It’s amazing how two little lines popping up on a stick can produce such a range of conflicting emotions in a person. Hopefully, that range tends more toward elation rather than the shock-filled-terro

Whether you’re trying to conceive or already pregnant, there’s a lot to learn about giving birth in Japan. While some things, like choosing a birthing facility, may be similar to your home country, other aspects, such as receiving regular ultrasound images and government benefits for having children, may seem unheard of back home. Luckily, from checking whether you’re pregnant to taking maternity leave, we’re here to guide you through pregnancy in Japan. 

• Confirming Your Pregnancy in Japan
• Registering the Pregnancy
• Pregnancy Check-ups in Japan
• Things to Consider
• Frequently Asked Questions 

Confirming Your Pregnancy in Japan

[

](https://cdn.savvytokyo.com/app/uploads/2021/06/pixta_93805805_M.jpg)It’s also possible to purchase imported pregnancy tests

If you suspect you may be pregnant, you’ll be happy to know that simple, pee-on-a-stick type home pregnancy tests (ninshin kensayaku) can typically be found at any drugstore. Prices can vary depending on the brand and the number of items included in the box. Some drugstores sell their own version, typically sold at a lower price. But it’s also possible to purchase imported pregnancy tests, such as Clear Blue. 

Typically, pregnancy tests recommend waiting until one week after your missed period for the best results. Because tests measure hCG, a hormone produced after implantation, they tend to be more accurate once enough hCG has been produced. 

Whether or not you choose to take a pregnancy test yourself, the ultimate way to confirm your pregnancy is to visit a hospital or ladies clinic. Be aware that you don’t need to go to the facility where you wish to give birth for this initial check-up. 

Your doctor will confirm your pregnancy via transvaginal ultrasound. While the doctor will be looking for a heartbeat, it may not be detectable at this early stage. If a heartbeat is not found, your doctor may ask you to return the following week for further confirmation. If a heartbeat is detected, you will be issued a ninshin todoke, a certificate declaring a confirmed pregnancy.

Registering the Pregnancy

[

](https://cdn.savvytokyo.com/app/uploads/2021/06/pixta_19806944_M.jpg)The entire process is free of charge

Take your ninshin todoke, identity documents, such as your My Number Card or passport and residence card to the local municipal office. If you don’t feel confident in your Japanese skills, bring along a translator as there will be some forms to fill out and plenty of information. The entire process is free of charge. 

Pregnancy Notification Form (ninshin todokesho)

One of the first things you’ll do is fill out the Pregnancy Notification Form (ninshin todokesho). While many large cities offer an English translation, it is not guaranteed and will depend on your particular office. In general, regardless of where you live, the form asks for the same kinds of information, such as mother’s name, address and insurance type. But, your municipality may ask for additional information about the mother’s physical and psychological health. Here are a few examples from Tokyo, Miyazaki and Okinawa.   

The Maternal and Child Health Handbook (boshi kenkou techou) 

It’s hard not to stress the importance of this book. Commonly abbreviated to boshi techou, you must bring this to all medical appointments as it records information about you and your child’s health from changes in height and weight to vaccines. In some situations, such as picking up your My Number Card, the boshi techou can even act as a form of official identification for your child. Many foreign language translations of the handbook are also available.

Pregnancy Health Check-up Coupon Book (ninshin kenkou shinsa jyushin hyou) 

In addition to the boshi techou, you will also receive practical information about giving birth in Japan, what to do and when and optional courses offering additional help for expecting mothers. You will also get coupons used for getting a reduced rate for up to 14 prenatal check-ups as well as other specific checks, such as a free dental exam.   

Maternity Mark, or Pregnancy Badge (mataniti maaku) 

This badge, which charmingly reads “there is a baby in my belly,” grants you all-access to priority seating areas on public transport and disabled car parks. Attach it to your bag so that other passengers know you are pregnant and will (in theory) offer you their seat. Unfortunately, how consistently the people around you will provide their seat depends on a case-by-case basis. 

Other Helpful Information

You will also receive a variety of guides and booklets about being pregnant and a parent in Japan. 

Pregnancy Check-ups in Japan

[

](https://cdn.savvytokyo.com/app/uploads/2021/06/iStock-1157670560.jpg)Ultrasounds are performed during every visit

Generally speaking, your prenatal check-up schedule will look something like this:

• First trimester: appointments every other week

• Second trimester: monthly appointments

• Third trimester: appointments every other week and every week from 36 weeks 

• Beyond 40 weeks/10 months: appointments every two days

This corresponds to around 15 check-ups in total, fewer than in other countries. Additionally, ultrasounds are performed each time, which means you end up with quite a collection of pictures of your child from long before they are born. 

While it’s nice to have the constant reassurance, it also adds to the cost and can be a little inconvenient, especially if you are working (although employers are legally required to allow you the time off for appointments). If you find it too much, you may be able to request that the appointments be spaced out more. 

Each check-up will likely follow the same pattern, so you will quickly get the hang of it. If your Japanese is limited, I would suggest bringing a translator with you on your first visit, at least. 

A typical check-up takes the following course and lasts between one and 2 1/2 hours, depending on the clinic and how busy it is:

• Check in at reception

• Give a urine sample and (if previously requested by the doctor) do a blood test 

• Weigh yourself and check your blood pressure using the available machines 

• Get examined by the doctor and receive an ultrasound (about 10 minutes total)

• Pay 

If you have a Pregnancy Health Check-up Coupon Book, you’ll be able to submit vouchers when you pay. Depending on where you live and the nature of the appointment, these vouchers will reduce your bill by ¥3,000–7,000, or by most of the appointment’s cost. 

Things to Consider

[

](https://cdn.savvytokyo.com/app/uploads/2021/06/iStock-1768671652.jpg)From maternity leave to preserving your baby’s umbilical cord

There are some extra things you should consider during your pregnancy. 

Non-invasive Prenatal Genetic Testing (NIPT) 

Conducted through an analysis of the mother’s blood test sample, this optional test checks for chromosomal abnormalities in the baby. It has been shown to be highly accurate, particularly in assessing the risk of Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome) and Trisomy 13 (Patau syndrome) in your little one. 

However, you should also consider two points about the test:

• At an average cost of ¥150,000–200,000, it’s expensive and not covered by national or private health insurance plans.  

• Although very reliable, the results give the probability of risk rather than the conclusive presence or absence of chromosomal abnormalities. So, depending on your results, you may want to undergo additional testing at an additional cost. 

Preserving Your Baby’s Cord Blood  

During your pregnancy, you will be given the option of preserving your baby’s cord blood. Immediately after your baby is born, medical personnel will extract blood from the umbilical cord (cord blood), a process that is pain-free for mama and baby. This blood is teeming with stem cells, which are important for tissue repair and maintenance. The decision to keep cord blood must be made by around the 34th week. You’ll have to fill out some paperwork and choose a payment plan. 

A private company specializing in stem cell storage will keep your baby’s cord blood. There are several benefits, including: 

• Treating a variety of serious conditions, ranging from blood cancers to problems with the immune system 

• Possibly being enough of a genetic match to treat immediate family members’ medical conditions 

• Lasting decades while in storage 

But, one of the biggest hurdles to think about is the cost. Depending on the stem cell storage company, it can cost about ¥3,000–4,000/month to safely keep cord blood. Multiply that by 10 years and you’re looking at a total cost of ¥360,000–480,000.  

Maternity Leave 

According to Japan’s Labor Standards Act, employers are required to allow mothers maternity leave from six weeks (for one baby and from 14 weeks for twins and more) prior to the due date until eight weeks after delivery. In addition, the Act on Childcare Leave provides for childcare leave until the child turns one (and until the child reaches one year and six months of age, if the parents take turns). During this time, labor and social insurance will cover up to 66 percent of the mother’s base salary, but each company has its own regulations, so please confirm all details with your employer. 

The best time for announcing your pregnancy to your employers will, of course, depend on your company’s culture, size and your relationship with your direct supervisors. You will also want to factor in whether you will need time off for prenatal appointments, morning sickness and when your precious baby bump starts to show. It goes without saying that your boss should find out privately and directly from you—this is particularly important in Japanese work culture.

Frequently Asked Questions 

[

](https://cdn.savvytokyo.com/app/uploads/2021/06/iStock-660586718.jpg)Thankfully, Savvy Tokyo is a hub for all things related to family and women’s health in Japan

Check out our posts on motherhood and parenting in Japan.

How hard is it to find a hospital or clinic with English-speaking services? 

That depends on where you live. Larger cities, like Tokyo and Osaka, will have clinics that advertise English and other languages for expats. However, smaller centers and rural areas are less likely to have someone who can speak English.  

Do I need to stay with one clinic only for my check-ups?

No. But be sure to consult with your clinic(s) about the proper transfer of your medical files. 

Is my partner allowed to accompany me to appointments? 

In general, partners are not allowed to attend appointments. But some clinics may allow them to accompany you to ultrasounds and discussions with the doctor. 

Are birth doulas popular in Japan?

No, but it is possible to find one, especially in larger cities. Depending on the doula, they can provide prenatal support, including preparing a birth plan, giving lessons on breathing practices and other useful techniques during labor. Also, some may be able to provide Japanese language assistance. However, as with partners, doulas may or may not be allowed into prenatal check-ups. Check with your clinic beforehand. 

Is it true that Japanese doctors are more strict about weight gain during pregnancy? 

Speaking generally, yes. But, of course, your experience will depend on the doctor. However, be aware that according to the official guidelines published by the National Institute of Health and Nutrition, women’s weight gain during pregnancy is dependent on their Body Mass Index (BMI):

• Less than 18.5: 12–15kg

• 18.5–25: 10–13kg

• 25–30: 7–10kg

• 30+: Your doctor will provide individualized guidance 

How was your experience of being pregnant in Japan? If you have something to add, please share your stories below!

This post was originally written by Rosie Blakely and updated by Elizabeth Sok in 2026.