For expats living in Japan, aside from the realization that you are expecting, the fear may be compounded even further by having to figure out prenatal care, doctors, official registration and the like in a foreign language and on foreign grounds.

The first thing you have to do is confirm your pregnancy. If you suspect you may be pregnant, home pregnancy tests (ninshin kensayaku, 妊娠検査薬) can typically be found at any drugstore for a few hundred yen.

To confirm your pregnancy head to your local hospital or ladies’ clinic for a checkup. Your doctor will confirm your pregnancy via transvaginal ultrasound. Once your doctor spies a heartbeat, you will be issued with a certificate declaring the pregnancy confirmed (ninshin todoke, 妊娠届).

After confirmation, take the ninshin todoke and your foreign residence card to your local health center to register the pregnancy. Upon registration you will receive a pregnancy goodie bag which includes:

  • Mother and child health handbook, boshi kenkou techou (母子健康手帳)
  • Pregnancy health checkup coupon book,ninshin kenkou shinsa jushin hyou (妊娠健康診査受診票)
  • Maternity mark, or pregnancy badge, mataniti maaku (マタニティーマーク)
  • Plus lots of booklets and other goodies

Prenatal checkups

Your prenatal checkup schedule will look something like this:

  • First and third trimesters—appointments every other week
  • Second trimester—monthly appointments
  • Beyond 40 weeks/10 months—appointments every two days

This corresponds to around 15 checkups total — more compared to that in other countries. Ultrasounds are performed each time. While it’s nice to have the constant reassurance, it also adds to the cost and can be inconvenient if you are working. If you find it too much, you may be able to request to space the appointments out more.

Maternity leave and notifying your workplace

According to Japan’s Labor Standards Act, employers are required to allow mothers maternity leave from six weeks (for one baby and from 14 weeks for twins and more) prior to the due date until eight weeks after delivery.

In addition, the Act on Childcare Leave provides for childcare leave until the child turns one (and until the child reaches one year and six months of age, if the parents take turns). During this time, labor and social insurance will cover up to 66 percent of the mother’s base salary, but every company will have their own regulations, so please confirm all details with your employer.

Cost of giving birth in Japan

It is expensive to give birth in Japan, but much of these costs will later be reimbursed through your health insurance in the form of a childbirth and childcare lump-sum grant of up to ¥420,000, payable per child to help families with the costs of the birth.

The basic birth fee for an uncomplicated natural birth, including a five-day stay (which is typical) ranges between ¥500,000 to ¥700,000 on average. This fee includes the daily hospital-stay rate with three meals a day. Many hospitals provide the option for a private room, the cost of which vary depending on whether you opt for one with a bathroom, couch, TV and other equipment.

The extra daily cost for a private room can range from ¥10,000 to ¥70,000 and beyond. Medical expenses (including birth costs and prenatal care) meeting a certain threshold (usually, a minimum of ¥100,000) over the tax year are able to be deducted from your income tax liability. As such, you will likely be able to receive a tax rebate by filing a return (kakutei shinkoku, 確定申告) by March 15th of the following year. For more information, please consult your local municipality.