Birth in Japan
Story and photographs by Tom Boatman
Published in TGA Eye (April-June 2003)
Your
own baby's smile is one of the most intoxicating delights on Earth.
Yet, there are uncertainties and fears associated with childbirth and
infant care, especially for those living far from home and trying to
adjust to a strange culture.
It's well documented that Japan has the world's lowest infant mortality rate. Nonetheless, any westerner who has had to pay a visit to a Japanese hospital might be less than eager to have a baby in one. Americans, in particular, are accustomed to sparkling, modern, high-tech (albeit costly) healthcare facilities.
Yet many Tokyo veteran mothers agree that Japan is an excellent place to start or add to a family. And why not—when the government is so keen on babies that it actually pays its citizens and resident foreigners to procreate. That's right. Those enrolled in the National Health Insurance system can register to receive ¥350,000 upon the birth of each child. And that amount is usually enough to cover most of a typical hospital delivery and stay in Tokyo.
Language
Wet-behind-the-ears foreigners who speak little or no Japanese are likely to find themselves heading toward either Aiiku Byouin , Nisseki Byouin (Red Cross Hospital) or Seibo Byouin (International Catholic Hospital), where English-speaking physicians and western methods are available. Toyko Eise Byouin (Tokyo Adventist Hospital) also has English-speaking staff and is highly rated for its maternity care.
"I think foreign women will find that Tokyo is a perfect place to have a baby," says Kim Forsythe, professional narrator and long-time Tokyo resident who delivered her first daughter, Natalie, at Seibo Byouin in Tokyo and is pregnant with her second.
Although she wasn't new to Tokyo, Forsythe was, at first, very nervous about facing pregnancy and the birth of her first child in Japan. She and her husband, Mark Ferris, director of a marketing company, had clear priorities. They wanted a conveniently located, clean, modern healthcare facility and an English-speaking physician.
These are common concerns among expectant foreign women and their husbands, according to Elena de Karplus, a certified childbirth educator, labor assistant and former director of the Tokyo Childbirth Education Association (TCEA). De Karplus has delivered three of her four children in Tokyo and has counseled some 1,200 couples on the birthing process. She cites "lack of support from friends and family, and being away from their own medical systems" as primary concerns for foreign mothers-to-be. "American women, in particular, are shocked when Japanese healthcare facilities don't match their expectations of what hospitals are supposed to look like," says de Karplus. "Long waits for appointments are another problem."
Midwives
Neta Geffen-Hahne, who has delivered all three of her children at Aiiku Byouin in Minami Azabu, has nothing but praise for the foreigner-friendly hospital known to cater to rich and famous Japanese. "I felt very comfortable for all my deliveries," said Geffen-Hahne. "It was a good experience because at Aiiku they accommodate your wishes and tell you what to expect every step of the way."
Part of the experience, according to Geffen-Hahne, includes preparing a birth plan with your physician. The plan allows expectant parents to consider issues such as whether or not to induce labor, the use of painkillers and the decision to administer an episiotomy. These are choices that are not often discussed with Japanese women in an ordinary Japanese hospital.
"I hardly knew the doctor was there because the midwives did all the work," says Geffen-Hahne. She was fortunate to have the same midwives for her second and third births, and they remembered delivering her earlier children.
Perhaps midwives are the key to Japan's low infant mortality rate.
"I have enormous admiration for Japanese midwives," says de Karplus. "In fact, I think the United States should import more Japanese midwives and fewer Japanese cars. Obstetrical care would improve in no time and the caesarian rate would shrink."
A pioneer
Seeking a totally western delivery experience, Forsythe sought out the services of Dr. Hideki Sakamoto. Sakamoto, who ought to be known as the godfather of foreign baby delivery in Japan, has personally delivered some 2,000 babies in 25 years of practice. He claims to average 150 foreign babies a year, working primarily at Seibo Byouin in Naka-Ochiai (Shinjuku-ku).
A professor of endocrinology, obstetrics and gynecology at Nihon University, Sakamoto has an office at the Tokyo Medical and Surgical Clinic in Shiba Koen, directly across the street from Tokyo Tower. He speaks fluent English and Spanish, and offers a western birth experience (which largely means an American experience). Sakamoto says that the three main concerns of the expectant mothers who see him are language, pain relief and their husband's participation in the birth process. "I don't do anything without the husband present," he adds. "In my practice, I have the husband there all the time, even during a caesarian."
Sakamoto also gives women the option of an epidural during labor to relieve pain—an option not normally available to Japanese women, which is a source of anxiety to foreign women. He explains that in U.S. hospitals, there's an anesthesiologist on the floor during the night. But this is not the case in Japan, and many physicians here are not experienced in administering anesthesia.
Clear from the start
While such practices are new to this country, Japanese couples are becoming more active in choosing the terms of their deliveries. According to Mike Kato, a Tokyo IT consultant, the key is making your wishes known. Because Kato speaks Japanese and his wife, Toshiko, is Japanese, they were able to go to a local Japanese hospital. But he made it clear from the beginning that he wanted to be part of the delivery.
The hospital, Ogikubo Byouin , made every effort to accommodate him. Kato was with his wife throughout her delivery and was handed his son, Steve, immediately after birth. However, his doctor admitted that she had never before had a father willing to participate in the delivery so closely.
One enjoyable part about having a baby in Japan is watching Japanese people go nutty over your child. According to Geffen-Hahne, it's not uncommon to have total strangers walk up to you and start interacting with your baby. "I could not go to Arisugawa Park without 10 people stopping me to get a better look at Mae," says Geffen-Hahne. "When I was out walking with Mae, I don't know how many times I heard someone say, "ningyo mitai [looks like a doll]."
Resources for Expectant and New Parents
Tokyo With Kids
Tokyo With Kids ( www.tokyowithkids.com ) is a Web site devoted to information on delivering and raising children in Japan. There is a bulletin board for placing classified ads (an excellent resource for finding a housekeeper or nanny), and there are discussion groups on topics ranging from diaper services to prenatal classes.
Tokyo Childbirth Education Association
As de Karplus now resides in Scarsdale, New York, the TCEA exists only as a Web site ( www.birthintokyo.com ). But it has links to information about expectant-mother and baby-care services, and de Karplus still regularly answers e-mails from women in Tokyo.
Tokyo Pregnancy Group
This group has meetings conducted in English every second Tuesday of the month at members' homes. For more information, contact Tiffany Wallwork (03-5452-7250) or Priscilla Carmichael (03-3717-8991), or visit: www.geocities.com/tokyopregnancygroup/ .
