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.

Rh-negative
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.

Maternity Leave in Japan

Here is an overview of the Japanese maternity leave system.

The information is current as of Sep 2011, and is provided only as a guide. Please note that TPG takes no responsibility for the currency or accuracy of the information provided. As the system is subject to change, it is important that you use this information only as a guide, and confirm all the details specific to your own situation with your own company.

If you are employed as local staff by a company in Japan and have Japanese national health insurance, you are entitled to these 3 allowances:

1. Baby Bonus （出産育児一時金）
This money is to help pay for your hospital fees during birth (390,000 – 420,000 yen). This can alternatively be covered through your husband's insurance if you are not working.

2. Maternity Leave allowance（出産手当金）
This is the money to support you for 6 weeks (42 days) before and 8 weeks (56 days) after the birth. You can receive 67% of your monthly salary during this period.

3. Childcare Leave allowance（育児休業給付金）
This is the money paid monthly from 56 days after the birth until 12 mths after the birth. You can receive 50% of your monthly salary (note there is a cap). This can also be extended for an additional 6 mths, if for example you need more time to get your child into childcare.

Here is a diagram to help you visualise these support systems:

If your baby arrives early?
- You will receive reduced pre-birth maternity leave allowance (you will receive less money). The 56 days post-birth maternity allowance and 12 mths childcare allowance will be calculated from the actual date of birth.

If your baby is overdue?
- You will receive an extended pre-birth maternity leave allowance (you will receive more money). The 56 days post-birth maternity allowance and 12 mths childcare allowance will be calculated from the actual date of birth.

Steps for applying for Baby Bonus, Maternity Leave and Childcare Leave

Below is a summary of the steps for preparing the applications for the baby bonus, maternity leave and childcare leave. In Japan, it seems common that your company will organise the documentation for you, so you just need to provide the necessary information. This was a strange concept for me at first, as I wanted to know all the details! Hopefully the following information will help others in a similar situation.

1. At 12 wks, I informed my boss that I was pregnant. This allowed my company ample time to notify staff (before my belly started to become noticeable!), and also time to prepare the maternity leave documents and temporary replacement staff.

2. At 20 wks, my company asked me for the following information:

• Doctor’s certificate
• Confirmation of the pregnancy and estimated due date
• Dates for starting and finishing maternity leave
• You can start 6 weeks before due-date, and finish 12 months from the date of birth. 
• It is recommended to be very specific about these dates and try not to make a mistake – once the documents are submitted it is difficult to change (I made a few mistakes:)). Ask your company if you are unsure. Of course, the date you return to work will be adjusted later depending on the actual date of birth.
• Whether baby will be your or your husband’s dependant（被扶養者）
• Usually the father has the baby as his dependant, but if mother’s salary is higher, she could have the baby as her dependent (for tax benefits)
• Where the baby will be born
• Hospital name, location

3. At 28 wks, company provided the following details and requested further information:

• My company provided an estimate of the amount of money that will be received for baby bonus, maternity leave, and childcare leave
• They advised that this estimation was under the current law and system, and that it may change before the baby is born (once the baby is born it is usually fixed)
• They requested my bank account details for the maternity allowance to be paid into
• Social insurance
• I had to pay for an extra 3 months of social insurance after I started maternity leave (even though I wouldn’t be working). I still don’t really understand the reason for this, but seems it happens under the Japanese system…
• I was advised that payment of inhabitant tax will be my own responsibility during maternity leave. Payment slips will be sent to my home address from the ward office.
• Baby bonus（出産育児一時金）
• This bonus is to help pay for the hospital fees during birth
• They asked me to find out if my hospital is a member of the birth medical compensation scheme （産科医療補償制度） (sankairyo hosho seido)
• If NO, will receive JPY390,000.
• If YES, will receive JPY420,000.
• Your baby bonus can be paid directly to the hospital, or into your own bank account. In the former case, you will only need to pay the balance to the hospital (for example, if your hospital is a member of the above scheme and your total stay in hospital costs 550,000 yen, you will only need to pay 130,000yen). You will need to notify your company whether you want the baby bonus to be paid to the hospital directly or into your bank account. I chose to have the money paid directly to the hospital as this was easier (my hospital fees cost more than 420,000yen, so I arranged for the baby bonus to be paid directly to my hospital and I will pay the balance after the baby is born). 

4. At 34 wks (before I started maternity leave), my company provided the documentation for:

• Baby Bonus （出産育児一時金）
• As mentioned above, I chose to have the baby bonus paid directly to the hospital, so my company submitted the application form to the insurance office to make direct payment to the hospital.
• After the baby is born, ask your Doctor to fill in the relevant sections on the form. Ask your hospital front desk for help if you have any questions.
• Maternity Leave allowance（出産手当金）
• After the baby is born, ask your Doctor to fill in the relevant sections on the form. Ask your hospital front desk for help if you have any questions.
• Childcare Leave allowance（育児休業給付金）
• After baby is born, need to go to your bank with your bank book and get your bank’s stamp on the document (as verification of your bank account), and then send back to your company.

Supporting documents required:

• Copy of front page of your boshi techo （母子手帳）
• Name of your baby and your and your husband’s name
• Date your baby was born (birthday) 
• Birth certificate from your local ward office 

You will need to send these 3 forms (Baby Bonus, Maternity Leave, and Childcare Leave forms) back to your company, together with the supporting documents, no later than 56 days after your baby is born.


Click here for more information in Japanese:

Baby Bonus (出産一時金)

Maternity Leave allowance（出産手当金）　

Childcare Leave allowance（育児休業給付金）

Hope this helps and if anyone has some additional information or would like to share their own personal experience, please contact us at TPG!

Expecting in Tokyo videos

These videos were made a few years ago but still have some great information about being pregnant in Tokyo.

Expecting in Tokyo Part 1
Website:
http://spinshell.tv/know/report/spinshell/expecting-in-tokyo-part-1

On Youtube:
http://www.youtube.com/watch?v=7kQbOpUfn5Y

Expecting in Tokyo Part 2
Website:
http://spinshell.tv/know/report/spinshell/expecting-in-tokyo-part-2

On Youtube:

http://www.youtube.com/watch?v=fa4jNP8D1Ew