As a Canadian, I balked when I heard that giving birth in Japan wouldn’t be completely free and that prenatal costs were not covered by health insurance. I won’t lie, I briefly contemplated going back home to have the baby but in the end, my daughter was born in Japan and everything worked out cost-wise. Every birth is different depending on the hospital/clinic, the room, the services and food offered, pain-relief, the type of birth, etc., so there’s a lot of confusion surrounding how much it costs out-of-pocket to give birth in Japan. However, I thought I would share how much it cost me as well as additional information about allowances and in order to help future moms get a better idea of how much yen it’s going to be.
Childbirth Allowance and Gifts
Japan’s health insurance system does not cover prenatal or delivery costs for uncomplicated pregnancies and deliveries. Women who are enrolled in the health insurance system (either National Health Insurance or Employees’ Health Insurance), however, will receive a 420,000 yen “Childbirth and Childcare Lump-Sum Grant” (or Childbirth Allowance) when they give birth. This can be paid to the hospital directly (the easiest option). Giving birth in hospitals and clinics outside of Tokyo, especially in the countryside, tends to be cheaper so some people end up making money from this, like my cousin-in-law who had two babies in Hiroshima.
Depending on where you live, you may receive something additional from your city or ward office to help with childbirth or child-rearing costs. Here’s a quick overview of what some wards in Tokyo offer (please keep in mind that this is subject to change):
- Chuo Ward – A 10,000 yen taxi ticket, a 30,000 yen coupon when your child is born to use at shops within the ward
- Minato Ward – The ward will provide some coverage for the remaining delivery costs after the childbirth allowance is applied
- Shinjuku Ward – A celebratory present for your child’s birth, 10,000 yen worth of gifts if you participate in an interview administered by the ward
- Sumida Ward – A gift certificate for 10,000 yen worth of baby products if you participate in an interview administered by the ward
- Taito Ward – A 30,000 yen gift certificate for a book store, etc., for the third child onwards
- Nerima Ward – A one-time monetary gift of 200,000 yen for your third child onwards
- Shinagawa Ward – A catalog where you can choose 10,000 yen worth of baby products if you participate in an interview
- Meguro Ward – A catalog where you can choose 10,000 yen worth of baby products related to cradles if you participate in an interview on cradles before your child is born
- Setagaya Ward – A one-time monetary gift of up to 60,000 yen for the birth of your third child onwards
- Arakawa Ward – A picture book
- Katsushika Ward – A 5,500 yen IC card, a catalog where you can choose 10,000 yen worth of baby products if you participate in an interview
Epidurals are also not covered by Japan’s health insurance system. I can’t speak for whether it’s worth it (although if giving birth feels anything like it did to be induced, I would get it), but if you want to try to save some yen and forgo an epidural, try reading Ina May’s Guide to Childbirth. I was hyped to have a med-free birth after reading this book. It’s incredibly empowering. You can also check out the stories of other women who have given birth in Japan to see their experiences with/without pain relief.
Prenatal Appointment Costs
Your prenatal appointments will be heavily discounted thanks to a wonderful coupon book you get from your city or ward office when you register your pregnancy. My prenatal checkups with the coupon were as little as 270 yen but varied depending on type of test done, etc. There are also only a certain amount of coupons for ultrasounds, blood tests, nonstress tests and so forth, so my additional ultrasounds cost 3000 yen while nonstress tests were 2000 yen. I also had to pay extra for a 4D ultrasound and anatomy scan.
For those who may not know, I had a C-section at a major hospital and was hospitalized for 10 days (3 nights in a shared room and 6 nights in a private room).
Below are my hospitalization fees before the childbirth allowance was applied:
|Private Room Fee||¥161,000|
After the childbirth allowance: ¥248,520
My health insurance (Employees’ Health Insurance) covered a majority of the remaining costs due to my C-section and I ended up paying only a few thousand yen out-of-pocket, likely for my private room.
For reference, a natural birth without an epidural at the clinic in Tokyo where I was supposed to give birth was around 600,000 yen before the childbirth allowance. If I had an epidural, it would have cost an additional 180,000 yen, bringing the grand total to approximately 780,000 yen. There would have also been additional fees had my child been born anytime between 6 PM to 8 AM, during the weekend, or on a holiday (because babies should know better than to come into the world outside of office hours!).
As I didn’t give birth at that clinic, I don’t how how much I would have had to pay out-of-pocket in the end; however, the following table (based on a survey of 50 parents) shows the range of out-of-pocket expenses for births throughout Japan:
|Out-of-Pocket Expenses||Percentage of Parents|
|¥0 – ¥100,000||16%|
|¥100,000 – ¥200,000||33%|
|¥300,000 – ¥400,000||6%|
|¥400,000 – ¥500,000||4%|
|¥500,000 – ¥600,000||0%|
As shown above, a majority of parents paid between 100,000 yen to 300,000 yen after the childbirth allowance and insurance.
Monthly Child Allowance
I’ve seen so much misinformation about this online so I thought it best to clarify it a little.
Under the 児童手当 (jidouteate) or Monthly Child Allowance, children up until the age of three receive 15,000 yen per month. Children from the age of three to the end of elementary school receive 10,000 yen (if you have three or more children, the third child onwards will receive 15,000 yen until the first child turns 18). Children in junior high school receive 10,000 yen.
However, not all children are not eligible for this allowance as it depends on the income of the highest earner in your household. Taking dependents into account, those whose income exceeds the following are ineligible for the Monthly Child Allowance:
|# of Dependents||Individual Income|
Therefore, based on the table above, if you have one child, both you and your spouse work, and one of you makes more than 8,756,000 yen before taxes, you will not be eligible for the Monthly Child Allowance. Instead, you will receive 特例給付 (tokureikyuufu) or a (loosely translated) “Special Allowance”, which is 5000 yen per month. If you or your spouse doesn’t work and you have one child, the income cutoff for the Monthly Child Allowance becomes 9,178,000 yen.