Pregnant in Japan- The Basics

Being pregnant is a life-changing event. Being pregnant abroad is certainly nerve-racking. Please use this simple guide to help you navigate the very basics of being pregnant in Japan.

Confirming Your Pregnancy

As in the US, at-home pregnancy tests are sold in drugstores. There are two types, the First Response-type tests used the day of an expected period and tests that can be used a week after a missed period. The tests that can be used a week after a missed period provide discretion as you simply take the box off the shelf, go to the register, pay, and leave.

On the other hand, First Response-type tests, while also found on the shelves, are merely a display of an empty box. You must take the empty box to the pharmacy, fill out your name and address(!) to receive the pregnancy test.

Blood test and urine tests to confirm a pregnancy may also be done at a hospital or clinic.

Pregnant for 10 months

Pregnancy in Japan is a 10 month affair. As in the West, it’s a 40 week long affair. Yet here, those 40 weeks become 10 months of 4 weeks each. Those ten months are further divided into three trimesters: 初期 shoki (first trimester=0~15 weeks), 中期 chuuki (second trimester=16~27 weeks), and 後期 kouki (third trimester=28~40,weeks).

There is a special word for the second trimester, 安定期 anteiki. It has no direct English equivalent but signifies the period in which the risk of miscarriage is less. In the US, this period is after 12 weeks, but in Japan, it is at 16 weeks. Thus, pregnancy announcements in Japan are often made at the 16th week/5th month mark.  

Maternal and Child Health Handbook

Once your pregnancy is confirmed, to go to city hall to register your pregnancy. Once your pregnancy is registered, you will receive your 母子健康手帳 boshikenkou techou (boshi techou for short, Maternal and Child Health Handbook) to be used throughout your entire pregnancy to record your vitals. In addition, the boshi techou is also used to record your vitals/tests results throughout your hospital stay and 1 month postpartum checkup. Furthermore, you use the handbook  for your child’s checkups and vaccines, starting with right after birth with birth weight and length, up until your child is 6 years old.

As this book is very important, Japanese mothers often purchase special boshi techou holders so that their handbook, hospital cards, insurance cards, cash, and other relevant items can be stored in one location.

Maternity Badges

Maternity badges are given out to help pregnant women find seats on public transportation. They are attached to handbags with the idea that persons sitting will notice the pregnant woman and kindly offer her a seat. In addition, the badges also serve as a means of communication for women who are too nervous or shy to speak up and request a seat.

Maternity badges are available for free at public health centers and some train stations. Pregnancy magazines often have specially designed maternity badges attached as a bonus gift with purchase.


After registering your birth at your local municipal office, you will receive a set of vouchers for every checkup until you give birth. Vouchers will help subsidize the cost of tests while vouchers for three ultrasounds free of charge are provided. Even with the vouchers you can expect to pay between 500 yen to 10,000 yen depending on the tests.

From 4 to 10 weeks, checkups are 2-3 weeks; From 12-23 weeks, checkups are every 4 weeks, then from 24 to 35 weeks, checkups are every 2 weeks, From the 36th week of pregnancy, checkups are weekly, and once you past the 40 week mark, check ups are twice weekly.

At every appointment, they’ll take your blood pressure and weight, and a urine sample. Afterwards, the doctor will check your ankles for swelling and check the baby’s heartbeat as well, The circumference of your tummy may also be measured.

Checkup Schedule

The following is my hospital schedule to use for guidance. Please consult with your healthcare provider in regards to your pregnancy and needs.

Month 2 (4-7 weeks)

  • Confirmation of pregnancy
  • Transvaginal ultrasound

Month 3 (8-11 weeks)

  • Transvaginal ultrasound
  • Blood test
  • Cervical cancer screening

Month 4 (12-15 weeks)

  • Ultrasound if necessary

Month 5 (16-19 weeks)

  • Quad screen test (voluntary, done at 15 weeks)

Month 6 (20-23 weeks)

  • 4D ultrasound

Month 7 (24-27 weeks)

  • Glucose challenge test

Month 8 (28-31 weeks)

  • 4D ultrasound
  • Blood test for anemia
  • ATLA screening

Month 9 (32-35 weeks)

  • Gestational diabetes, chlamydia screening
  • Medication and retest for those who tested positive for chlamydia

Month 10 (36-40 weeks)

  • Ultrasound and fetal measurements
  • Blood test for anemia
  • HPL screening
  • Non-stress test

Weight Gain

There is an adage in Japanese, 小さく生んで大きく育つ “Chiisaku unde, ookiku sodatsu,” which means to give birth to a small baby so that they will grow to adulthood. Perhaps this is why Japanese women don’t gain much weight.

Pregnancy weight gain in Japan is based on BMI. For reference, please look at the following guidelines, which are from a handbook provided by my hospital. Please check with your healthcare provider.

Underweight/BMI 18.5 and under: Suggested weight gain- 10-12kg

Average/BMI 18.5-25: Suggested weight gain- 7-10kg

Overweight/BMI 25 and over: Suggested weight gain – 0-5kg

Hospital Reservation

Once your pregnancy is confirmed, you may want to look for a hospital or clinic where you want to give birth and reserve a spot as quickly as possible.

There are many factors to consider when choosing a hospital. For example, distance and ease of attending appointments is a major factor, as well as your level of comfort around staff. Does this hospital offer water births? Will my partner and/or children be able to attend the birth? Does the hospital provide epidurals or perform VBACs? Does the hospital provide private rooms and will my partner and/or children be able to stay with me?

As it will be your birth, think about the facilities and services that best match your needs.

Pregnant in Japan- The Basics

Read about my pregnancy and birth in Japan:

Pregnancy Pampering- How I Treated Myself

Natural or Epidural? – Birth in Japan 

My Birth Story – Birth in Japan 

My Hospital Stay – Birth in Japan

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