Labor/Birth,  Pregnancy,  Second Trimester,  Third Trimester

Birth Preparation Class in Japan

My husband and I started off our 10-day Golden Week this year by attending a 3-hour 教育出産準備クラス (Educational Birth Preparation Class), which was provided by our clinic. We had to sign up beforehand and had completely forgotten about it until we wanted to discuss the birth plan with the clinic (clearly we’re on top of this “parents-to-be” thing). This class was only available for women who were at least 28 weeks along in their pregnancy and nothing was available except for the first day of Golden Week, and as we decided not to travel anywhere, we really lucked out!

The class cost 2000 yen but if the partner wanted to attend, it would be just 3000 yen for two. The class size was quite small with just 7 couples in attendance. We sat in a circle on some cushions on the floor, which was uncomfortable at first but served a purpose later. We also received a small bag full of samples such as powdered formula and baby skincare products (pictured above).

Self-Introduction

The class began with a self-introduction in which we went around the room and introduced ourselves (this was in Japanese but is something I dislike doing in any language). We also had to state our due date and one thing we were worried about or struggling with during our pregnancy. I may have mentioned that as a Canadian, I was pretty worried about giving birth in Japan.

Interestingly, a lot of women had the same concerns, primarily that our left leg hurt! It turned out that as the uterus tends to be on the right side of the body, the left leg was working extra hard to make up for the imbalance. Some women also mentioned that they had trouble sleeping and we learned that the closer we get to the due date, the less we’re able to sleep. It’s almost like our bodies are preparing us for the sleeplessness that comes when we have a child! Many of the spouses expressed not knowing what to do to support their spouse when in pain, so later on they learned some massage techniques to help us mamas out.

Nearing the Due Date

We received a brief explanation accompanied by a projected illustration of how our bodies will change closer to the due date. Naturally, as the baby becomes bigger and is ready to be born, our organs become more squished and the baby’s head is right against our bladder, making us want to go to the bathroom much more often. (As I’m already going once an hour, I can only imagine what that will be like!)

After that, we learned about signs that indicate that we may need to visit the clinic (whether or not the baby is coming), such as bleeding (おしるし), water breaking (破水 or はすい), and contractions (陣痛 or じんつう) that are 7 to 8 minutes apart. The basics. Once any of those things happen, we were advised to call the clinic.

Childbirth

Here we did a little exercise where we worked with the couple next to us to determine the order of events that lead up to a baby being born and the hours after. We arranged about 30 cards that were labeled things like “going to the washroom”, “how much longer”, “water broke”, “take a bath”, “walk around”, “kangaroo care”, and surprisingly (perhaps reassuringly), “laugh”.

It was interesting to learn the actual order but I somewhat wished they had put it on a screen or gave us a handout because there were so many things that I find it hard to remember. I found it a bit surprising that we were encouraged to take a hot bath before coming to the hospital as it would relax our body and make it easier to give birth. We were also told to make sure not to have any cold drinks because it would hinder labor.

One thing I liked about this clinic is that it encourages skin-to-skin bonding right after the baby is born. We can decide whether or not to clean the baby up and then get to bond with the baby on our breast and feed the baby right away for the next hour or so. This is known as “kangaroo care.” I’m really excited for this – after feeling this baby growing and moving inside of me for so long, I want to meet her and get to know her so badly!

Clinic Stay

When arriving at the clinic, we would be provided with a rather large bag containing things such as a robe, special sanitary pads, and two pairs of underwear. However, we would need to bring some things of our own:

  • the mother and child handbook (of course!)
  • a 骨盤(こつばん)ベルト (an abdominal or postpartum belt)
  • a pair or two of special underwear that opens from the bottom
  • slippers
  • pajamas that open easily from the front (for breastfeeding)

❀Read: Hospital Bag in Japan Checklist: What to Pack❀

In a July 2019 baby forum I’m a part of, one mom was asking whether women wear bras or underwear during labor. I think every clinic (and country) is different but at my clinic, we change into the hospital provided underwear and robe when we arrive at the clinic – no bra. I didn’t ask this (I’m a little too embarrassed) but I do wonder whether I’ll be completely naked while giving birth, if I’ll only be in the robe or if I’ll be given some other type of clothing to change into. I’m not sure whether I’ll even care!

We also received a schedule for our hospital stay. As a very independent-oriented North American, I cringed a bit when I saw it.

7:00 AM: Time to wake up and get ready!
7:30 AM: Breakfast
11:45 AM: Lunch
12:30 PM~: Visiting hours start
17:45 PM: Dinner
~20:30 PM: Visiting hours end
21:00 PM: Bedtime

Thankfully, we don’t have to follow the schedule completely if we don’t want to because I feel like the last thing I’d want to do while recovering from birth is eat breakfast at 7:30 AM (I hardly eat breakfast, and when I do it’s a granola bar at 10:00 AM while working) in a cafeteria with a bunch of women I don’t really know who are also probably also in pain and exhausted.

Unfortunately, visiting hours apply to the spouse as well; however, there is an option for your spouse to stay overnight in a guest bed in your room for 5000 yen per night. My husband is planning on doing that and going home for a bit to do my laundry and take care of our rabbit.

If I don’t have a C-section, my hospital stay (as with most postpartum hospital stays in Japan) will be 4 days and 5 nights and consist of the following:

Day 1

  • Weighing mom and baby
  • Changing baby’s clothes
  • Shower for mom (if she’s feeling well enough)
  • Medical examination of mom

Day 2

  • Full body massage

Day 3

  • Checkup for mom (blood pressure, blood test, urine test)
  • Discharge examination

Day 4

  • Checkup for baby
  • Hospital bill payment

For those who have a C-section, their hospital stay is a bit longer at 7 days and 8 nights. The schedule consists of a few more checkups and care to help with mom’s recovery. (Update: I ended up having a C-section! Click here to read my birth story.)

Delivery and Recovery Room Visit

Lastly, we visited the delivery and recovery rooms. There is only one delivery room with two beds, a futon bed on raised tatami for laboring (which is going to be interesting, I never imagined in my life I would be experiencing childbirth on futon) and a more western-style delivery bed. The nurses put on an amusing show where one of them pretended to be a laboring woman and went through the process of giving birth. I’ve always heard that women in Japan should be quiet or strong while giving birth so it was nice to see her pretending to be in pain and not holding anything back. We also saw a newborn baby who was brought over from the next room. It’s so hard to believe I’m going to be delivering a baby around that size in about 5 weeks!

Overall, I felt very reassured seeing the delivery room, although I do wonder what would happen if two women end up going into labor at the same time. The clinic said it has never happened, so fingers crossed it won’t in my case either because I don’t think I can have a baby with someone going through the same thing next to me. I’m a pretty private person and giving birth is probably going to be the most life-changing moment of my life, so I don’t really want to be distracted by someone else (who’s not a medical professional) during this time.

I also met a nurse who can speak English. Although I have no trouble conversing in Japanese and communicate with my coworkers, friends and husband’s family only in Japanese, I felt that giving birth would be a life event where I would feel most comfortable speaking in English. The nurse completely agreed and said there were many foreign moms who are fluent in Japanese but preferred to communicate in English while giving birth.

The recovery rooms were actually not on the itinerary but my husband and I asked to see them. There were three private rooms and one large shared room with four beds. The private rooms generally consisted of a single bed, a tiny cot for the baby, a small television, a window, a shower room, bathroom and in some, a couch and table for visitors. My husband and I knew from the beginning that we wanted a private room, so I’m hoping we’ll be able to get the biggest room (although it’s first-come-first-served… or first-baby-first-served?). The private rooms are also more expensive than the shared room and the largest room carries the higher price-tag, and given how expensive it is to have a baby in Tokyo already (compared to other cities and prefectures), hopefully we will have a good chance of snagging the room. As an aside, the Canadian in me is miffed about the cost but it does seem like the quality of care and the length of time spent in the hospital does offset this. (Update: The cost was much lower than I anticipated. For a breakdown of the cost to give birth in Japan, check out this post.)

Hopefully this information has been or will be helpful for you mamas-to-be or those curious about having a baby in Japan. I’m always curious to hear your thoughts or experiences so please leave a comment below!

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8 Comments

  • Barbara Bell

    I’m a Canadian who gave birth in a hospital in Japan in 1981. Have always been glad it was my second child, as the first was hard enough while I was living in my own country! (The one born in Japan, as it turned out, was the most normal of all my deliveries.) I came to your website to see if things have changed in the past 40+ years. Back then, it didn’t seem too common for mothers to have childbirth education to help them deal with labor, and it was certainly treated as highly unusual for my husband to say he wanted to be there, too. No complaints about the hospital – everything was great, except that they didn’t yet have rooming-in for babies, and I wasn’t allowed to have my baby (even for feeding) for 24 hours, as I was thought to need time to “recover.” It looks as if things have changed and I’m glad to hear it.

    • Kay

      Thank you so much for sharing your experience, Barbara! I can’t imagine how difficult it must have been to give birth in Japan back in the 80s when there probably were zero resources for foreigners. I am really surprised that there weren’t many childbirth classes even in Japanese! And not being able to see your baby for 24 hours must have been really hard, especially as you gave birth once in Canada and that wasn’t the case.

      If you don’t mind, I’d like to share your comment on my Twitter account. I think it’ll be interesting for my followers!

      Edit: I am also curious about the birth in Japan being the most “normal”. If you have time, I’d love to hear more about why!

  • Barbara

    Sure, you may share it!

    There may not have been many resources for foreigners, period, where we lived, which was in the mountains outside Joetsu City in Niigata, on the Japan Sea. The hospital was in Joetsu. During our two-year stay in the country, we were pretty much the only foreigners in the area, with the exception of one other family of missionaries living some distance away; we met the husband twice and I spoke on the phone to his wife once. But the local Japanese people treated us extremely well. I have to say that – even with social conditions in the hospital (lack of baby contact etc.) being what we considered “outdated” at the time (and I am glad to see that times have changed, YAY!) – the medical care was exceptional, with technology more advanced than I had seen in Canada, and everything else very similar to my Canadian hospital.

    We heard that there were in fact some childbirth prep classes available, but according to the younger of the two doctors in attendance, who spoke English, it was unusual for the husband to request to be at the delivery – also that it was normal to schedule deliveries during the week (by inducing labor) if possible, as it was more expensive to give birth on weekends or holidays, AND that pain relief medication was not too common. I could just imagine being in a protracted induced labor with no pain relief so I opted out of choosing my delivery date based on what day of the week it was. We were still covered by our Ontario health insurance at the time, so I didn’t have to worry about the cost at any rate. I had already been through one childbirth experience in Canada so I didn’t think I needed a lot of training, but apparently I was enough of a curiosity, with my previous Canadian experience and awareness of what was going on with my body, that it made an impression on some of the staff.

    I am so happy that Japanese women have more now than was common then. It must have been pretty rough on them…one of my Japanese friends (an unmarried woman with no children) told me her sister, during labor, was not permitted to sleep, and that she came out of the experience with a bruised and swollen face because the nurses kept slapping her to keep her awake. Pretty sure they wouldn’t have done that to me; I was the first foreigner ever to give birth in that hospital, and my baby was the first foreign baby ever born there. It’s odd, because sleeping/drowsiness at certain stages of labor is common and doesn’t hurt anything that I know of.

    “Normal” birth means that this baby, our first son Johnny, was the only one with whom I didn’t have back labor. Having experienced the ordinary kind of labor vs back labor, I can sincerely say that ordinary labor, felt mostly in the front/abdomen/pelvic region rather than primarily against the spine from the baby’s hard skull being turned that way, is far, far, FAR preferable to back labor. He also came relatively quickly, with only a couple of hours of really hard labor at the end of pretty much the whole day of quite manageable contractions. Two others of my deliveries were relatively normal like this (except for the back labor!) and three were long and quite difficult, with at least two needing forceps to get out. (Yes, we have six kids. When a slightly older child -not ours – once told Johnny, who was about 8 at the time I think, that having babies hurt women and that sometimes they screamed, and he asked me about it, all I could say was, “Well yes sometimes it did hurt, but I never screamed, and besides if it was that bad I wouldn’t be having so many of you kids, would I?”)

    The hardest thing about giving birth in Japan was indeed not being able to have my baby with me. They didn’t even bring me the baby for feedings; they made an announcement on the PA system once every four hours, and all the moms (perhaps not the ones who had had C-sections; trying to remember if there were wheelchairs in evidence?) went down and lined up outside the Breastfeeding Room, where each of us bowed as we were handed our own baby, then sat around the room together where we were given exactly 30 minutes to try to breastfeed… I think the idea was that the nursing staff, who circulated among us watching and offering suggestions, could help us all at once, which saved time and trouble for them. Now breastfeeding is a skill that takes lots of time and patience, as you may be aware. It’s also not an easy thing to learn in a room full of strangers; privacy (with the exception of a sympathetic coach of some sort) is much more conducive to the relaxation needed for learning the process. Most of the moms, quite understandably, tried for a few minutes, then accepted a bottle of formula already prepared by the nursing staff and fed their babies that way. I understand that Japan does have a high respect for breastfeeding, although in practical terms in the hospital environment there may not have been quite as much help as mothers needed in this area. (Again, this may have changed in the past 40 years.) I had already breastfed one child, but of course that child wasn’t Johnny, and it would have taken more than 30 minutes a few times a day for him to get the hang of it, so I was glad to be able to go home and spend the time we both needed, learning.

    They would have let me go home earlier, but the hospital was in the city, and in the mountain village where we lived it snowed the day after Johnny was born and the roads were impassable, so I couldn’t go home or see my husband and our daughter for six days. That, too, was somewhat unsatisfactory, but there wasn’t much that could be done about it. And of course we didn’t even have email or Facebook or video conferencing back then.

    They gave me a private room because they said they thought I’d be more comfortable than in a shared room when I didn’t speak the language very much. It had its own very nice bathroom but I wasn’t allowed to take a shower or wash my hair because I was “sick” (having just given birth)!!! Imagine the waste of a nice private bathroom with a shower! We had a wonderful ofuro at home, but no shower. This is another aspect of the childbirth experience in Japan that I trust people are more enlightened about nowadays. The private room also had a kitchenette (I guess for a family member who might stay with the patient to care for them), a nice couch, an armchair I think, and a coffee table; my friend Keiko, who was allowed to come into the delivery room with me (along with my husband, two doctors, at least two nurses, the hospital midwife and I don’t remember who all – the room was packed full of medical personnel along with my own two support people) stayed overnight once or twice with me. She worked in town and would come there after work in case I needed help translating anything. Keiko was the one who told me about her sister being repeatedly slapped while in labor. She had always wanted to be a childbirth support person and had, I believe, taken some medical training as a young person before choosing a different career path. So she was very excited to be allowed to be present when my baby was born. I had never in Canada had, or seen, a hospital room with its own couch and kitchenette, though I seem to remember that private bathrooms were part of the standard deal. It’s been a long time since I last did this!

    The first day after Johnny was born all they would let me eat was soupy white rice with no salt. (There is a name for this dish which you might know, but I’ve forgotten it.) This was considered food appropriate for “sick” people, which naturally includes mothers who have just given birth and are generally quite ravenous. I was able to get Keiko to smuggle me in some other, more interesting food, if I remember right. After the first day, I got delicious Japanese food served in little bowls on a tray. I hadn’t taken the trouble to learn how to use chopsticks before this, so I had to learn how to use them or go hungry. It was messy at first, but I did learn eventually and have been glad ever since that I was forced to acquire this necessary skill.

    Hope this is of interest to you!

    • Kay

      Thank you so much for this thoughtful and detailed write-up of your experience giving birth in Japan in 1981! Wow, it’s so interesting. I was surprised to read that the technology in Japan in 1981 was better than Canada, but I suppose in the bubble era Japan was technologically advanced. And then they just… stopped caring.

      I was really shocked that women got slapped while in labor, I’m glad you didn’t get smacked, yikes!

      I wasn’t aware of the differences between ordinary and back labor, thank you for sharing and explaining that.

      It’s still more expensive to give birth on weekends and holidays, and when it comes to epidurals, those have to be scheduled too at some clinics that offer them, so you have to be induced. This was my plan but then I ended up having an emergency C-section.

      I didn’t get very much help with breastfeeding, unfortunately, and it ultimately didn’t work out. I don’t know if things would have been different had I given birth in Canada. But thankfully, we were able to take as much time as needed to feed our babies. It was indeed scheduled every 4 hours, though. No PA announcement, however!

      Your room sounds amazing! A kitchenette! I did not have that in my private room. It’s nice that your friend could come visit you, too.

      Ah, they gave you okayu! I had something similar as well, but no fancy food due to the hospital being quite strict as patients were high-risk.

      I really want to share your experience with people who visit my blog, I think they would be fascinated to hear about how it was like for a foreigner to give birth in Japan in the 80s. Could I post this as an article? I’ll share the article with you before I make it public and you can revise whatever you like. I can also link to your social media etc.

      Please let me know what you think!

  • Barbara

    Yes, it would be all right to share this on your blog. Anything that might be seen as derogatory (such as the mother being slapped during labor) certainly happened a very long time ago, and, as I said, I hope it isn’t happening any more these days. Social customs even in medical settings do vary from place to place; and over time, yes, they change. On the other hand, reading what you said about Japanese women still being expected to be tough during labor and delivery, to be ganbatte imasu (so to speak), and not to want pain relief, reinforces what I heard back then.

    It isn’t only in Japan where women have been expected to endure pain in childbirth without analgesia; a few hundred years ago in Scotland a midwife was put to death for offering some unidentified “powder” for pain relief to a mother in labor, and the mother was put to death for accepting it. Pain in childbirth has during some eras been wrongly (and I will say as someone who’s studied the Bible, without any Scriptural precedent AT ALL) believed to be part of the “curse” that was put on Eve due to her disobedience to God in the garden of Eden, so trying to avoid pain in that situation was seen as further rebellion against God’s will. Queen Victoria, although not the first, was one who helped remove the stigma of such pain relief by accepting chloroform during one of her deliveries. So there were times when European women were supposed to just tough it out, too, it would seem.

    Here’s an article I found about back labor: https://my.clevelandclinic.org/health/articles/21767-back-labor

    After I had experienced back labor a couple of times, I learned from a visiting regional nurse in Canada that frequently changing position while in labour was supposed to help. With subsequent births, if all I could manage was just to roll from one side to the other in between the hardest contractions, at least I tried to do that. Walking, rocking, crawling around on the floor, standing in a hot shower, and other methods for helping control discomfort in labor work for a lot of people, but in my case nothing helped much. However, any of these positions/actions were much preferable to lying on one’s back. The regular exams in which I had to be on my back, even for a few minutes, were not at all nice, especially during these later stages. Fortunately, most doctors and nurses I dealt with were willing to wait a minute or two if I was in the throes of a contraction when they came in to check me.

    You can see why I was very, very glad that if only one of my childbirth experiences didn’t involve back labor, it was the one that took place in the hospital in Japan where there were so many other unfamiliar factors to deal with.

    • Kay

      Thank you, Barbara! I will create the post this weekend and send it to your gmail so you can take a look and revise/approve it before it’s made public. I will also include your latest comment regarding back labor as I think it’ll be helpful.

      It’s really awful how women were expected to grin and bear the pain of labor throughout time. I imagine this wouldn’t have been the case had men experienced similar pain!

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