they never insisted on taking over baby duties.
That said, it was not so much an ease-in as it was a ramp-up. Mama was essentially given 6 days to go from a state of being bedridden to being able to take care of self and Baby. Be mentally prepared to work hard at the hospital and not just sit back and relax!
Our hospital officially supported English, but not everyone is on the same level, and medical terms are difficult to translate by nature. Nurses were armed with an iPad translator, but knowing (or searching beforehand) common terms like “blood pressure” or “drip” in Japanese helped smooth the conversations.

The one thing we weren’t explicitly taught that we needed to know right after discharge was how to set up Baby’s sleeping environment. We decided to practise room-sharing, with Baby’s cot following safe sleep practices from this AAP resource: How to Keep Your Sleeping Baby Safe: AAP Policy Explained.

Childbirth Expenses

A brief breakdown of the cost of childbirth including pre-natal checks.

Childbirth

The entire childbirth cost about 681,000 yen. This is after the 500,000 yen lump-sum childbirth allowance. This covered the childbirth, c-section, and hospitalization for both Mama (8 days) and Baby (6 days).

Of the entire cost, 300,000 yen was for the c-section itself (which was considered an emergency c-section). Side note this was covered by National Health Insurance (NHI), so this amount represents the 30% NHI co-pay.

Pre-natal checks

The ward office gave coupons to subsidise certain checks:

14 coupons for pre-natal checks (worth 5,090 yen each). Each visit typically came up to 410 yen after the coupon. We received an ultrasound scan of Baby at most of these checks.
4 for detailed ultrasound checks (worth 10,440 yen each).
1 for a cervical cancer screening for Mama.
1 for a hearing test for Baby.

Unscheduled visits

We made a few unscheduled visits prior to birth, outside hospital hours. These were covered under NHI, so each visit was around 3,000 yen.

Offsetting childbirth expenses

Aside from the 500,000 yen childbirth allowance and coupons mentioned above, here were a few other schemes that helped reduce our childbirth expenses in Tokyo 23 wards:

A few checks out of the norm (eg, blood tests) was covered under NHI, as with prescriptions.
akachan-first: vouchers for use to purchase items from a catalogue: 50,000 yen at pregnancy, and another 100,000 yen at birth.
Cash allowance from my ward: one-time 50,000 yen cash by bank transfer.
Also from my ward: up to 6n subsidized stay at selected hospitals or postpartum centers (works out to each night stay costing 5,000 yen).
Subsidized hourly help (costing 300 yen an hour) up to 60 hours, usable for chores such as babysitting (or siblings-sitting) or picking children up from preschools, housecleaning, cooking, laundry, groceries shopping.
018 support: 5,000 yen monthly until the child turns 18.
Child allowance: 5,000 yen to 15,000 yen monthly depending on income, child’s age and number of children. From Oct 2024, the income limit is going to be removed, and the allowances will be increased to monthly “15,000 yen per child … up to the age of 2, and 10,000 yen per child from the age of 3 through high school age [ie, 18 years old]”
Children’s medical subsidy: free healthcare for the child until 18 years old (technically speaking, it pays for the NHI 30% co-pay).
Medical expenses deductions: The out-of-pocket medical costs above are eligible for medical expenses deductions, which reduces taxable income for this year. Given that the costs already exceeds 100,000 yen, this meant that all of our other out-of-pocket medical expenses for this entire year can be deducted too.