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There is a growing number of households having difficulty paying childbirth costs in the face of the coronavirus pandemic.

A lump-sum childbirth allowance of ¥420,000 is granted to women belonging to the public health insurance program when they give birth to reduce the financial burden, but that alone may not be enough to cover all costs.

The income decline in many households due to hard times amid the pandemic has brought the quandary to the surface.

In the case of a 28-year-old woman in Fukuoka, her ex-husband stopped sending her child support, making it impossible for her to pay costs for an emergency birth procedure.

To prevent other women from facing a similar predicament, she is calling for the government to boost the lump-sum allowance and loan support for childbirth.

The woman, who asked to remain anonymous, got divorced in January last year. After taking custody of her then-2-year-old and 10-month-old daughters, she found out she was pregnant.

Soon the coronavirus gripped the nation. The divorced husband, who works in the construction industry, lost his job amid the pandemic, leaving her to rely on the child-rearing allowance issued to single parents for sustenance.

She paid ¥150,000 to obstetrics and gynecology for the epidural labor option.

Epidural labor, aimed to ease the pain during childbirth, costs about ¥100,000 more than a natural childbirth.

Despite the cost, the woman opted for the procedure because she had difficulty and experienced strong pain while giving birth to her two daughters.

Giving birth to her elder daughter took two days, and she swore never to experience the agony and excruciating pain that she suffered while delivering her second daughter. The lump-sum childbirth allowance of ¥420,000 and a ¥150,000 reservation fee for epidural labor were set to cover the cost.

On the day of the birth, she had another difficult delivery, which required an unexpected procedure. After enduring pain for about three hours, she gave birth to a girl, filling her with joy.

But the bill handed to her before she was discharged stated an additional cost of nearly ¥80,000. She was, however, out of savings.

She was at a loss at what to do after a person in charge at the gynecologist told her that she couldn’t be discharged and that they couldn’t give her a birth certificate unless she made the payment.

The mother grew up at an orphanage until she graduated from junior high school. Her father, her only kin, who refused to take custody of her, died about four years ago, leaving her with no relatives to turn to.

She consulted a 51-year-old male acquaintance, who helps support people facing economic hardship.

He had helped her before when she moved into an apartment, and he again took care of the negotiation on her behalf. She was finally discharged after he agreed to become a joint guarantor for the additional cost. She later paid the remaining cost using child care from her husband she obtained afterwards.

There is no law that states that medical institutions can rebuff the discharge of patients who can’t pay delivery costs. But she wonders what could have happened if the man weren’t there to help.

“If I had to stay longer at the hospital, I would have incurred more costs,” she said. “I don’t have parents to ask for help and I’m scared to think what could have happened to me.”

When she was pregnant, the possibility that she may run out of funds crossed her mind. She consulted the Fukuoka municipal office to see if there was any loan program and was told about the high-cost medical care benefit system that would reimburse the person beyond the cost-sharing maximum amount.

But they told her that she won’t be able to use that program because, unlike cesarean section, natural delivery is not covered.

She briefly had considered living on welfare, but hesitated to apply due to fears that she may have been forced to cancel the epidural procedure or sell her car.

“When I started working again, I would be left with a limited number of job possibilities without a car,” she said. “I considered having a cesarean section then. I wish there were a childbirth loan support program.

“Not everyone has money,” she said. “I wish they could make the cost cheaper or raise the one-time allowance.”


Lump-sum childbirth allowance

A lump-sum childbirth allowance of ¥420,000 per child is granted to women belonging to the public health insurance program when they give birth to reduce their financial burden. The allowance can be reimbursed or offered to the hospital before the mother is discharged so that she does not need to pay a large amount of money and wait to get reimbursed later.

In December, the Health, Labor and Welfare Ministry faced calls from ruling party lawmakers to raise the amount but decided to leave it as is.

Childbirth fees are more expensive in urban areas and the one-off allowance alone may not be enough to cover all costs, so some municipalities are offering their own subsidies.

According to a survey by All-Japan Federation of National Health Insurance Organizations conducted in fiscal 2016, the national average cost for a natural childbirth delivery was about ¥506,000. The highest was more than ¥620,000 in Tokyo, while the cheapest was a little over ¥390,000 in Tottori Prefecture. The costs tend to rise year by year, and large gaps also exist depending on the regions or hospitals.

Taking into account those differences and people worried about their financial burden amid the coronavirus pandemic, Minato Ward in Tokyo has expanded its own subsidy program. Aside from the lump-sum childbirth allowance, it has raised its own subsidy to up to ¥310,000 from ¥180,000 for childbirth since April 1 last year.

This section features topics and issues from the Kyushu region covered by the Nishinippon Shimbun, the largest daily newspaper in Kyushu. The original article was published Jan. 26.

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