Pregnant in Japan: How to find a doctor, hospital or midwife

Finding a doctor, specifically an OBGYN or midwife, in Japan can be difficult at times, particularly if you don't speak Japanese. Of course, if you live in Tokyo, or another metropolis, you'll have a far easier time (and most likely, many fellow expats with recommendations). But if you're like me, and many others outside of the big cities, a little more searching is sometimes required... (Note: resources and words to know are listed towards the bottom of this post).

Finding a doctor or midwife is important to do early if you're planning to give birth in Japan, as women "reserve" spots far in advance at hospitals and clinics for their deliveries. And let me stress, from my own experience, some places fill up fast (depending on your location). My due date is late August, and I didn't think we needed to be that serious so soon about finding a place to give birth, until we started calling around in February and discovered that many ladies clinics were already full for August (though, supposedly August is a popular month to give birth in Japan).

Now, women in Japan typically either give birth in a) a hospital or b) a ladies clinic (or sometimes a midwife clinic). When I started my research for myself, I spent time looking for midwives that specialize in home births to see if it was an option here, just so I could weigh all the possibilities, but from what I was able to find, most independent midwives specialize in other things related to childbirth than the actual delivery itself (such as breastfeeding or infant bathing consultations). I think I had heard some statistic from the U.S. saying that most women in Japan use midwives to give birth, but I think that was taken out of context. Yes, midwives often do work in the ladies clinics and at hospitals along with the doctors for childbirth, and there are special midwife clinics that do deliveries around Japan as well.

Personally, I wanted to try and find a ladies clinic or midwife clinic for our child's birth, as I'm not a big fan of hospitals in general and have heard here that they tend to be more strict in their rules (though this depends on the hospital). And, as I seemingly have a difficult time finding decent doctors for some reason (both here and in the U.S.), this task was not easy, especially as we aren't really that close to any large cities (the closest being 30-45 minutes driving time away).

The irony of all this is that we literally live next door to a ladies clinic. When we moved in, we thought it was funny that we lived next to one, although we soon found that the doctor there wasn't particularly nice and the clinic in general did not like me coming for anything, as I'm not fluent in Japanese. This is certainly understandable, as it could be a liability for them, but they flat-out refused to see me the first time I went in for something minor and not related to being pregnant (long before I became pregnant), and not too kindly either, which was a bit surprising. Not until I brought my fluent husband in with me did they relent and agree to see me for something minor (and even then they didn't really let him in the exam room anyway - which is typical here). But I digress.

So we visited the clinic next door immediately after I discovered I was pregnant through a pregnancy test, just to confirm. Another bad experience with the doctor resulted, which I won't detail here, and proved to be expensive as they did an ultrasound to confirm the pregnancy. (I should note that health insurance here does not cover pregnancy and childbirth, but the government does provide financial assistance once you've registered the pregnancy, which I will go into detail about later). Then they told us to come back in 8 weeks, when the baby was more "visible", so that they could give us an official paper to take to our city health office to register the pregnancy and get the "Maternal and Child Health Handbook".

As far as I know, some cities will handle this differently, but in my city apparently you can't register the pregnancy until the baby is visible. Ladies, please feel free to share how this works or worked for you in your location. Could you register right away or did you have to wait a certain period of time?

I didn't want to go back to the doctor next door, who we later found out through word of mouth and online reviews didn't have that great of reputation anyway, so we found another doctor. That clinic was booked for August, so we temporarily saw this second doctor until we found a clinic for the birth. This second doctor was quite friendly and gentle (something I tend to look for when I see OBGYNs here), and our visits were painless enough. Every time I went in, I'd weigh myself, take my blood pressure with a machine, and pee in a cup, and then the doctor would do an ultrasound (vaginal the first time we saw him and abdomen the second time). I also had to do a blood test (there should typically be two during the entire pregnancy), in which they took at least 5 vials of blood it seemed - longest blood draw I've ever had!

My only complaint with this doctor - and one every woman should be aware of if they are pregnant in Japan - was that he disapprovingly told me (while stamping in my handbook) that I had gained too much weight and needed to be careful. I knew about this beforehand, as I'd read (from both expats and Japanese women) that doctors in Japan can be strict about weight gain - but it can still be frustrating, especially since I had not gained a single pound/kg during the first 12 weeks of pregnancy (in fact I felt like I had lost weight, and I'm already quite small normally), and then suddenly in four weeks I gained 4 lbs (about 2 kg). However, this is quite in line with the typical U.S. weight gain for pregnancy, and I eat a relatively healthy diet (and only eat when I'm hungry), so I'm not too worried about it.
For more on weight gain, nutrition and diet in Japan, this post has information on what to expect regarding your pregnancy in Japan.
In searching for a place to give birth, we saw many doctors - most didn't speak English (which we expected around where we live and were fine with), and had varying practices in how they do birth. For example, some clinics have strict visiting hours, and women are expected to stay at the place after the birth typically 4-7 days. Some clinics will not allow the baby to sleep in the mother's room, and some clinics don't allow the mother to move around very much during labor (before delivery).

Another important thing to keep in mind is that in Japan, episiotomies are fairly standard, and some of the doctors we saw said they always perform them.

Eventually, we were running out of options, places were booking up, and I grew increasingly frustrated that we wouldn't find anything good. However, I sent an email to Brett Iimura of the Childbirth Education Center asking if she knew of anyone in the Shizuoka area, and she responded with a few places, including two midwife clinics, just a little farther away than we had originally wanted but worth looking into.

After visiting one midwife clinic and one of the ladies clinics Brett recommended, (and reading reviews online), we finally decided on the ladies clinic, which is about a 40 minute drive from our home. The doctor is very kind, incredibly flexible as to what we were thinking in terms of a birth plan, speaks English (which was a nice bonus and not something we knew beforehand), and so far hasn't mentioned anything about my weight. The clinic has long visiting hours and will let me bring my own food and snacks in (another bonus - many clinics seem to serve fancy food - I think because it feels like luxury to women, like something they would get at a nice hotel). Basically, this clinic fit nearly everything on our list and birth plan and we're happy with it so far. Now hopefully the birth itself will go well...

Some words to know when looking for a doctor or midwife:

obstetrics and gynecology  - 産婦人科   (さんふじんか, sanfujinka)
hospital  - 病院  (びょういん, byouin)
clinic  - クリニック  (kurinikku)
ladies clinic  - レディスクリニック  (redisu kurinikku) Note: not all ladies clinics do births
maternity clinic  - マタニティクリニック  (mataniti kurinikku)
midwife - 助産婦  (じょさんぷ, josanpu)  or 助産師  (josanshi)
midwife clinic/maternity home - 助産所  (じょさんじょ, josanjo)
maternity/midwife "hospital" - 助産院  (じょさんいん, josanin) (similar to josanjo)

So, how do YOU find a doctor or midwife?

Ask around

It's likely both expats in your area and Japanese women will have a good idea about which doctors, clinics and hospitals are good and which aren't. Japanese women we know were helpful in telling us about the reputation of places in our general area. And if you have a decent number of expats around you, see if any have had children in Japan and what they did.

Read reviews

Women's Park, which I mentioned in Pregnant in Japan: Resources, has an extensive list of hospitals and ladies clinics with reviews written by Japanese women. Yes, the website is all in Japanese, but I've found it to be mostly conversational and not too difficult to understand. However, Google translate or another translation tool may also come in handy (and faster if you can't read Japanese that well). No, the translations aren't perfect by any means and some sentences might not make much sense after translated, but I honestly think it's a fantastic way to find clinics and discern which are good and which aren't. You can also learn the general costs of each place. From personal experience, I found this resource to be indispensable and the reviews very helpful. Note: You need to sign up for an account to read detailed reviews.

If in Tokyo, Nagoya, or another large city, you can join one of the pregnancy groups or inquire through them to find good recommendations. See the Pregnant in Japan: Resources post for links.

Women's Park website - clinic/hospital locator

To find a midwife in Japan, you can visit the Japanese Midwives Association website, and then check out the list of midwives and midwife clinics in Japan (Japanese only). You can also look up your prefecture's chapter, see if they have a website and possible list of midwives and clinics throughout the prefecture (Shizuoka does).

To the ladies (or gents) out there who have gone through this before - do you have any other ideas, thoughts, or recommendations? Please share in the comments!

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