First Steps to Take If You’re Pregnant in Japan

For a foreign woman living in Japan, getting pregnant can add on a whole new layer of stress and uncertainty to an already challenging life. Not only do you have to deal with the language barrier and cultural differences, but you also lack the support network you’d get from family, friends, and your community back home.

I sat at the kitchen table bawling my eyes out the night that I found out I was pregnant. My husband was excited and overjoyed with the news, but nothing he said seemed to comfort or reassure me that everything would be okay. Sure, I wanted children, but I had no idea what the next 9 months had in store for me. We had just moved recently, and I was in the process of quitting my old job and starting a new one.

• How should I tell my boss that I’m pregnant?
• Would my new company fire me? Could they?
• How were we going to save enough money after just moving?

These fears compounded the intense feelings I was going through as I stared down at the positive pregnancy test sitting on the table. Fast forward to now, I’m about one month away from having my baby, and it’s safe to say that everything will be okay.

I put together this guide to help other women that may be pregnant in Japan and feeling the same mix of emotions that I did in the beginning. If you have any questions after reading it, just leave a comment and I will be sure to respond to you and help the best that I can.

I hope this guide will assuage any worries you may have and make your pregnancy experience in Japan a more exciting one!

1. Take a Pregnancy Test at Home

If you’ve missed your period and you’re wondering if you might be pregnant, the first step should be to take a pregnancy test at home. This might seem like a no-brainer, but the hard part is actually finding them. You would think that in the land of 24-hour convenience stores on every corner that you could find one there. After all, they sell condoms and medicines for a drunken night out. Alas, I have yet to come across a convenience store that actually stocks any.

Pregnancy tests in Japan can be found at most drugstores and major department stores that have a pharmacy. Here is a list of some common chains that are popular throughout the country.

Where to buy pregnancy tests in Japan:

1. HAC
2. Matsumoto Kiyoshi
3. CREATE
4. AEON
5. Ito Yokado
6. Welcia
7. FitCare DEPOT
8. Don Quijote

Pregnancy tests can usually be found in the same section as condoms. I spent a lot of time searching the aisles where the feminine hygiene products were located thinking they would be there. Instead, I found some across from the painkillers and medicine.

Most pregnancy tests in Japan cost between 400 to 2500 yen. The range in price depends on how many tests are inside the box, and whether or not they’re digital. If you and your partner are trying for a baby it might be cheaper to buy a larger box.

If you have trouble finding the pregnancy tests while in the store, you can ask one of the clerks:

Where are the pregnancy tests? 妊娠検査薬はどこですか？(Ninshin kensa yaku wa doko desu ka?)

OR

Do you have any pregnancy tests? 妊娠検査薬ありますか？ (Ninshin kensa yaku arimasu ka?)

Be careful not to confuse the ovulation tests with the pregnancy tests though. Ovulation tests are called 排卵日予測検査薬 (はいらんびよそくけんさやく).

So, now that you know where to buy pregnancy tests, it’s time to take one and wait nervously for the indicator to tell you whether or not you’re expecting a little one!

2. Visit Your Doctor for Confirmation

So, what should you do if the at-home pregnancy test says you’re pregnant? Chances are it’s pretty accurate, and you are indeed pregnant if it says so. However, it’s still a good idea to book an appointment with your doctor and get confirmation.

Depending on where you live in Japan, you may need to submit official documentation announcing your pregnancy to your local ward office. There are many benefits to doing this that I’ll explain in a bit. The confirmation paper that you’ll receive from your physician will be one of several documents that you should take with you.

I visited the Bluff Medical Clinic in Yokohama to have a blood test done to confirm my pregnancy. It’s great because all of the doctors and staff speak English. They accept National Health Insurance, Social Health Insurance, and others. The best part is that you can see what time slots are available and can book your appointment online at any time.

The doctor gave me the option to receive my blood test results at my next visit, or by email. I opted for email to save myself travel time and expenses. I had my appointment on February 12th, and received my results by the next day! He sent a PDF attachment that I was able to print out and take with me to submit to my local ward office.

As I previously mentioned though, you may be able to skip this step depending on the requirements for your ward. Healthcare in Japan is really cheap though. I only spent about 1500 yen ($15) to get the blood test done, so I recommend getting it just in case.

3. Register Your Pregnancy at Your Local Ward Office

After you’ve confirmed your pregnancy with your doctor, your next step is to head to your local ward office. It’s important to get this done as soon as possible, because you’ll receive a maternity package that will be very helpful (and sometimes required) throughout your pregnancy.

What to Take with You to the Ward Office:

• Residence card
• Health insurance card
• ‘My Number’ card
• Pregnancy confirmation from your doctor (optional)

If you’re unsure of where your ward office is located you can check the Tokyo Ward Office and Yokohama Ward Office listings.

Once you arrive at the ward office, you should head towards the 母子保健系 (ぼしほけんけい) section or something similar. Your partner doesn’t need to be with you when you go, but it’ll be much easier if you’re together, because the registration process requires information from both parents.

Luckily, my ward office was able to provide the necessary registration forms for me in English. If your ward only has documentation available in Japanese, you can use the picture above as a reference for some of the information you may be required to fill.

After completing all of the necessary paperwork, you’ll receive a package containing everything you’ll need to take with you to hospital and dental visits. You’ll also receive information on local support groups in your community.

What’s Included in Your Maternity Package:

• Maternity handbook
• Maternity badge
• Payment vouchers
• List of local hospitals, clinics, and dental offices
• Pregnancy and childcare support information
• Interview opportunities

You’ll need to take your maternity handbook and vouchers with you to every hospital visit, so be sure to hang onto them tight.

Pregnancy related costs aren’t generally covered by health insurance in Japan, because it’s not considered and ailment or disease. This means that you’ll have to pay for everything out of pocket, and will be reimbursed at a later date by the government.

Be careful not to lose your copies of the completed vouchers! If there’s any kind of error or mistake, they’re your only proof of when and where you received treatment. You’re required to submit a voucher at each hospital visit if you want to get any of the money back.

4. Choose a Convenient Location for Your Prenatal Tests

The hospital or clinic you choose to have your prenatal tests done doesn’t have to be the same place where you’ll give birth.

I started out by visiting a major hospital in my area for the first 18 weeks or so of my pregnancy. It was a really big hassle, because they didn’t take appointments on weekends, so I had to request time off from work.

I highly recommend finding a good “Ladies Clinic” in your area. The wait times are usually shorter, and they generally have a more relaxing atmosphere. Most of the doctors and staff are female, and offer a full range of gynecological services.

Once you reach the third trimester and get closer to your delivery date, you request a “shokai letter” from the clinic doctors to take with you to the hospital where you’ll deliver your baby. This introduction letter will include information regarding all of the testing you went through, and the results.

READ: What to Pack in Your Japanese Maternity Hospital Bag

5. Decide If You Want a Medicated or Non-medicated Birth

One of the biggest decisions you’ll need to make during your pregnancy is whether you’ll want an epidural as an option or not. Most hospitals in Japan don’t offer them for normal vaginal births. The ones that do usually cost more money and are fully booked well in advance. This means you really have to decide early on.

If you know for sure you want an epidural or you’re at least considering it, reserve a spot at a hospital that offers it during your first trimester.

There might not be any available bookings if you wait later than that.

When you visit the hospital, the doctors will want to know where you’ll have your prenatal tests done. Also, they’ll ask you to write down any special requests you may have during the delivery. Most will give you options for postpartum care such as having a shared or private room with a difference in cost.

READ: My Labor and Delivery Story in Japan

Think about your budget and which delivery plan will be best for your and your family.

6. Start Saving Your Money

Having a baby in Japan is expensive, but not nearly as much as in the US and other parts of the west. I mentioned before that you’ll get vouchers in your maternity package to reimburse some of the pregnancy related costs. You’ll still have to pay for everything up front though, so take a good hard look at your savings and expenses.

My husband and I opted for a hospital that offers an epidural and private room for mothers. A 5-day stay costs around 600,000 yen ($6000) that we had to pay in installments. Although we had all of the money set aside, they asked us to pay it in 3 payments. Every hospital is different though.

If you choose a hospital that doesn’t guarantee an epidural, you could expect to spend around 500,000 yen ($5000). You could get by with paying even less if you’re willing to share a room with other mothers. The hospital you choose will give you a list of all the fees it charges during your first visit.

A good rule of thumb is to save between 400,000 to 600,000 yen for delivering your baby and providing postpartum care for up to one week.

Definitely put together a baby registry to share with your family, friends, and coworkers. Pick reasonably priced items so that others can help you furnish and stock up your baby room as much as possible without breaking the bank.

One little known fact is that many Japanese companies give gift money to long-term employees that have a baby. If you’ve been working at your job for more than a year, it’s something to look into. However, before requesting the gift money, you’ll have to plan how and when to tell your company you’re pregnant!

7. Tell Your Japanese Company You’re Pregnant

This was perhaps the hardest and most stressful step for me during my pregnancy. I found out that I was pregnant after I had accepted a position with a new company at a university, and was set to begin training.

Luckily, I had almost a full month off between when my job at the eikaiwa ended, and my university teaching position began. I spent the entire time in bed with debilitating morning sickness, and dread that I would be immediately fired.

Questions I asked myself were:

1. Can my Japanese company fire me for being pregnant?
2. Will my contract not be renewed?
3. Will I still receive a salary while I’m on maternity leave?
4. How much time am I allowed to take off to care for my child?
5. What will happen if I can’t perform the same tasks as before I was pregnant?

If you’re nervous like I was, I hope there’s some comfort in knowing that you can’t be fired for being pregnant in Japan.

Your employer might not be happy with you, but they’d be in deep legal trouble for firing you after finding out you’re pregnant.

Thankfully, my supervisor was very supportive and encouraging when I explained everything to her. I did end up crying mostly due to the hormones, but also from the stress that had built up to that moment.

What Your Japanese Company Will Need to Know

Your company will need to know when your baby is due in order to register for your maternity leave. This is something that all pregnant women are eligible for regardless of if they’re a full-time or part-time employee. It also doesn’t matter how long you’ve been with the company.

Laws regarding maternity leave are frequently updated and being changed. For me, I am able to take off from 6 weeks prior to my due date until 8 weeks after the baby is born. I also qualify for 60% of my salary that will be paid for by the government for the duration.

If you’ve been with your Japanese company for more than a year, you may also be eligible for childcare leave once the maternity leave ends. These are two separate benefits that shouldn’t be confused with one another.

Childcare leave can last for up to a year or more if your company promises to rehire you after it’s over. You’ll receive 60% of your salary for its duration as long as you meet the qualifications. I’ll go into more detail about that later.

Aside from maternity and childcare leave, you’ll also need to discuss your schedule for prenatal appointments. Depending on your hospital or clinic, you may need to take time off work to attend all of the required examinations.

Lastly, you should discuss any necessary changes to your work responsibilities in order to accommodate your pregnancy. For example, you may no longer be able to sit down on the floor and get up quickly if you teach small children. Or, you may need to take more frequent restroom breaks.

One of my university courses that I taught was on the third floor of an old building without an elevator. I always had to stop walking halfway up while carrying my heavy teaching materials in addition to my growing baby bump. My company and university were kind enough to reassign my class to a room in a different building with escalators.

As your pregnancy becomes more physically challenging for you, don’t be afraid to ask your company to accommodate you!

READ: How to Breastfeed Easier in Japan

8. Learn What Japanese Foods Are Safe to Eat While Pregnant

Aside from all the doctor visits and examinations, your next big concern will probably be what to eat. Overall, the food in Japan is quite healthy and safe. You may not have much of an appetite during your first trimester, but it’ll quickly ramp up once the nausea wears off.

I found myself surviving off of salty chips, crackers, and rice during my first 12 weeks or so of pregnancy. The smell of anything else completely turned me away and seemed downright repulsive. I couldn’t spend a whole 40 weeks on such a diet though.

According to the American Pregnancy Association here are some of the foods to avoid if you’re pregnant:

1. Raw or under-cooked meat
2. Raw or under-cooked poultry
3. Raw or under-cooked eggs
4. Raw or under-cooked fish
5. High mercury fish
6. Raw sprouts (Ex. bean sprouts)
7. Cheeses with mold (Ex. blue cheese, camembert, etc.)

The American Pregnancy Association website has a more thorough list of what foods you should avoid eating while pregnant.

Fermented foods such as natto and miso are great for you and the baby. Japan also has a huge assortment of pickled vegetables to choose from that are packed with nutrients. Japanese doctors are very critical of your weight during pregnancy and will check it every visit.

So, fill up on as many veggies as possible to satiate your hunger while keeping your weight gain under control.

I hope that you found this post helpful and that it’ll make your pregnancy a bit easier in Japan! If there is any information I left out or you have some questions, leave a comment below and I’ll definitely respond to you! Cheers and congratulations on your pregnancy!

READ: How to Ride Japanese Buses With a Baby