In some respects, the Japanese health and social support system can be a little confusing when it comes to pregnancy. This is the case for Japanese and foreigners alike. From discount vouchers and booking hospital beds to the different types of medical facilities, the system of care and support can all seem somewhat arcane.
The following is designed to give an overview of what to expect, what you need to do, and a rough idea of expected costs. As a disclaimer, my authority on the subject extends no further than that granted to me by many phone calls to hospitals, inquiries at government offices, and hours of searching Japanese websites and hospital homepages once my wife became pregnant and the panic set in of realizing that I had no clue whom I was supposed to call or where I was supposed to go. Nevertheless, I hope it will provide some basis to get you off on the right footing should you find yourself in a similar situation.
Pregnancy & the Japanese Health System
Pregnancy is not covered under general health insurance in Japan. There are two reasons for this. Firstly, being pregnant is not considered an illness or injury—the typical remit of health insurance. Secondly, because each pregnancy requires a different level of care, there cannot be a fixed fee. Furthermore, hospitals and clinics in Japan offer different levels of “service,” from hotel-like treatment with your own separate room at private hospitals to a more standard level of care elsewhere. Note: While the government approved plans in early 2026 to bring childbirth under public health insurance, this change is not expected to be fully implemented until fiscal 2028.
To provide financial support to families, Japan offers “maternity vouchers” (妊産婦健康診査費用補助券, ninsanpu-kenkō-shindan-hiyō-hojoken) to expecting mothers. These are essentially discount vouchers used at hospitals and clinics to reduce the cost of regular check-ups. The discounts offered by these vouchers differ depending on where you live (although they are standardized across the 23 wards of central Tokyo), as do non-medical auxiliary services such as post-birth support.
These vouchers are included as part of a maternity pack provided by the local city office, which also includes the Maternity and Children Health Handbook (母子健康手帳, boshi-kenkō-techō). This little book is very important and must be taken to all checkups and hospital visits. English versions of the handbook are also available.
Check-ups
If a home test is positive, you should have a doctor confirm the result. This typically costs between ¥5,000 and ¥10,000 and includes a urine test and an ultrasound. Once the pregnancy is confirmed, go to your city office to collect your Maternity and Children Health Handbook. To receive this, you will need to submit a “pregnancy notification form” (妊娠届出書, ninshin-todokeshutsu-sho). Do not lose this pack. In principle, maternity vouchers cannot be re-issued.
You can then begin regular checkups (妊婦健康診断, ninshin-kenkō-shindan). You will need to find a clinic and make your first appointment.
Generally, expecting mothers have 14 checkups. Typically, the schedule is:
- One checkup per month until the 23rd week
- One checkup every two weeks from the 24th until the 35th week
- Weekly checkups from the 36th week (40 weeks being the average term)
Naturally, the actual frequency will depend on your situation and consultation with your doctor.
The vouchers act as discounts; they do not cover the full cost of the check-ups. With the vouchers, costs roughly break down as follows (though they vary by facility):
- ¥10,000 to ¥15,000 for the first check-up (including multiple blood tests).
- ¥3,000 to ¥5,000 per check-up after that (increasing if further blood tests are required).
All told, you should expect checkups to cost about ¥100,000 ($626) in total after the discount vouchers. Additionally, you may have costs for prescriptions for symptoms like headaches or nausea, which should be covered under your general health insurance.
Choosing a Hospital
Most hospitals, clinics, and maternity homes in Japan require expecting mothers to make a reservation for the birth in advance (分娩予約, bunben-yoyaku). You can begin making inquiries once you have an expected delivery date, usually around the 8–10 week stage. Reservations are required even if you are already attending that facility for checkups. Popular hospitals book up quickly, so it is important to act fast. You will usually need to pay a deposit, typically between ¥100,000 ($626) and ¥200,000 ($1,252).
Women in Japan spend an average of six days in the hospital for childbirth. Broadly, there are three types of institutions for delivery:
1. General & University Hospitals
These are favored for having the staff and equipment to handle complications. However, waiting times for checkups can be longer, you may see different doctors, and the amenities may be more basic.
2. Private Hospitals
Private hospitals (個人病院, kojin-byōin) and clinics (診療所, shinryō-sho) often offer higher levels of comfort, such as private rooms and gourmet food. Not all clinics have delivery facilities; some only provide checkups. While more expensive, they offer more personalized care. In high-risk cases, they may advise delivery at a general hospital.
3. Maternity Homes
Maternity homes (助産所, josan-sho) specialize only in natural delivery and do not handle checkups or complex procedures like C-sections. They provide a homely environment and are typically the most affordable option.
To add some context, roughly speaking, just over half of women in Japan choose private hospitals; just under half choose general or university hospitals; and less than 5% opt for maternity homes.
Understand the Rules & Facilities
Facilities often have specific rules. Some may be female-only (not allowing male partners to accompany patients), while others require you to have attended their clinic from early pregnancy. Consultation hours also differ; notably, not all places offer appointments at the weekend.
Crucially, not all facilities offer “painless delivery” (epidurals). Natural births are heavily encouraged in Japan, and epidurals are often only available during standard business hours. Japan also remains one of the few countries where episiotomy is still widely practiced.
Beyond that, medical institutions are chosen based on word-of-mouth, reputation, and proximity to home. Many expecting mothers will visit multiple places to see the facilities, and the home pages of private hospitals and clinics will often have photographs of comfortable rooms or gourmet meals to entice you.
What about English speaking staff?
Many hospitals with English-speaking staff are located in Minato or Shibuya Wards. Even if not explicitly advertised, some doctors and nurses may have good language skills, but if your Japanese is limited, it is best to find a facility specifically geared toward international residents.
Changing Hospitals
If you move or choose to deliver elsewhere, you will need a referral letter (紹介状, shōkaijō) from your current doctor, which costs about ¥3,000. Typically, you must start having checkups at your delivery hospital by the 32nd week. You cannot turn up at a new hospital just to give birth without being examined in person beforehand.
The Costs
As of 2026, the average cost of a natural birth nationwide is approximately ¥550,000, while in Tokyo, it typically exceeds ¥650,000.
To offset the financial burden, families receive a “childbirth lump-sum allowance” (出産育児一時金, shussan-ikuji-ichikin). Since 2023, this amount has been ¥500,000 per child. Additionally, the government provides a ¥100,000 “Childbirth and Child-rearing Support Gift” (¥50,000 after pregnancy notification and ¥50,000 after birth). This brings the total standard support to ¥600,000.
Most hospitals use a direct payment system, claiming the allowance on your behalf so you only pay the remaining balance to the medical institution, reducing the burden of an otherwise large payment.
Preparing for Delivery
Hospital Bag
With a six-day stay post-birth, many mothers prepare a full suitcase. Essential items include:
- Maternity and Children Health Handbook
- Health insurance card
- Inkan / Seal (though signatures are widely accepted for foreigners)
- Patient Registration Card (診察券, shinsatsu-ken)
Register for a “Maternity Taxi”
Unless you have your own transport, you’re going to be relying on a taxi. While taxis are everywhere in Tokyo, you don’t want to be frantically trying to hail one in an emergency. The GO app is the primary service used in Tokyo now. Fortunately, many taxi companies offer a maternity service (陣痛タクシー, jintsū-takushii). You register your details online for a 24-hour priority hotline. Major providers include: Nihon Kotsu, Ebara Kotsu, and KM Taxi.
Post Birth
Registering the Birth
First, you need to register the birth at your local city office within 14 days using a birth certificate issued by the hospital. At the local city office, you should submit a Birth Notification Form (出生届, shussei-todoke). Also take your handbook because you will be given a small certificate to stick inside.
You should also apply for a Birth Notification Certificate of Acceptance (出生届受理証明書, shusshōtodoke-juri-shōmeisho). Because foreign nationals do not have a Japanese Family Register, this acts as an official Birth Certificate for embassy registration.
Applying for Permission to Stay
Children of foreign nationals are granted 60 days of stay without a specific status. If staying longer, and you hold a resident status other than Special Permanent Resident (特別永住権, tokubetsu-eijūken), you must apply for a Status of Residence at the Immigration Services Agency within 30 days of birth.
- An application form (available at immigration)
- A questionnaire for both parents (only one needs to be present)
- Residence Certificate (住民票, jūminhyō) for the whole family
- Birth Notification Certificate of Acceptance (出生届受理証明書, shusshōtodoke-juri-shōmeisho)
- Taxation Certificate (課税証明書, kazei-shōmeisho)
- Certificate of Tax Payment (納税証明書, nōzei-shōmeisho)
- Certificate of Employment (在職証明書, zaishoku-shōmeisho)
Child Support
To support families, Japan provides a child benefit called jidō-teate (児童手当). Following significant reforms in late 2024, income limits have been abolished, making it available to all residents. The benefit now also extends until the child reaches 18 (high school graduation). Current monthly payments are:
- 0 to 3 years: ¥15,000 per month
- 3 to 18 years: ¥10,000 per month (¥30,000 for the 3rd child onwards)
Minato City’s website is a good source for updated information in English regarding local childbirth subsidies and the expanded child allowance.
How do I apply for child benefit?
Submit an application (認定請求書, nintei-seikyūsho) within 15 days of birth. Payments are made every even-numbered month (February, April, June, August, October, and December) to the applicant’s bank account. You must still submit an annual “update notification” (現況届, genkyō-todoke) to the municipal office to ensure information is current.
