Pregnancy and birth in Japan: a cultural primer for foreign mothers

Gems for prospective moms: Cover up your extremities, don’t put on much weight at all — and scrub that toilet


While pregnancy and childbirth is a universal experience, having a baby in another culture can be full of surprises. Just ask any foreign woman who has given birth in Japan.

Maternal and infant mortality rates are among the lowest in the world, making Japan one of the safest places to have a baby. However, some aspects of Japanese prenatal care may leave foreign women bemused, bewildered — or even belligerent.

The K-A International Mothers in Japan is an online community for foreign women raising children in this country. More than 130 women whose youngest child is under the age of 15 participated in an online survey for this article. Of these, half gave birth within the past three years. The majority of participants come from Western nations.

Based on the survey results, the biggest single issue for these foreign mothers is the fairly limited weight gain recommended for pregnant women. More than 7 in 10 women received instructions about acceptable weight gain from their Japanese doctor or midwife, with 7-8 kg being the most commonly cited range (by 40 percent of respondents) for a singleton pregnancy. Somewhat alarmingly, at least from a Western viewpoint, 17 percent of the mothers who received guidance were told that the optimal gain was 6 kg or less.

The vast majority of women in the survey put on between 10 and 15 kg during their last pregnancy. This fits in perfectly with current Western wisdom, with weight gain of around 10-14 kg usually recommended for a woman whose pre-pregnancy body mass index (BMI) falls within the normal range. However, some of their Japanese caregivers took a decidedly dim view of such figures.

“I was told I’d have too fat a vagina to deliver vaginally, that my child would be too big and that I’d never ever be able to lose the weight,” reports Laura, who put on 11 kg with her pregnancy.

Kelsey was given a relatively generous 10 kg allowance.

“They said, ‘We can’t deliver the baby if you put on any more weight — the table cannot support you!’ ” she says. “Funny thing is, I ended up putting on 13 kg and they delivered my baby just fine.”

A number of the women resented that medical staff made value judgments based on what they assumed “foreigners” ate, chastising their patients for indulging in too much bread, junk food or sugary drinks.

“The doctor seemed to think my diet consisted of foods seen in U.S. movies and TV shows — potato chips and ice cream. When signs pointed to a raise in my sodium uptake, she accused me of eating sausage, when in fact, the sodium culprits were umeboshi and soy sauce,” recalls Amy, referring to the pickled Japanese-plum condiment.

The staff at Mejiro Birth House in Tokyo are familiar with the needs of Japanese and non-Japanese patients alike.

“While there are some exceptions, a weight gain of up to 10 kg in total is preferable for Japanese women, due to the fact that Asians generally have a smaller build,” explains midwife Yuko Hoshino. “Our non-Asian patients can safely put on a little more than this, though.”

Dr. Hideki Sakamoto, a bilingual Tokyo-based obstetrician and gynecologist, has many foreign patients among his clientele. He supports the more holistic approach currently favored in the West, using a woman’s BMI as a guide for weight gain, rather than adhering to a rigid set of criteria.

“If an expectant woman starts out underweight she should put on a little more, and similarly, if her BMI is in the overweight range, then she should put on less,” he says. “I know of no scientific research that supports the Japanese tendency to promote relatively small weight gains in pregnancy, but the practice is very likely a carryover from the past when smaller babies made for easier deliveries and less risks of complications,” Sakamoto notes. He also points to ongoing research by the International Society for Developmental Origins of Health and Disease suggesting that children of women who put on less than the recommended weight in pregnancy may have an increased risk of health problems later in life.

Although stringent guidelines are a potential source of stress during pregnancy, some women commented that the payback came after giving birth.

“I am glad that my doctors were strict about weight gain, because after my baby was born, I didn’t have to worry about losing weight or buying new clothes,” says Julie. “I was back in my pre-pregnancy jeans in three weeks. My friends from back home usually take months to get their figures back.”

Some of the standard pregnancy advice in Japan can flummox foreign women. Some were discouraged from doing any form of exercise at all, while others were advised to perform strenuous regimens of squats and floor cleaning in order to tone up their muscles for the impending birth.

Among the oddest advice was this gem from Mary: ” ‘If you clean the toilet, you’ll get a beautiful baby’. Can’t help but feel a male made up that advice.”

One of the most commonly mentioned conventions in the survey was to ensure that the belly and extremities stayed warm by covering up.

“I was told to keep my belly covered at all times — with multiple layers even in the midsummer heat — because if the belly cooled off the baby would catch a cold,” says Heidi. “The midwives also said to always wear socks so that the pressure point above the ankle that connects to the uterus is covered and kept warm. After hearing that a few times, I started carrying socks in my bag to put on when entering the clinic for a checkup.”

Brett Iimura of the Childbirth Education Center in Tokyo is well-versed in helping foreign women navigate the Japanese medical system, and offers the following insight on the “Don’t get cold” phenomenon: “There is some evidence that the difference between upper-body and lower-body temperatures is implicated in something called hieshō, in which some women are particularly sensitive to cold, and this is thought to have implications for birth.”

“Traditionally, it is thought that the belly and feet need to be kept warm, especially during pregnancy, which is why pregnant women are often admonished by passers-by — especially by older women — if they are scantily clothed or not wearing socks, even in the heat and humidity of a Tokyo summer,” says Iimura. “Perhaps science will eventually show there is a physiologic basis for this advice, at least for some women.”

Britain’s Duchess of Cambridge may have been out of hospital and in front of the world’s press just hours after giving birth to Princess Charlotte, but women in Japan can expect a much more generous postpartum hospital stay. While 24 to 48 hours is becoming the norm for a regular delivery in many countries in the West, the majority of the survey participants stayed between five and eight days (60 percent). In general in Japan, it is considered that women need ample time to recover and rest from the rigors of childbirth.

Some women thought a compromise between the Western and Japanese extremes was best, suggesting that three to four days would be an optimal hospital stay. Others said it should be up to the mother to decide when she is ready to leave.

“I really think Japanese women need more choice and autonomy,” Rachel says. “They should be encouraged to trust their instincts, to be allowed to go home if they want, or to stay if they feel they need to, and be properly taught how to care for their baby, rather than have it taken off them.”

Xana grew to appreciate the merits of a longer hospital stay with subsequent births.

“The first time,” she says, “I thought, ‘Ugh, I have to stay for a week?’ The third time, I thought, ‘Woohoo! Great food, no cooking, laundry or taking care of kids (other than the newborn) for five days!’ I knew it was the only five-day vacation from chores I’d have for the next 18 years at least.”

Mothers with new babies tend to be magnets for unsolicited advice in any culture, and Japan is no exception.

“I was asked by a kindly lady at the supermarket how old my baby was. When I said ‘Two weeks,’ she proceeded to yell at me about how dangerous it was to have the baby out so young,” Lucy recalls. “What was I supposed to do? I was alone and needed to shop! Japanese mothers traditionally stay with their own mothers for the first month or two after birth and stay in the house with the baby. No chance of that if your mother is in a different country!”

“Stay home with a new baby for the first month” is fairly standard advice in Japan, with the view that the fragile newborn and the new mother should rest and build up their strength. However, few of the mothers in the survey followed this advice, particularly those who already had older children.

Corin, a mother of three, advises other women to trust their own intuition.

“Try not to take all advice to heart,” she says. “People advise out of concern and based on what they are accustomed to. If you don’t agree with the advice, say ‘thank you’ and then ignore it. Do what you are comfortable with and try to listen to your instincts.”

The mothers in the survey said that having someone to discuss their concerns with, either in person or through online forums, was a huge help when experiencing pregnancy in a culture that isn’t their own. In line with this, a small but growing trend is to request the support of a doula — someone who offers emotional and physical support to a woman before, during and after childbirth.

Stephanie Kawai is one of a handful of English-speaking doulas in Japan.

“Every birth experience is unique, but going through labor and giving birth in a country like Japan can add a whole new level to that experience due to cultural practices, expectations and, of course, the language barrier,” she says. “A doula can be a wonderful voice of support, and offer reassurance by guiding you not just through each contraction but also through the Japanese culture of birth.”

K-A International Mothers in Japan’s Facebook page: www.facebook.com/KAInternationalMothersinJapan. Your comments and story ideas: community@japantimes.co.jp

  • Japanese Bull Fighter

    Curious use of the word “foreign” in this article. Does the author really mean “white”? Most foreign nationals in Japan are in fact from Asian countries. Vietnamese for example outnumber both Europeans and North Americans.

    • Gordon

      Think of the audience. The English Japan Times is not for Vietnamese; it is for ENGLISH speakers from ENGLISH-speaking countries. We all know that there are many different foreigners in Japan, but to specifically state each time that you are speaking to foriegners from English-speaking cultures is extremely pedantic. I do not watch the Women’s TV Channel and then complain about the under-representation of men. The English Japan Times and the Women’s TV Channel are designed for niche markets.

      What is worse is that you assume that the author was speaking to ‘white’ people only. Most English-speaking countries are multiracial, so if anyone needs to apologize, it should be you, Japanese Bull Fighter.

      • Japanese Bull Fighter

        Japan is multiracial too. I’m Japanese but I’m white. For better or worse, I’m male so pregnancy is not an issue for me.

        Precisely because countries are multiracial, the foreign-Japanese distinction in the article seems bizarre. Would the weight gain recommendations discussed be appropriate for an American whose genetic ancestry was 100% Japanese, Chinese, or Vietnamese?

        You may find my emphasis on the nationality makeup of foreigners in Japan to be pedantic but I find the implicit assumptions behind the JT use of the term foreigner to be offensive.

        Even following your claim that the JT is “for English speakers from English speaking countries,” the JT usage makes little sense. India has nearly as many English speakers as the total population of Japan. English is an official language in India. It is probable that most of the Indians in Japan are functional in English. Would they be included in the advice to foreigners about pregnancy weight gain?

        If you are talking about people of white European ethnic and genetic background, why not say so?

      • Laura

        Those surveyed were not just white, why would you assume that? And those with Asian ancestry in the US are also given more generous weight gain parameters than those given in Japan.

      • Japanese Bull Fighter

        Actually, the text does not appear to say anything about recommendations for Asians other than Japanese.

      • Laura

        It states “This fits in perfectly with current Western wisdom, with weight gain of around 10-14 kg usually recommended for a woman whose pre-pregnancy body mass index (BMI) falls within the normal range.” It doesn’t say “for white women.” In Western countries, you are given those guidelines regardless of ethnicity, just like Japanese doctors here generally give THEIR guidelines across the board to patients, regardless of genetics. Do we have to spell everything out or you?

      • Japanese Bull Fighter

        That’s not what UK sites say. The figure I kept seeing was 10-12 kg with the advisory that it depends on the individual. Are you arguing that the UK is not a “Western” country?

      • Laura

        Perhaps English isn’t your strong point. Did you see the word “around” in that quote? That means that the weight guidelines are in that area, not ONLY that. So, “around 10-14kg” would also include “10-12” and “10-11.” Or do you think it’s only accurate if she gives a full chart of all Western countries and details one by one how the weight gain recommendations compare?

      • Japanese Bull Fighter

        Yes, a full chart is just what I would like. Or, at least a statement of the range and distribution. “Western” is a very vague term. I suspect that many Japanese and non-Japanese use it to give general validity to claims that are based on the writer’s knowledge of one and only one country.

        When someone says Western, I always wonder what they are talking about. West of the Mississippi? West of the Rockies? West of the Urals? The original EU countries? The Expanded EU? The East vs West divide of the Cold War years? Are Australia and New Zealand included? Are Russia and the Ukraine Western?

        I have lived in both Britain and the US. Both countries are presumably “Western” but on a whole range of things including medical issues, “common sense” is very different. Because I have lived in two countries “divided by a common language” as Brits like to say, I would not make a Japan-Western comparison just from US experience or just from UK experience because I know that on most points there is as much difference between the US and the UK as there is between the US and Japan or the UK and Japan.

      • Laura

        Well, if you’re looking for a full chart with all the countries, then you’re better off looking at a different kind of media – academic articles perhaps. The Japan Times isn’t where you’d go for such a detailed representation of the data. A statement of “around 10-14kg” adequately describes the prevailing weight gain guidelines in Western countries (and if you don’t know what is meant by “Western countries,” then perhaps you need to read up on it as the vast majority of people DO know what is implied).

        This article, again, is not talking down on Japan, not making “us vs them” arguments, nothing like that. It’s basically giving women an idea of what they can expect that MAY be different from their experiences that they would have expected “back home,” which is very nice knowledge to be armed with.

      • Japanese Bull Fighter

        What women from some countries might find different.

        And, I have in fact read up on the concept of “the West” and “Western countries.” As a result I know that these are very amorphous concepts that are generally used by someone trying to claim greater validity for what they are saying than is really the case.

        Japan is one single country. It is different from all the countries comprising “the West,” whatever that is. Except, the countries of “the West” are also very different from each other. Such comparisons are the stuff of what Edward Said called orientalism.

      • Laura

        Which is why I put “giving women an idea of what they can expect that MAY be different.” There’s no guarantees or value statements given here. You are applying that yourself. The article also doesn’t claim that all “Western” countries are the same, either. If you were paying attention, it says that this is what information was given from a survey of foreign women in Japan, many of which are from Western countries. The estimated weight guidelines attributed to the “West” were there as a reference as to why the weight gain advice in Japan might be shocking to foreigners. Again, no value statements, no saying that the Japanese way is better than other ways or vice versa. You’re putting words in the mouth (pen?) of the writer.

      • Japanese Bull Fighter

        I checked a number of Japanese language sites for advice on weight. All included a do it yourself calculator but all also included the same general guidelines.

        Thin: 9~12kg

        Standard (normal) 7~12kg


        In other words, the Japanese recommendations for Japanese people overlap the “Western” guidelines. They are not mutually exclusive. Generally, the pattern seems to be the heavier your are, the less you should gain. The lower figures some women quoted in the article may have been due less to Japanese vs “Western” common sense than because their doctors thought they were overweight.

        I would also note that the French recommendation for no more than a 9-10kg gain fits within the Japanese normal recommendation thus making it “Western” if France is assumed to be a “Western” country.

      • Laura

        Although the sites are getting more with the times, the actual experiences of those who are pregnant are different. Even my boshi techo says 7-10kg. Also, many other people I have talked to have said they were given recommendations for weight gain before even being weighed, so if their recommendations WERE adjusted for current size, it wasn’t measured but rather assumed. I know for myself, I was at a normal BMI and chastised for gaining 5kg total at 30 weeks.

      • Japanese Bull Fighter

        There are several problems inherent in relying on a self-selected survey conducted through the Internet. The experiences of someone N years ago may not be typical of what is prevailing practice now. People who experienced something they did not expect or that they disliked are probably more likely to respond than those who were completely happy with their experience. ObGyn specialists who cater to foreigners might not have the same notions of what is appropriate as do those catering primarily to Japanese. Given the small number of respondents overall and the smaller numbers for some of the patterns taken up, there is also the technical issue of whether the sample is large enough to warrant generalization.

        As for being given recommendations for weight gain before being weighed in, I would think that experienced doctors and nurses would have a reasonably good notion of weight just by looking at people. The sites I looked at in English and Japanese all give “rule of thumb” guidelines for weight gain.

        Medical common sense is a moving target in any country, especially Japan. I’ve seen gaijin oriented sites describing Japanese medical practice in terms that might have been reasonably accurate when I first came to Japan in 1971 but which no longer apply to what I have seen in Japan through my own experience, that of my wife (two births in Japan), and my children (ages 14 and 11). Indeed, there have been distinct shifts in some areas just within the span since I immigrated to Japan (1997).

      • Laura

        Laura Japanese Bull Fighter • a few seconds ago

        The sample size is going to be quite small because it asked foreign women which, as you well know, is a rather small portion of the population of Japan. It also states that over half of the participants gave birth within the past 3 years, so their experiences are not out-dated. They also reflect the current experiences of myself and my friends, both Japanese and foreign. And, again, the article does not posit that this is How It Is, but that these are some experiences of some foreign women. It is also not all negative, but rather well-balanced.

        As for judging weight of people by looking at them, that is rather hard even for those who deal with bodies all day. Complicate that by having someone with a totally different physiological structure than you are used to dealing with and you will have terrible accuracy. Also, physicians should not eyeball these things as starting weight is also important when dealing with appropriate dosage of medications should they be necessary

      • Japanese Bull Fighter

        If you and other women are happy with the article, I suppose that’s all the counts. I would wonder if the tone and what seem to be somewhat extreme cases might create unnecessary anxiety. And as always I would add the caveat that the survey addresses Anglophone foreign women in Japan. For the JT audience, that’s to be expected. There are far more foreign women in Japan who have Portuguese, Tagalog, Korean, or Chinese as their first language. For my teaching purposes, I’ll be looking to see if I can find anything in either English or Japanese on how women of the vastly larger Chinese, Korean, Filippino, and Brazilian groups view the maternity system in Japan.

      • Hendrix


      • Japanese Bull Fighter

        Just checked an English language site for expats in Germany. Says the German recommendation is 10-11 kg weight gain. Is Germany not a “western” country?

      • Japanese Bull Fighter

        Just looked at some sites dealing with being pregnant in France. Apparently the French “rule of thumb” is 1kg gain per month for a maximum of 10. Is France not a Western country?

      • Squeakyginger

        Did you read the whole article? The third paragraph says that the majority of those in the survey are from ‘Western countries’. Doesn’t necessarily mean they are all ‘white’.

      • Japanese Bull Fighter

        Majority is hardly a precise term. Assuming 130 participants a simple majority would be 66. In the colloquial usage of majority it might be far more.

      • Hendrix

        ” I’m Japanese but i’m white” dont make me laugh… they see you as a Gaijin thats all you will ever be, wake up and smell the coffee.

      • Japanese Bull Fighter

        Not where it counts. When it comes to voting and getting government services, I’m 100% Japanese.

      • Jonathan Fields

        No, you’re not. You’re required to receive that stuff by law, but Japanese people will never truly see you as one of their own. You know it’s true, JBF.

    • jimbo jones

      you’re a broken record with this foreign=/=white rant. we get it. it’s an english speaking audience. anything academic to add?

      • Japanese Bull Fighter

        Lots of Asian people are English speaking. English does not correspond with ethnicity or “race.” Singapore is an English speaking country in Asia. So are Australia and New Zealand. The article is about pregnancy advice based on nationality – Japanese vs non-Japanese. But, neither the language you speak nor your nationality determines you genetic makeup or you BMI.

        Further, the article seems to assume there are two patterns of pregnancy and birth: the Japanese pattern and the foreign pattern. Advice to pregnant women is in fact different among foreign countries, even English speaking ones. I know because my wife was pregnant in Britain. The British system of care and advice for pregnant women is quite different from that which prevails in the US although both are English speaking countries.

      • Laura

        I don’t see where you get that she’s presenting that there are only two ways of thinking, Japanese or “foreign.” Actually, that’s more of a way of thinking in Japan, that there is only “Japan” and “Gaikoku,” in which all of Gaikoku does the same thing and speaks the same thing and can never be understood by Japan (and vice versa).

        This is a result of foreign women in Japan who were interviewed about their experiences. I don’t see it as a Us vs Them thing, but rather, “if you’re foreign and pregnant in Japan, you might come across this!” To someone who is experiencing this stressful time in her life, to know her experiences are not just her own is comforting.

      • Elizabeth Tsuruta

        “Singapore is an English speaking country in Asia. So are Australia and New Zealand.” – Australia and New Zealand are in Asia?

      • Laura

        Learn something new everyday!

      • Martin McNickle

        English does not correspond with any ethnicity or race, or the English language?

        Also, the term “foreigner” doesn’t correspond with just “white” as you’ve been trying to imply.

    • Garthgoyle

      I really don’t see where you got that the author is referring to white people when talking about foreigners.

      • FeministSafeZone.blogspot.com

        Uh, maybe he got that from where the author cited a doctor talking about physiological differences, aka ‘smaller build’ of Japanese women vis a vis “foreigners.” Given the comment I doubt the “foreigners” he was referring to were Vietnamese or Koreans, whose builds are more-or-less the same as Japanese women, if you didn’t notice.

      • Laura

        That still doesn’t mean that all “foreigners” referenced are white. As Martin pointed out, black people would certainly be called “foreigners” in Japan, as would a variety of other people.

      • Martin McNickle

        So I’m guessing foreigners can’t be black also? It’s a little disturbing that the only other example of foreigners you provide is “other Asians.”
        Last time I checked, North Americans come in many colours besides white, and even Europe is a melting pot.

    • GIJ

      Well, I’m curious about your curiosity. What makes you think the author Kittaka really means “white” when she uses the word “foreign?” Is it because Kittaka herself is a white woman originally from New Zealand? Do you suspect that when a woman of Kittaka’s background writes that “the majority of participants come from Western nations” in reference to the survey data used for the article, she really just means that most of them are white? If so, why?

      • Japanese Bull Fighter

        Because there are no references to any advice based on your ethnic or genetic background. For example, would a Japanese doctor give a pregnant Chinese woman from Singapore the same weight gain advice he or she would give to a large Nordic woman?

        If there had been something in the article about whether Japanese doctors do or do not give different advice depending on whether you are foreign in nationality but Asian, perhaps even Japanese, in terms of physique, then I would assume that she was not just assuming that foreign means white European.

        I also have to wonder precisely how many “Western countries” she has checked in terms of what constitutes the recommended weight gain.

        i checked a few UK web sites. While the article states that Western common sense is 10-14 kg, UK sites say 10-12 and provide do it yourself calculators to determine appropriate weight gain. Same for Australia. US sites gives 11.3 to 15.9 for “normal” weight women. New Zealand government sites give 11.5 to 16 kg for “normal” weight women.

        Just looking at these English speaking countries, it would appear that there is not one well delineated “Western” weight gain standard that can be set off against a Japanese standard. Moreover, sites explicitly state that it depends on the individual.

      • Laura

        “For example, would a Japanese doctor give a pregnant Chinese woman from Singapore the same weight gain advice he or she would give to a large Nordic woman?”

        Yes, yes they would.
        And if you didn’t see anything in the article about “whether Japanese doctors do or do not give different advice depending on whether you are foreign in nationality but Asian, perhaps even Japanese, in terms of physique,” then clearly you need to read again because that is clearly in the article.

      • Japanese Bull Fighter

        I read the article again. I still can’t find any references to doctors giving advice based on whether they are foreign but also Asian in physique.

        I also noted that the article relies on a number of one off anecdotes from busybody types. I wonder if this is a Japanese peculiarity? And, do single examples document a pattern?

      • Laura

        The article shows that the advice given is generally the same across the board (though there are some exceptions, as in the midwife who was quoted as saying foreigners can gain a bit more). The foreign women are being given the same advice as the Japanese women. So, the doctor (usually) wouldn’t care if you are Asian, white, black, mixed, or where you are from. They give a “one-size-fits-all” approach rather than considering each woman on a case-by-case basis.

        So, to a person who is expecting guidelines falling on “Western” points of view, to be told that the minimum from their home countries is probably over the maximum “allowed” here, that’s a big shock. The article isn’t saying one is right or one is wrong, but saying that it is what you can expect to hear.

        Also, the anecdotes are not being presented as “you WILL face this,” but “this is what some people have experienced.” Again, the article is giving examples of what people have reported as their experience. It’s not presenting it as hard data to make a point. If you’re looking for things like that, you’re looking in the wrong place. Japan Times is NOT that kind of publication and the readers are generally not here for that kind of in-depth data and analysis.

      • Japanese Bull Fighter

        As you might guess, I’m not a big fan of articles based on one off personal experiences because they are just that – personal experiences.

        I certainly understand that the Japan Times does not (usually) provide “in-depth data and analysis” but in theory the JT is “the world’s window on Japan.” That’s what it proclaims in some of its advertising material.

        But, articles like this and most articles I see are less about Japan than about a very small minority of foreigners in Japan, predominantly white Europeans from North America, Europe, Australia and New Zealand.

        Perhaps the JT should change its slogan to reflect what it actually does, something like “the world’s window on whinging gaijin in Japan.”

      • Laura

        Sharing experiences and giving each other a view of what they might expect is “whinging.” Really? I think this gives a great view of a snippet of Japan. Sure, it’s from the eyes of foreigners, but when the target audience is foreigners, it is useful to have a foreigner’s perspective on it.

      • disqus_qRIfrj3zeJ

        This column is called “The Foreign Element.” If you don’t want to read about “whinging gaijin in Japan,” maybe you should avoid reading this column.

      • Japanese Bull Fighter

        Yes, I think you are right, but I would love to read something in English about other foreigners in Japan, especially the Chinese (far and away the largest group in Japan). Unfortunately, I don’t read Chinese so I cannot see what is being said in the Chinese newspapers being published in Japan. JT could do a real service by getting columnists from other ethnic and national groups.

      • disqus_qRIfrj3zeJ

        If there was a large demand, I’m sure they would. How many Chinese expats read Japan Times and are disappointed by lackluster Chinese representation? Perhaps you’d have better luck just learning Chinese.

      • Martin McNickle

        If you’re not a big fan of these articles, why do you bother reading them and commenting? Duh.

      • Kym

        Busybody types, eh… Pot, meet kettle.
        As a *foreign* mum in Japan, I thoroughly enjoyed reading this article. If it wasn’t to your taste, go look for an article written for white, male busybodies. There are plenty of them out there, mate. PLENTY.

      • Japanese Bull Fighter

        I read lots of things, but since I teach a course in Japanese to Japanese students about comparative childcare systems, I am looking for material that is useful in teaching, and at least in terms of the headline, this article appeared relevant to my course. I’m an not, however, looking for things that are “enjoyable.”

      • Kym

        No kidding, you don’t strike me as the kind of person who enjoys life.
        There are several women who are commenting on this thread who also teach Japanese students, and I’m sure, like myself, once they have discovered an article is not appropriate, they move on and look elsewhere. They don’t feel the need to criticise the writer for not writing an article that reads like an academic essay.

      • GIJ

        “I still can’t find any references to doctors giving advice based on whether the woman is foreign but also Asian in physique.”

        I just realized that while you have really serious problems with the use of the word “Western” as it is applied to Europeans and North Americans, you apparently have no problem with using the word “Asian” as a blanket term to describe more than 4 billion of the world’s people stretching from Turkey to India to China to Japan to Indonesia.

        If it’s so problematic to *ever* talk about Western culture or Western countries, then why is it all right to refer to the existence of an Asian physique? The body types of Chinese and Koreans and Japanese are not the same, let alone those of Turks, Iranians, Bangladeshis, and Filipinos.

      • Japanese Bull Fighter

        I fully agree with you.

      • GIJ

        OK, if you agree with me then in the future do try to refrain from referring to the notion of being “Asian in physique” as you did above. Such a term is no more valid or applicable than labeling someone as being “Western in physique.”

      • Japanese Bull Fighter

        No problem. My usage was sloppy. I violated my own rules for terminology. Mea culpa.

      • Laura

        Since you seem to know so much about pregnancy in Japan and how to write a proper article, I’d love to see yours.

      • GIJ

        “If there had been something in the article about whether Japanese doctors do or do not give different advice depending on whether you are foreign in nationality but Asian, perhaps even Japanese, in terms of physique, then I would assume that she was not just assuming that foreign means white European.”

        In this hypothetical situation, you would not be assuming anything. Rather, this would be a case of your changing your view of the author’s perspective based on the presentation of additional information.

        I can only conclude that, given your rather extremely negative view of virtually every article you comment on at this website, you *assumed* from the start that the author equated “foreign” in the title with “white” and you went from there to the comments thread.

      • Japanese Bull Fighter

        Precisely. I don’t feel obliged to comment on articles that do not have vague assertions and other problems.

    • disqus_qRIfrj3zeJ

      The group she polled, K-A International Mothers in Japan, is for moms of any nationality/ethnicity. There are women (and a few men) from all over the world in that community. So no, the author does not mean “white.”

      • Japanese Bull Fighter

        I know. I looked at their Facebook site but I would still describe it as a predominantly white organization. As such, it does not represent the ethnic or “racial” makeup of the foreign population in Japan.

      • disqus_qRIfrj3zeJ

        No, you didn’t, because their Facebook community is hidden from non-members. What you looked at was the separate public version which is primarily for posting news, and doesn’t have nearly the same amount/range of members as the active community.

      • Japanese Bull Fighter

        Thank you. That is good to know. I followed the link at the bottom of the JT article.

  • Laura

    Oh so true~ If you’re pregnant and a foreigner in Japan, find a good support group of women who have been there and done that! I didn’t have that my first time around, and it was so stressful, especially when being told to do things that were, to my knowledge, harmful to myself and baby (boiled cabbage only diet from third trimester???). 32 weeks in on my second and this time it’s MUCH better thanks to online support.

  • Japanese Bull Fighter

    At what percentage does a country shift from being mono-racial to multi-racial?

    • Martin McNickle

      About the time you grow a clue, I suppose.

    • Hendrix

      certainly a lot more than 1% ….

      • Japanese Bull Fighter

        Is there something inherently good about a country being multi-racial or multi-ethnic? A number of countries are mono-racial or close to it – Korea, Dominican Republic, many countries in Africa. I don’t see them getting criticism for being that way.

        Look at countries that are multi-ethnic. Very often being multi-ethnic is associated with internal warfare (Ukraine, Fiji), terrorism (China), or even genocide (Rwanda).

        Yugoslavia was multi-ethnic. Cyprus is multi-ethnic. Iraq is multi-ethnic. Syria is multi-ethnic. Myanmar is multi-ethnic. Being multi-ethnic was/is not a good thing for these countries.

      • Laura

        Was anyone saying there was anything good or bad about the racial or ethnic makeup of a country? Nope. Stay on topic.

      • Japanese Bull Fighter

        At least two people raised this. Not my idea.

      • Laura

        who? I don’t see anyone making value judgements.

      • Japanese Bull Fighter

        You are correct in that no one has explicitly made a value judgement but the homogeneity of Japan is something almost never cited as a virtue by foreign commentators. Unless someone thinks it is a problem, there’s no obvious reason for raising the issue in any venue least of all this one.

      • Hendrix

        You have just basically put forward an idea that is deeply racist, that countries with other cultures and other ethnicities are prone to conflict, war and misery…. you certainly have bought into the “ethinic purity” myth that Japan subscribes to daily…. well the Japanese see you as a Gaijin and if you cant see that then you must be on another planet…. keep taking the blue pill.

      • Japanese Bull Fighter

        No, I have put forward some deeply realistic examples from the recent historical record. Only a small number of multi-ethnic multi-racial societies have worked well for any length of time. The United States is not one of them.

        Given your perception of Japan as a society where immigrants even if naturalized will always be seen as gaijin, it is you yourself who is saying that Japan could not function as a multi-ethnic or multi-racial society.

        If Japan cannot, as you seem to believe, accept immigrants, why should it bother to try?

        I have lived in Japan off and on since 1971, permanently since 1997. I am well aware of how I might be perceived. If this bothered me, I would have returned to Britain.

        In practice having citizenship but being seen as a a gaijin works to my advantage. Very often gaijin are paid more than Japanese for the same job and given preferential treatment and service. Particularly in teaching, there are jobs where preference is given to gaijin and that is determined by your country of origin, not your current passport. But, because I have Japanese citizenship, I can take any job I want or have no job at all without worry about visa status.

        Some commentators have suggested that if I do not like what I find in this column, I should not read it. Perhaps you should think about how that advice might apply to you. If you do not like Japan or the Japanese, why not keep your distance from them?

      • Hendrix

        ” If Japan cannot, as you seem to believe, accept immigrants, why should it bother to try?” what sort of nonsense statement is that? …. is your head on the wrong way around? …. and who said i didnt like Japanese or Japan? …. don’t make assumptions it shows your ignorance.

  • Kelsey

    All of this rings true…my pregnancy here was one of the saddest moments in my life..it made me not want to have another kid again ever. From the stress of weighing in at the doctor, to how I was treated at work. But I was very thankful to find the KA group; the ladies there gave me a lot of advice and I ended up feeling a lot better once my daughter was born. Without the emotional and educational guidance of these foreign women (many from Western countries, as listed in the article, but some other places) I was able to have a safe delivery and survive postpartum–and stay married. I owe a lot to the KA group and those women.

  • Kym

    Thank you for another great article, Ms George-Kittaka.

  • Erinn LaMattery

    Louise, what a great article, thank you so much for taking the time to interview as many people as you could to gain the input you did for this article on what we foreign women living in Japan face when pregnant. Having gone through it 4 times now, it’s nice to see some of the frustrations over the advice and counsel we have been given by our doctors, nurses, local grannies being put into words. I actually found my 4th pregnancy the most frustrating, I got the most unsolicited outrageous advice from nurses and grannies, if it weren’t for the fact I’d already done it 3 times and everything seemed right on track, I’d have started to doubt my instincts as a mom.

    Mr. Japanese Bullfighter, I seriously don’t know whether to laugh or cry over your attempt to take up some sort of crusade. What that crusade is, I haven’t yet figured out. You claim to be a ‘white Japanese’, so that leads me to believe you are either:
    1. albino Japanese (but I doubt it)
    2. you were born in Japan to caucasian parents who were for some reason unknown to us unable to pass on their citizenship to you and therefore the only option was for Japan to grant it to you
    3. You renounced your (caucasian) citizenship and have become a Japanese citizen. Kudos.

    But, your continued attempts to fight for your cause in this comment thread is:
    1. minimizing the real and true life situation of women who have actually gone through pregnancy in this country and given birth, and endured some very outdated opinions and advice on that pregnancy.
    2. trying to actually make this article of greater ‘scientific’ research than it actually is. This article is the word of mouth from the people who have done the deed: been a foreign woman giving birth in a foreign country. Whether the woman is caucasian (as I am) or other (as many are), there is one area we all seem to bond on: the stress of having a child away from your home country, family, friends and in an environment that is really, to be honest, foreign. I don’t think Ms. Kittaka was trying to prove a scientific point, and if you are looking for something more ‘official’, perhaps you should stay away from option types of articles.

    May I suggest you take a moment to appreciate the amazing strength any woman of whatever ethnicity has to go through childbirth, and then add on to it living in a country, amongst a culture and language not their own, and give those women a word of appreciation for not only going through with it, but doing it with courage and determination to make it work despite so many challenges in their path.

    • Hendrix

      I’m glad someone has finally taken the time to put Japanese bullfighter , a well known apologist, in his place… well done.

      anyway, what this article highlights is the ignorance and general stupidity of the Japanese healthcare system when dealing with foreigners… i could also give examples but too long to go into.

    • Mark Makino

      He’s right that the essentializing of foreigners, Westerners, and Japanese is a common and distressing problem in articles in Japan’s English-language press, and that this article has that problem in evidence. You’re right that it’s not the point of the article, but of course it’s not really the point of any article. It’s just very common.

    • Steve Jackman

      According to his own past comments here on The Japan Times, Japanese Bull Fighter is originally a British citizen of rather advanced age, who renounced his British citizenship to become a Japanese citizen. His comments remind me of the senile rants of an uncle of mine, who is not quite of sound mind.

      For some comic relief about maternity in Japan, try watching the excellent report by Rupert Wingfield-Hayes on BBC being aired today, or watch and read his report on the BBC Website (title: The beauty contest winner making Japan look at itself), in which he writes about his own experience, “When my (Japanese) wife got pregnant, one of her friends congratulated her with the words: “It’s not easy for us Japanese to get pregnant with a foreigner”. I didn’t know whether to laugh or cry.” Yes, I wouldn’t know whether to laugh or cry either.

  • Kanagawa Kats

    Thanks for another great article, Ms. Kittaka. I really enjoyed taking the survey and reading the article. It’s tough being a mom in any country, but giving birth in a country where you might not always understand the culture and/or language adds complications. Having the support of other moms who’ve done it before you is priceless.

  • Shaun O’Dwyer

    Er…not wanting to start another front in the culture war here, but…epidurals and other types of pain relief are rather hard to come by for labour pain in Japanese hospitals, aren’t they? My anecdote- laden survey of Japanese mothers in my acquaintance indicates “many” would’ve liked to have had the choice of taking them when giving birth…

    • Hendrix

      yes , there is a general consensus that Japanese mothers to be have to “suffer” a bit to be real mothers, not joking… my wife went thru hell , in my country she would have been given an option of pain relief early on… in Japan? nothing… suffer all the way.

    • Laura

      Yes, not even an option at my clinic. You can get paid meds after, but during?? Nope! Fortunately, my labor wasn’t too bad or long, but I feel for those who went longer and harder!

  • mrdavidnet98

    When my wife became pregnant in Japan I have to admit we were a little apprehensive to say the least. However, we had nothing but praise for the whole process from pre-natal check-ups to post-natal support. In almost every way it was better than our previous experience in England, although as we were NHS it isn’t really comparing like with like. Two main surprises were the doctor telling us the sex of the baby without asking us if we wanted to know, as would happen in the UK, and the elective induction to fit in with my leave from work! Overall, I can honestly say that the whole experience was top class from beginning to end.

    • Laura

      That’s great that you had a positive experience. There are certainly some great places. I had a horrible place up until the third trimester of my first pregnancy. Once my doc told me I had to go on a boiled cabbage ONLY diet because I was too fat (up less than 5 kilos, had started at a normal BMI), I switched and found a LOVELY clinic. This time is much much better, but not everyone is so lucky!

  • Hendrix

    yeah, I don’t know what he is smoking but it sounds good

  • Susan

    What a fun and informative look at the process of having a baby in Japan! One of the very best aspects of my experience was the pre- and post-natal education. Since my own mother was not here, having a clinic teach me how to breastfeed, bathe, and take care of my newborn was invaluable.

    Thank you for sharing some important options with your readers. It’s important to shop around for the doctor and birth environment that suits one’s individual needs, and that’s often hard to do in a foreign country.

  • Tangerine 18

    An excellent article, very interesting.

    It’s also nice to see that the many posters here refused to allow a loudmouthed, needy, attention seeker to spoil the thread for everyone else.

  • skillet

    My son was born in Japan. I remember being so happy. After all the insurance and various stuff had come through, we actually MADE MONEY.

    Hospital care was good too. No drive by delivery. Wife was there quite a while.

    I hate American hospitals. Ever since I got sent home from surgery once catheterized. It was soooo demoralizing walking around in the parking lot out to the car carrying a pee bag.

    When I got bit on the knee by a copperhead a year back working in my garden, I went home from the emergency room the same evening. Woke up the next morning in my bed vomiting, difficulty breathing, going to bathroom on myself.

    My whole leg turned purple and swelled up like a balloon. But after 5 days in bed, I got better. At home. Hospital did nothing but send me a 2000 dollar bill. Insurance paid nothing.

    My cousin, a doctor commented sarcastically, “You were a managed care success”.

    The best help I got during the ordeal was the free nurses advice from the public poison control hotline. They called me up 3 times a day. Were much more concerned than my doctor or the hospital. They gave me good advice. Keep my leg propped up and let my wife bring me meals in bed.

    USA medicine is going downhill.

  • Maeve Cook

    I am almost 6 months and was told the same thing about my weight gain at Japanese birthing clinic two weeks ago. My height is only148cm so it sounded more reasonable to me. (At least, that’s how I convinced myself.) The strict weight control is also helping me to prevent stretch marks, although I still think they are unnecessarily too strict. (So far I have no stretch mark.)

    When my husband and I first visited the current clinic, we both could see a doctor who spoke fluent English and he seemed to have more understanding about outside world. But since that time, I’ve been seeing another doctor. My husband isn’t even allowed to see ultrasound and we both are feeling very anxious. At last checkup, I tried to explain something to the doctor but couldn’t think of the noun in Japanese so I pronounced it as close to Japanese-English as I could. His response was only ‘Huh?!’ with obvious disrespectful face. I like the clinic itself but I don’t know how they would react if I tell them how we feel.