Sep 27, 2011

3rd Trimester - Personal Account

Here is a personal account of the 3rd trimester of pregnancy in Tokyo at a Japanese public hospital, continuing on from my previous posts about 1st and 2nd trimesters. Depending on which hospital you go to in Japan, there may not be alot of English available, and also this may be your first pregnancy, so I have tried to explain my experience in as much detail as possible.

As with 2nd trimester, each checkup in 3rd trimester will involve the following routine tests and measurements:
- Urine test
- Blood pressure
- Body weight
- Size of uterus
- Heart beat of baby with a Doppler
- Check for any signs of swelling in ankles and feet
- General questions such as how are you feeling and has the baby been moving, etc

The checkups during third trimester went relatively smoothly. I had a checkup every 2 weeks, and then every week in the last month of pregnancy. At each appointment the nurses helped me get the necessary birth documentation ready and provided information on what to bring to the hospital when the baby comes.

My blood type is Rh-negative, and my husband is Rh-positive, so I had to receive some extra tests in third trimester. There is alot of information on the internet about this if you are in a similar situation – basically, if you are Rh-negative and your baby is Rh-positive (inherited from father), and your baby’s blood mixes with your blood, your body could respond by producing antibodies which attack the baby’s blood causing serious complications including anaemia. I had received a few blood tests in 2nd trimester to check that I wasn’t developing antibodies, and the doctor also checked on the ultrasound that the baby wasn’t developing anaemia. Then at 28 weeks, after another blood test to confirm that no antibodies had been produced, I was given an injection of Rh-immunoglobulin (to prevent the production of antibodies). If my baby is born with Rh-positive blood, I will be given another dose of Rh-immunoglobulin within 3 days after birth.

Costs for Pregnancy Check-ups in 3rd Trimester
The following is an example of the costs for maternity check-ups at a Japanese public hospital. I have Japanese national health insurance and used the yellow discount tickets from the ward office (Kuyakusho) that were received with my boshi techo.
Note - these costs are only provided as a guide. Actual costs may vary depending on which clinic/hospital you go to.
Also note that ultrasound scans cost approx. 5,000 yen each time, as it is not covered by insurance.

28 wks: 3000 yen
- regular checkup
- I didn’t have a scan this week as had one at 27 wks before I went overseas the week before
- As I am Rh-negative blood type, and my husband is Rh-positive, I also had an Rh-immunoglobulin injection (70% covered by insurance at my hospital)

31 wks: 3000 yen
- checkup, scan (my scans after 30 wks were free – I was hesitant to ask the reason why in case they charged me (☺!) but hopefully this is standard for 3rd trimester at all hospitals)

33 wks: 3000 yen
- checkup, scan (free)
- I also had an antibody-screening blood test as noted above

35 wks: 5000 yen
- checkup, scan (free), and streptococcus test

37, 38, 39, 40 wks:
- checkup, scan
- at 37 wks, will have fetal heart monitoring for 20 min to check baby’s heartbeat

I am posting this update on 3rd trimester just in case I don't get the chance to later (!) - I will try and update with the costs after 37 wks at a later date. All the best to you all with your pregnancies!

Click here for information on all 3 trimesters.