Even though not all of us have had the experience of (or indeed, possess the required biology for) bringing another human into this world, it is easy to imagine that this is one of the most exciting (look at these cute baby boots! ), amazing (this is my child O_o ), uncomfortable (I’m beached >.< ) and terrifying (I have to push a human out of where?! ) events that anyone can go through. Giving birth in a foreign country takes that experience to a whole new level.
This post was brought to you by my incredibly brave friend who went through all that follows, told me about it over multiple iced teas, tolerated me spitting out said iced tea as I rolled around on the floor with laugher and then ultimately, turning her hard earned experiences into a post to allow others to do that same (and hopefully provide some information along the way).
With that, we present: 10 facts about giving birth in Japan.
(1) The 10 Month Pregnancy
Japan has an obsession with order: citizens know how to queue better than the Brits when waiting for the bus, each day is dedicated to a different type of garbage and there is a form for everything. In keeping with this, your pregnancy will be a tidy ten months, not nine. This actually isn’t due to Japanese women crossing their legs to ensure they hit the required perfect figure, but because the months are counted as exactly 28 days. Since actual months vary from 28 to 31 days, nine calendar months is equal to ten 28 day months.
In agreement with the overall tidiness off the country, this means there is no debate over when each pregnancy trimester begins. The first trimester (ninshin shoki) lasts for the first four months, the second trimester (ninshin chuuki) runs from month five to month seven and the third trimester (ninshin kouki) is the eighth to the tenth. The only immediate catch to this is that it is difficult to answer the demanding questions of your mother-in-law as to how far along you are by looking at the date on your computer.
(2) Baby On Board
Moving on with the theme of order, newly expectant mothers in Japan are issued with a maternal and child health handbook. This information pack explains (in Japanese) the pre-natal checkups and classes you can attend. You also get a cute badge to display that will hopefully ensure you are offered a seat on a packed subway car before it reaches the stage where it is obvious someone either moves, or you’re giving birth on their foot. The pre-natal checkups begin as early as five weeks, with about one ultrasound a month after a heartbeat has been confirmed. After the six month mark, this increases to one ultrasound every two weeks. Parenting classes run from around the beginning of the third trimester (month eight in your tidy ten month planner) and cover pregnancy exercise and nutrition, labour, delivery, breast feeding and infant care.
(3) Dealing With The Language Barrier
Which brings us to the next obvious question: what do you do if you don’t speak Japanese? While not impossible to find a doctor who speaks English, it is more typical to find that medical specialists are reluctant to operate entirely without Japanese. Within the wider sphere of health care personal, there is almost no support for non-Japanese speakers. In my friend’s case, her husband was bilingual and able to act as translator for most of the time. However, there were occasions when work commitments prevented him from joining his wife for the events she had to attend. At these times, my friend called upon a free translator service in the city, where volunteers would accompany foreigners at times when they needed help with language. This proved to be an invaluable asset, with the volunteers being both friendly and having fluent English.
The availability of a doctor who speaks your language may be one reason to select a particular hospital to monitor your pregnancy. However, there are other reason to select your hospital carefully, one of which is…
(4) Pain Relief
… not all hospitals offer epidurals or other types of pain-relieving drugs. Either through teeth-gritting bravery or a feeling that intense and prolonged pain takes you closer to the divine (when more likely you will wish you were headed in that direction), pain relief during labour is rarely offered in Japanese hospitals. Therefore, should you feel that a completely natural birth involves too much screaming, a little planning and research is required.
Hospitals that do offer epidurals require you to announce your desire in advance and likely need to have you on a fixed schedule, meaning that your labour must be induced. Since babies are not known for their time keeping skills, my friend inquired what would happen if she went into a natural labour before her inducement date.
That would be fine –she was assured– if the labour was early she could still have an epidural… providing it was on a working day between 9 am and 5 pm.
With an anaesthetist not being on call, epidurals could not be offered outside working hours. When my friend expressed anxiety at this rather limited schedule, her male doctor tried to reassure her that a natural birth would not be that painful. There are perhaps times for such advice, but I was assured month eight is not one of them.
(5) The Disembodied Doctor
“How many people were in the examination room with you?” I asked my friend after her first routine examination.
“One,” she replied. “Probably.”
Probably? During this rather personal investigation, it is normal for a curtain to be drawn around the expectant mother’s abdomen which obscures her view of anything below that area, including the doctor himself. This actually reminded me of a trip to a salon, where a paper towel is often placed over the customer’s face while the hair is washed. I was fortunate enough to have a hair dresser who had previously worked abroad to explain this to me in advance, else I might have felt slightly insulted that my features needed to be covered!
In both the case of the salon and the medical examination, this step is done for the comfort of the patient. In both the case of the salon and the medical examination, it can be rather disconcerting if you’re not expecting it.
“I only spoke with the doctor,” my friend described. “But there could have been a whole crowd of people there!”
(6) Old Wives Tales
As the third trimester rolls in, parenting classes begin. As well as the information listed in point (2), these groups are a chance to meet other expectant mothers who are likely to share some of your doubts and concerns. Most of the information given is firmly established advice but in a few cases, the particulars point towards local hearsay:
Ankles –my friend was firmly told– must be kept warm. If it is cold outside, or you are in an air-conditioned room, then you must wear socks to cover your ankles. Cold ankles lead to a difficult labour.
(7) The Vending Machine Of Forbidden Fruit
With the due date now looming only a few months away (although hopefully within work hours), my friend was given the opportunity to visit the maternity ward where she would actually be giving birth. The tour began in the hallway where two vending machines stood side by side. The one of the left sold juice while the one of the right dispensed coke.
“This vending machine you may use at any time,” the lady giving the tour said, pointing to the left-hand machine. “This one…,” she indicated the machine on the right, “You must not use.”
No coke products for new mothers, even though there was a machine right there. If the Biblical sin of Eve partaking of the forbidden fruit truly led to pain in childbirth, then the hospital was offering a modern day re-enactment of Eve’s choice to all new mothers.
(8) Please Bring Your Own Towels
The maternity hospital is solely focussed on the medical well-being of the mother and her new child, leaving all other services to be provided by the mother herself. This extends to towels, cups, almost all toiletries and sometimes even bedding.
Expectant mothers coming into the hospital must bring all of the above along with a straw, fruit knife, cup, towels and a baby wipe container (although not the wipes themselves). Hospital pyjamas may be rented for 70 yen per day, so long as you wash them yourself in the available machines.
I confess a hospital not always providing sheets was a particular surprise, since I would have thought it would be preferable to ensure all the beds were squeaky clean. Even with laundry hassles aside, sleeping on institutionally regularly changed sheets after a physical ordeal would have my vote for both comfort and hygiene.
Each bed in the four women rooms has its own console containing a small fridge and a TV screen. Both of these can be used via a card purchased from the hospital. Headphones –unsurprisingly– must be brought from home.
(9) Protecting The Innocents
Like many women, my friend was keen for her husband to be in the delivery room alongside her. Apart from the added language translation provision, he also wished to see the arrival of his first child and probably deserved to share a healthy portion of the suffering. The presence of the father is perfectly acceptable for the maternity hospital. He attends a class describing what he must do and then is free to join his wife by her head.
Her head and not any lower.
The opinion in Japan is that if the father moves away from his wife’s top side and sees the actual birth, he might be scared. My friend thought little of this view, either believing that her husband could handle the experience or that he deserved to be traumatised given what she is going through.
On a similar note, the new mother is advised not to scream during labor for the baby’s comfort. It’s hard to have a strong opinion on this subject, since I don’t recall my own birth. However, my gut feeling is I probably had other things on my mind than my mother’s distant vocalisations of pain. If I didn’t …. well, it wouldn’t be the first time I would make her cry out.
(10) Baby Bonding Time
Assuming the birth goes smoothly, the new mother stays in the maternity hospital washing her pyjamas for five days. If a cesarean is performed, this can be extended for up to two weeks. Visiting hours start at 1 pm to 8 pm daily and include not only doting extended family members, but also the father. Limiting the time the father spends with his new family was also a little surprising, although it may prove that seven hours a day is more than enough for everyone involved.
When he visits the father does have one other restriction placed on him: he is not allowed to retrieve his new son or daughter from the nursery himself. While this might stem from security concerns, I prefer to think that that if the father isn’t trusted to watch the birth, no one is prepared to hand him an infant.
In every way that is truly important, my friend’s experience in Japan has been positive. The quality of the care and the support offered through the hospital and classes has been excellent. Yet as with all cultural adventures, the road is littered with surprises. Perhaps this can be considered excellent preparation for the road to come.