A few weeks ago after Ellie was born, I had the opportunity to talk to several different doctors, nurses, and translators through the process of getting Ellie’s heart checked out for her murmur. My interest was definitely sparked after my conversations, and ever since, I have been doing more reading on the differences between America and Japan in regards to birth and maternity care.
It’s funny how as an American, I thought that the entire world functioned the same way that we do.
I thought that epidurals and pain relief were available everywhere.
I thought all women and babies were released from the hospital only a few hours or days after birth.
I thought that a “support person” was encouraged in basically all delivery rooms, and that all women usually chose to have their husbands present.
I really never gave a second thought to how the rest of the world functioned in regards to maternity and newborn care, at least until I lived in a part of the “rest of the world.”
Sitting in the Japanese pediatric cardiologist’s office, I had a pretty cool discussion with our translator. She began to ask questions about our birth experience, and told us how things were different in Japan. We gave birth at an Americanized hospital, so though our daughter was born in Japan, I had a birth experience just like I would have in the states.
The conversation between her and me started with a question that she asked.
“Did you have an epidural?” She asked me kindly.
“Ohhh, yes. But it didn’t even work in time, unfortunately.” I replied, likely with wide eyes. After all, my birth experience was still very fresh on my mind as it had only been two days since I delivered Ellie.
“So you felt everything?” She questioned.
“That’s what women over here do- they don’t have epidurals!” She said as she smiled at my raised eyebrows.
“You mean they don’t have pain relief?” I asked with what I’m sure was even wider eyes.
“Nope, not at all.”
I had heard this rumor through the grapevine as I neared the end of my pregnancy, but wasn’t sure if it was totally true. So after coming home from Ellie’s appointment, I did some reading on the cultural aspects of birth in Japan. From what I read, Japan is slowly becoming more like America in the practices they have regarding birth, but there are still some very drastic differences. So here are 5 facts that I found fun and interesting about the differences between birthing and recovering in Japan vs. America.
1. Pain relief isn’t a thing in Japanese births.
As I said, many of my American friends told me that the Japanese do not readily use pain relief during birth, and the vast majority of information I read states the same. Most state that even the use of ibuprofen is often looked down upon. Traditional Buddhist beliefs within Japan state that women should receive the full experience of childbirth, pain and all, due to a few different factors. This is said to prepare the mom for what motherhood holds, and is supposed to help her bond better with her baby. Because traditional Japanese views regard patience and suffering as important life lessons, receiving a medicated birth is often looked down upon, especially by older generations. Pain is often said to be a major life “experience” and something that is to be felt, not masked.
2. Japanese insurance only provides a “lump sum” payment for the coverage of your delivery.
This payment is said by multiple sources that I found to be 420,000 yen, or approximately $4,000 USD. According to the Japan Times, the average cost of an uncomplicated delivery is around 500,000 yen, or a little less than $5,000 USD. Often though, uncomplicated births are completely covered by the lump sum allowance.
Typically women are expected to pay up front for their deliveries, and will be reimbursed at a later date by this lump sum. If a delivery is complicated, or a C-Section takes place, deliveries may cost thousands of dollars more, and the woman/her family are expected to foot the total bill.
Women are first required to report their pregnancy to their city upon its confirmation. They will then be provided with a handbook on their maternity and new baby’s care. Many hospital sites that I visited stated that all checkups must be paid for out of pocket, but that your city may have coupons covering the vast majority of an office’s services. These coupons can be found within your handbook.
In addition, if an epidural is asked for (this only happens in about 5% of all births) the cost of said epidural is usually completely uncovered by insurance. From the sources I read it is likely that an epidural will cost at least 100,000 yen, or a little less than $1,000 USD. Oddly enough though, many sources state that newborn and child care is often completely free and covered until the child reaches the age of 15.
3. Fathers are not often present in the delivery room.
At both hospitals we have delivered at, it was expected for Drew to be my “support person,” and he was actually involved in several aspects of my labor such as holding my legs during pushing, cutting our babies’ cords, or verbally encouraging me during contractions.
Many accounts of birth stories in Japan that I read stated that women often do not have their husbands in the delivery room with them at all, and that they were sometimes even encouraged to face the pain of birth bravely, and alone. Furthermore, women will often choose to deliver their babies in their hometowns, and often their husbands/the fathers will not travel with them for a variety of reasons. Many women leave two to three months before they are due, and return home months later with their newborn. This is not a strange occurrence, and most hospitals will not even blink at a woman arriving to deliver completely alone.
4. Babies typically do not stay in your room, they stay in the nursery.
The concept of “rooming in” with our baby was also a very startling concept to our translator. She stated that she thought that would be incredibly tiring for the mother, who had just given birth.
During my research, many sources stated that mothers are immediately encouraged to nurse their babies- sometimes for up to two hours straight after delivering- but as soon as the nursing session was over, most infants were required to stay in a nursery for the first three days of their life.
I have now delivered at two hospitals who do “total rooming in” meaning my babies have been with me from the second I gave birth to them until the second we left the hospital. Any procedure, any need to take the baby from the room- I have been fully allowed to come along for. In general, most sources stated that mothers and babies are almost fully separated for the first three days of life, with visits being allowed for nursing the newborn.
This could also be due to the sharing of recovery rooms, sometimes up to 4-5 patients per room, which seems to be a fairly normal practice in Japan. The Japanese view privacy and remaining polite very highly, so the absence of newborns from shared recovery rooms makes sense from a “let’s just keep to ourselves” standpoint. No crying babies means everyone in that room is able to sleep.
5. Postpartum care extends much longer than most American hospitals encourage or allow.
According to our translator, the minimum hospital stay for mothers after giving birth is one week from the time of delivery. She was actually absolutely shocked when we said that Ellie was only two days old and that I was discharged around 24 hours after giving birth. Our Ellie was in the hospital for a bit longer due to her heart, but I as her mother was completely released and allowed to simply stay in the room with her until she was as well.
The Japan times states that from their survey, at least 60 percent of women asked stated that their hospital stay was from five to eight days. Even when a woman gives birth at a birthing center or at home with a midwife, the typical range of care extends around five days. This seems to not be viewed as a sad or lazy thing, but rather a privilege that allows the mother to sleep, recover, and heal. During this time, mothers use the advice and help of doctors and nurses, and learn how to properly care for their infants.
Living overseas has broadly expanded my narrow mind in regards to so many aspects of my way of life, and the way the Japanese view the birthing process was seriously eye opening to me. It is funny how stepping foot out of America makes you realize how culturally different the rest of the world is from your tiny little “Americanized box.” If you have time some day, I encourage you to pick another country, and read about their birthing practices. Some of the things you will read will absolutely baffle you, both about the other country, and about how we do things in the United States. In the end, babies will be born every day all over the world. The beauty of birth absolutely remains the same across the world, the process may just look a little different from various sets of eyes.
Citations from the reading/research I did:
“No Pain, No Gain. Maternity Culture in Japan” The Economist. October 20, 2016. https://www.economist.com/asia/2016/10/20/no-pain-no-gain
“Make Giving Birth Easier in Japan” Japan Times. https://www.japantimes.co.jp/opinion/2017/12/03/commentary/japan-commentary/make-giving-birth-easier-japan/#.W4ke82QzaAw
“Pregnancy and Birth in Japan” Japan Times. https://www.japantimes.co.jp/community/2015/06/03/issues/pregnancy-birth-japan-cultural-primer-foreign-mothers/#.W55icSN97-k
“Prenatal Care” Japan Healthcare Info. http://japanhealthinfo.com/pregnancy-and-childbirth/prenatal-care/
“Giving Birth in Japan” RCM. https://www.rcm.org.uk/news-views-and-analysis/analysis/giving-birth-in-japan
“Giving Birth In Japan” Japan Window. http://japanwindow.com/giving-birth-in-japan/