Having a Baby in Japan

Hospital tray

About five years ago I posted “Almost a Japanese Housewife,” the story of an Australian friend.  (Link). We called her “Ruth” to protect her privacy. Recently she talked via Skype about the birth of her first child. Thanks to Ruth for the photos.

Ruth’s story

In the classroom

In Australia my friends went to any doctor for a blood test or a urine test, but in Japan you go to an obstetrician who gives you an internal examination, a vaginal ultrasound. The chair used for the examination—also for Pap smears—is like a dentist’s chair with stirrups. It lifts you up and spins you around into a private, curtained off area so your privacy is protected from the person examining you.

After the pregnancy is confirmed, you get a certificate to take to the health center, where you register with the government. You get a special handbook for recording all the appointments and test results and then later all the child’s immunizations and check-ups. You carry it with you like a passport in case you need medical attention. I was pleased that a bilingual version was available. It taught me the Japanese equivalents of a lot of medical terms. Early in the pregnancy I got so many pamphlets and brochures and a plethora of information. It was bit overwhelming, but I felt grateful knowing where to go if anything bothered me.

For example, the health center offered counseling and referrals for free or government services. I don’t know whether these services are so available in Australia. I felt I’d be told what I needed to know. I got a sticker for my car so I could park in reserved spaces and a symbol to wear on public transport, making it more likely that people would offer me a seat. I wore that on my handbag very proudly.

Japanese maternity wear is pretty depressing, like grey smocks from 30-40 years ago. I took pictures and sent them to a friend in Australia who sent me some dresses for Christmas. I got maternity jeans and other things online at the Japanese warehouse of H&M, which carries European clothes. So I was fashionable at a bargain price.

Map iwht Aichi Prefecture

My Japanese is better than that of most non-Japanese people I know, but still I have to think harder than I would if everything were English, which it might be in a more international area. But I’m in the sticks. [laughs] I’m in Aichi Prefecture, on the main island of Honshu, on the Pacific Ocean side. It’s not rural, but anything outside a large city is considered “country.”

I had to have a minimum of sixteen obstetrician appointments, as opposed to the eight or so my friends in Australia had. At each appointment I had an ultrasound, which is also a joyful experience since I got enough pictures to fill a photo album. In Australia you get four to five.

Then the morning sickness came. I was so sick I thought I was going to lose my mind. When you have food poisoning, at least after you throw up there’s a period of relief, although the nausea might return. I got no relief. After two weeks of this I said to the doctor, “This is horrible. I can’t take it.”He looked at my urine test and said, “There’s no disease in your body, so all we can give you is a drip for dehydration. We don’t give anti-nausea medication to pregnant women.” He said I should make sure I had a sports drink or jelly between meals. I felt like yelling at him, “Do you think I’m actually having meals? You can put your sports drink or your jelly where the sun doesn’t shine.”But I was too sick to work myself up to that. I just left, and I cried while waiting to pay my bill.

Ninja-the-cat-discovers-Mei

They used to prescribe anti-nausea drugs thirty-nine years ago when my mother-in-law was pregnant with my husband. I was told they stopped because the drugs had caused birth defects. I seriously considered going to Australia even though I don’t have health insurance there, but I was so ill.

I lost about four kilos during the six weeks of throwing up, and I felt nauseated for another month. In retrospect I guess I the doctor might have taken me more seriously if I’d waited to complain until after I’d lost more weight. But the nausea didn’t affect my baby, and I know some women have it so bad they need to be hospitalized for the whole pregnancy. There are safe medications, or safer ones, so I wonder whether not making them available isn’t part of this very slowly crumbling patriarchal society which doesn’t value women as much as it should. Women are also not given pain medication during labor. It’s not without risk, but I would have appreciated the option. The power’s with the men, and they’re not having babies.

At every appointment you get weighed, but in Australia only if there’s medical reason, Back when my mother-in-law was pregnant, the doctors always said, “Eat, eat, eat!”At some later date, the idea crept into the medical community that women shouldn’t gain much weight because a smaller baby would make for an easier birth. This is terribly dangerous. I read online that Japan was the only first-world country where birth weights were falling instead of rising.  If the fetus doesn’t gain enough weight, it can cause a lot of trouble in the womb and later in life.

I was given guidelines which said I could gain six to twelve kilos. Some Japanese women fuss, “Oh, I can’t eat this, I can’t eat that.”Some get scolded for gaining weight. Some try to put the criticism aside because their weight isn’t something they can control. Every baby grows differently. One advantage of going to a large hospital was that there was not just one doctor, a Supreme Being who could be as mean as he wanted. The doctors are held accountable by the hospital’s board of directors. So there’s less nasty weight-shaming.

Their first walk

Every couple of weeks my weight was checked and recorded. I never knew what feedback I’d get. Once I’d gained more weight than usual since my last appointment, and the nurse said to me, “Oh, you should be careful of your food.” I got very angry, and so did my mother-in-law, who’d come along with me. She said. “Why should you be worried? If I saw you from behind I wouldn’t know you were pregnant. Don’t listen to her. That’s crazy.” My mother said the same thing. By the next appointment I’d lost weight, and at the end they actually praised me for having a gradual weight gain.

Part of me was happy at the praise, and the other part was really angry. Why are we even talking about this? It was not healthy. It was stressful to worry about how many grams different I was from the last time. I really hope attitudes change. I held my tongue because these were the people responsible for treating me. What if I had to have a C-section? I didn’t want them to think I’m that belligerent foreigner. I just complained to everyone else.

A friend of mine was in the waiting room after me, and I said to her in English, “This is ridiculous. I only gained six kilos. In Australia at this stage women are allowed to gain ten.” Later I discovered that the doctor actually spoke English. The walls were so thin she would have heard me complain.

I chose to go to a large hospital with all the departments, like surgery. In Japan most women prefer a maternity clinic, which would absolutely have no drugs. The maternity clinic is like a hotel with massages and facials and French cuisine. Going there is like a vacation except that it’s painful and you come home with a baby. But if something goes wrong they’d have to be carried off in an ambulance to a hospital. Would you enjoy five-star French cuisine after you’ve popped a baby out of you? If women want to do what their friends and their mothers did before them—okay, fine. But Japanese food is pretty nice, and the hospital is no exception. I would just have preferred larger portions because I was really hungry with the breast feeding.

I did have to have an emergency C-section because the umbilical cord was wrapped around the baby’s neck three times. So I was told, “You’re going to have a C-section in three hours, or you can come back on Monday.” I said we should get it over with,

In Japan they generally do the incision vertically, while in western countries it’s usually horizontal so you can wear a bikini afterwards. One of the doctors asked me which I preferred. Was I asked because I was not Japanese? I was so scared. It was all new. I hadn’t looked it up. I said, “Whatever’s best.”  “Well if you have a vertical cut it’s actually easier to get the baby out.”  So now I have a vertical scar on my abdomen. I’ve actually worn a bikini twice since Mei was born. Having a little bit of scar exposed hasn’t bothered me at all. It’s like a badge of honor.

Mei in highchair

That surgery was scary. I didn’t like being in the operating theater in an oxygen mask. I didn’t want to be awake when they were cutting me open, and I didn’t like not being able to feel my legs. I believe what they gave me is called an epidural—the needle went in my spine while I was lying on my side with my knees at my chest. They had to do it twice because the first shot wasn’t enough.

After the operation the medicine and drugs were in a bag connected to the hole in my back. There was a button I had to push to release more of the drug.  I hated having the thing in my back., And after about a day and a half I asked them to take it out. They objected that I still had plenty of medicine left. Again, Japan is pretty anti-drug. During surgery you get the hard-core stuff, but afterwards it’s actually similar to what you get at a pharmacy for headaches. For a couple of days I took low-dosage oral medicines. The incision area was uncomfortable, but not so painful that I needed to have anything stronger. I’ve been in Japan so long that I’ve become a bit sensitized to medicines, so they may be more effective than they might be if I were in Australia, where people pop paracetamol every time they have a headache.

I was pretty overwhelmed with feelings, having the baby and trying to develop breastfeeding. The world changed so much it didn’t seem to matter that my abdomen hurt. I left the rest of the medication at the hospital, figuring if I needed to I could just go to the pharmacy. A friend in Australia was given a strong drug during her C-section, and she was sent home with it after two or three days, not six

Hospital stays are probably so much longer because of the Japanese wanting everything to be perfect and no loose ends and everything safe and whole and complete. So even though I wanted to be home—are the cats all right? does the vacuuming need to be done?—I did want everything to be okay. I was able to have a bowel movement before I left the hospital, which was important after a C-section when all the organs are jostled around.

Reading in bed

My husband wasn’t allowed in the operating room, which is a big difference between Australia and Japan. I wish he had been, Husbands can come for a regular birth. He was allowed to stay with me for the first night in the hospital. After the first night the baby comes into your room with you.

The staff at the hospital were really good and the nurses extremely knowledgeable. They gave me a lot of information about breast feeding. My mother is a child health nurse, midwife and lactation consultant, so I had lots of information from her. But there’s a big difference between learning from books and having someone holding your breasts and telling you what something means or making suggestions and coming to check on you. I felt that was excellent.

Japan is very pro-breastfeeding, but in public women don’t without a baby smock that covers the breast and the baby. Every shopping mall has rooms for breastfeeding. I’ve heard of formula companies handing out gift packs with nappies and formula as a way of getting their products in the hospital door. But where I was there was none of that. All they talked about was breastfeeding. We had a couple of workshops—which they don’t have in Australia—with all the women who’d just given birth. Everyone was pretty shell-shocked as we sat receiving a lecture about how to go on with life: what to eat, what to avoid, what we’ll need, who to ask to help, when the next appointment was. One woman raised her hand asked what formula the hospital used. The nurse said, “I’m sorry, we don’t give out that information. Besides, we change it all the time.” I felt it was excellent that they didn’t give any advertising to formula companies.

Finances were pretty good. I paid for the first couple of appointments before the pregnancy was registered, but they weren’t expensive. After that the city government issued coupons for the hospital appointments. The hospital stay itself was about $6,500 because I had to have a C-section. The government paid about $4,500 in one lump sum, and our health insurance covered the rest, A stay in a smaller maternity clinic with the fancy massages and French cuisine would probably have been more expensive. In the end we actually made money off the birth because we got a refund of about $14.

On the day I was discharged, the hospital offered me a class in how to bathe the baby, but I’d already had one. When I got home my husband’s mother arrived with lunch. She lives just down the road. Introducing Mei to the cats was pretty interesting. I think they were surprised that humans came so small. I wasn’t supposed to do any heavy lifting, much housework or driving for a month. But my mother-in-law came over twice a day for about six weeks. She’d harness one of our cats and walk him every lunch time. Otherwise he’s unhappy about being inside. Then she’d come back in the evening to bring groceries and cook dinner. It was really a big help. I admit I wanted my control back, so I sneaked in several vacuuming and laundry sessions. Nobody noticed.

Being a mother required a massive psychological change. It was a big shock not being able to go to the toilet when I wanted to because I had a baby to look after. If I put her down she might cry. People don’t believe you should let babies cry themselves to sleep anymore, it’s better to be nurturing. Also, I’d worry if I didn’t have my eyes on her. That’s probably part of the universal experience in households with a nuclear family. It was different when many generations lived together and you had built-in babysitters.

Before I left the hospital I had to complete a checklist rating my feelings. Of course a woman could lie, or she might not know how she felt because her hormones were all over the place. Later at home you get a visit from the health center. You’re asked if you’re feeling depressed or stressed out. They have counseling services available, and they offer advice about how to get things done. When I was pregnant I wondered about post-partum depression. Would counseling services in Japanese be enough? Probably. I’m glad I didn’t have to find out.

Traditionally, a Japanese woman takes the newborn back to her home town and spends the first month or two at her parents’ house. Someone looks after them almost around the clock. Her family would know if she was in trouble. Many Japanese women even arrange to have their babies close to their parents’ house. In my case it didn’t make sense to take Mei back to Australia.

Mei is six months old now. We attend all the checkups and baby groups. She seems to be bigger than the other children, maybe because she’s half Australian. She’s a very happy, smiley baby. There’s a fad now for mixed-race children, so with her whiter skin and not-so-dark hair she’s considered quite a winner. In Japan the popular singers and models and actors are half-Caucasian and half Japanese. She gets a lot of compliments.

When Mei was three months old, I started teaching English again once a week. I was the employee chosen to speak to a newspaper reporter about the classes. It was no big deal. After that article appeared I was contacted by a state-wide Sunday paper doing profiles of non-Japanese living in our state. What do you think about Japan? What would you like to change? What are your views of your home country? Mei got in the newspaper as well—only three months old and already in the newspaper. And it was good for her photo album. The journalist asked about my plans for the future, and I said I’d written a series of five bilingual children’s books but had so far been unable to find a publisher. He was kind enough to mention them in the article, so hopefully the right people will see it.

Overall, except for the morning sickness I felt really special and really precious. Yes. I’m laughing because I told you how scared I was and how horrible the morning sickness was, but I’m willing to go through it again to have more children. I have time to decide whether to find anti-nausea medication. In Japan after you have one C-section all others will also be by C-section, while in Australia they let you try a natural birth. But at least the next time there’ll be no surprises. I’ve heard mothers forget the pain of childbirth as soon as they see the baby, but the memory is still pretty fresh in my mind. When Mei was born I was 36, which is old here. I think people assumed we weren’t able to have children. Now they’re happy for us.

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