Like so many other women, I couldn’t have imagined what it would be like to be pregnant and give birth in the midst of a pandemic. There were many downsides, as well as some surprising benefits (if you’re a natural introvert who enjoys the home life), and I had the joy of navigating all of this with my husband in a foreign country. So, if you’re wondering what it’s like to give birth in Japan with the added drama of a global pandemic, look no further.
A note about pregnancy in Japan
Although I’ll spend most of this post describing the delivery experience, I just wanted to touch on a few things about Japan’s healthcare system. The country has quite an extensive National Health Insurance scheme and, although pregnancy is not technically covered, each resident will receive the equivalent of 420,000 JPY (depending on where you live) to cover delivery costs. Women will also receive a number of coupons from their city hall which they can use to cover most of the appointment costs. You’re then welcome to choose a place to deliver – anywhere ranging from a standard hospital, to a birthing center, or even at home with a midwife.
We, however, went with the university hospital 5-min down the road, mostly because it was one of the only places with English-speaking doctors. And when I say English-speaking, most doctors will still not be fluent, but it definitely beats having to use Google Translate!
Over the course of my pregnancy I attended an appointment every 2-3 weeks with an ultrasound done at each one. I only realised that this number of ultrasounds was pretty high compared to a country like the UK, for instance, where the norm is two. Not that I’m complaining though. Those scans were some of my favourite highlights of pregnancy.
Side note: I had a ball comparing some of my other pregnancy experiences with The Travelling Surrogate from the UK. It definitely helped with the sense of isolation that this pandemic created; to be able to chat to someone who was able to say, “No way, me too!” – even if that person was on an entirely different continent.
All in all my pregnancy went pretty smoothly, at least until after the horrors of the first trimester had passed. The next bit gets a little more complicated.
How it started
It was my 40-week appointment and, like the previous week, they checked my cervix to confirm that I was still just 2cm dilated. After a quick ultrasound where baby girl was looking very squished in there, I was told to come back in 3 days and, if I hadn’t given birth by the following week, they would induce. ‘Alright, nothing to worry about’, I thought. I just needed to keep working out, walking and it would happen when it happened. I just didn’t know how soon.
Driving back from the appointment I started to feel a bit of back pain which got slightly stronger over the course the next few hours. I decided to take a walk to see if movement calmed things down, bounced on my exercise ball for a bit, and when the waves of pain didn’t abate I became pretty confident that I was in early labour.
Off to the hospital for the 1st time
By midnight I was having low to moderate intensity contractions every 4-5 minutes and so we called the hospital as we’d been instructed weeks beforehand. After asking me if my water has broken (it hadn’t), and a few other questions, we were told to come down to the hospital for an assessment. ‘This is it!’, we excitedly said as we bundled my hospital bags into the car. We went in via the emergency room where my husband waited while I had an assessment done. Despite regular contractions, my cervix was still only around 3cm dilated, and we were told to come back when my contractions were 2-3min apart or if my water broke.
So back in the car we got, somewhat disappointed, and prepared to wait it out. I bounced on the ball, got a bit of sleep between 1:30am and 4:30am, after which the contractions became too painful to do anything but lie down through.
Off to the hospital for the 2nd time…
At 9am we called the hospital again, spoke to a midwife, got back in the car, and headed over for a morning appointment. Walking was agony and it took me about quadruple the time it normally would have to get up to the assessment floor. My contractions were 2-3min apart (I’d been conscientiously logging them since the previous day on my app), and my mucus plug had started to show, so I thought this MUST be it.
Nope. Still 3cm. ‘We can’t admit you yet’. The poor midwife who could obviously see how much pain I was in, gently suggested I stop logging contractions and just try to relax. Have a bath, eat something perhaps. I’d try the bath, but I’d already thrown up my breakfast and was not interested in attempting that again.
Preparing to settle in
So we got home, my husband ran me a bath, and I spent some time laying in there for a couple of hours. The contractions were still very regular and intense, but I just kept telling myself that all of this was normal and temporary. And tried to relax. I decided that the only way they would probably admit me was if my water broke, and so started the YoutTube search fest.
We watched videos on how to get your water to break. This had me doing workout moves pretty similar to what I’d been doing already, but I could only keep that up for so long. We did research on how to give birth at home and resuscitate a newborn in case, heaven forbid, they still wouldn’t admit me and we had to do an emergency homebirth. And then I just lay there counting to 7, groaning through every contraction, praying that my water would break.
Early that morning (now around 36 hours since the first contraction started) it did. I felt a pop, a bit of a gush, and then a steady trickle. Thank goodness. I’d been burned before though so now, when we called the hospital, we tried to get them to agree to admit me before going there. Well, at least my husband tried because he’s the only one who can speak enough Japanese to argue like that. ‘No can do’. They had to have a look at things and then make the call on admitting me or sending us home. Yet again. We contemplated waiting a few hours, but I was in so much pain and I thought they just HAD to take me if my water had broken.
3rd time’s the charm
At 2am we were back in emergency. 3cm dilated. My heart sunk. But, the doctor said that since my waters had broken they would take me. “Finally!”, I uttered a sigh of relief at which both the doctor and midwife laughed. I’d already said goodbye to my husband at the emergency entrance, a fleeting kiss through 2 masks, so headed to the labour ward to get settled and let him know I was staying. Lying down was just not doing it for me, but I found this giant pink beanbag that I half-squat/half-sat on – the pressure of which slightly helped with the pain.
An unplanned induction
Although I was now 6cm dilated after my having been there for 4 hours or so already, the doctor expressed some concern that my contractions were getting weaker and further apart. This was something that I confess I actually enjoyed because it brought a bit of welcome relief from the pain. I asked if we could wait 20min to see if things changed before consenting to an induction. Looking back I’m glad that I was able to advocate for what I wanted, even if it was just giving something a bit more time. I changed positions, moved around, but 20min later everything was still the same. So, I was hooked up to an oxytocin drip at around 7:45am.
Getting through the worst of it
I could feel the contractions steadily getting stronger over the next few hours. I’d always wanted an unmedicated birth, and Japan for some reason doesn’t really do epidurals for natural births so I didn’t really have a choice, but at that moment I could understand why so many women opt for one. In the end though, I’m glad I was able to do it unmedicated as I didn’t need to worry about recovering from an epidural in addition to dealing with the normal trauma from delivery.
Every hour or so I had a group of medical professionals come in to check my cervix. This experience was by far the worst of it; I much preferred the pain of childbirth. It being a teaching hospital too, for every check I had 3 people line up to give the most painful and invasive experience I’ve ever had. On top of that, they needed to wait for a contraction before going ‘digging’. I’m not sure if it was necessary, but I’m very happy to erase all memory of the 3 times it happened.
It was 11:30am and I was now 10cm dilated. Seeing an end in sight, I asked the midwife how long she thought I had and she replied, ‘Probably around 4-5 hours’. That was not what I wanted to hear. I sat back down on my pink beanbag and started to push with each contraction like they’d asked me. It wasn’t even 20min later that I knew this baby was coming, and I did not like the idea of pushing her head down into a beanbag with every contraction. However, they seemed to think differently, so I simply stood up to show them I was serious. This coincided with a particularly intense contraction and urge to push, during which the midwife felt the baby’s head and decided that the baby probably was, in fact, coming now.
In the delivery room
The midwife helped me shuffle over to the delivery room and I hopped onto the table with a flurry of activity around me. I kind of got the impression that they weren’t exactly ready yet because I remember a couple of moments when I felt a contraction coming on and was worried that there was no one there to slow down the head. I envisioned popping this baby out and having to catch her myself! Thankfully someone always arrived in the nick of time.
Just a note about covid and people restrictions: My husband was not allowed into the labour or delivery room, nor allowed to visit afterwards. During the morning I’d had him on the phone, up on a little tripod, which I was planning on taking in to the delivery room with me so he could see the birth of his first child. You know, reasonable expectations, and something we’d been told would be alright weeks ago. Today, however, it was not. Without the energy nor time to argue, I went into delivery alone.
I had the foresight to ask them to delay cord cutting as soon as we got into the delivery room. Something, again, which we’d asked our OB about beforehand and been told was okay. I’m glad I did because I was met with several looks of confusion and a, ‘We don’t do that in Japan’. Thankfully my OB happened to be there at the time and, being in a position of authority, told them that yes it was alright to wait a few minutes before cutting the cord.
Everything went very quickly from there. I had around 8 people looking on while I pushed with each contraction, perhaps wanting to see a foreigner give birth? How it was reasonable to have that many people in the room, yet it still not be okay to have my husband amongst them is beyond me. I digress again, but it’s a really sore point of contention.
I must have pushed for about 20min, possibly less, before our daughter was born. I could see them eyeing the foetal heart rate with those last few and saw myself that her heart rate was dropping slightly. I almost flagged on the final push, but found a bit more effort in me somewhere and baby girl (well, at least her head) came into the world. The rest of her followed around 30sec later and we did get our delayed cord cutting.
I also underwent a last-minute episiotomy (a cut made into the perineum) by one of the doctors on the final push, which is again, not something I wanted. However, I do think that if I’d not had an induction, the tissues might have had more time to stretch and perhaps I could have avoided that too.
I spent 2 hours in the room getting stitched up and recovering. I’m pretty sure they gave me a pitocin to deliver the placenta, but at that point I was beyond caring to ask about anything else. I finally got to call my husband as we appreciated the birth of our healthy baby daughter. Well, at least virtually appreciate.
Wrapping things up – a very long stay
My hospital stay was probably similar to most women, perhaps with a bit more admin. I logged every pee and poop (both baby’s and mine), and every breastfeed; took our temperatures and pulses twice a day; watched multiple midwives exclaim in surprise when they realised they didn’t have to squeeze quite so hard to test whether my milk was coming in; and then spent a LOT of time taking photos for my husband and family. All of my interactions with staff happened with a small translation device. This wasn’t always terribly accurate, but I could get the gist. Failing this, my very basic Japanese did come in handy too when talking about the more simple things, like pain levels and how much I ate for breakfast that day.
Something I did not anticipate being such an issue was wanting to leave after 2 nights. We had been told stays for natural births were 5 days, but I’d assumed if both baby and I were healthy, we’d be able to go home earlier. Boy was I wrong. After speaking to several people and being told, ‘This is just how we do things in Japan’, I finally spoke to the paediatrician who really just confirmed this, but in a nicer way. She acknowledged that our baby girl was perfectly healthy, but we couldn’t leave because the hospital’s process was to monitor bilirubin levels for 5 days until discharge. End of story. I could sign a form to discharge myself, but they would still need to keep the baby for the full period. I thanked them for their time as I teared up behind my mask, and watched them leave the room.
I’m not sure if they had any legal standing in keeping me or my child there, especially against our will, but I was feeling so defeated by that point I just didn’t have it in me to push further. It was pretty upsetting because not only had I been through this whole thing alone, but I had to continue to face that isolation for the next few days when all I wanted was to be home with family. Japan is advanced in so many ways, but sometimes the cost of this efficiency is an absence of human emotion and understanding.
That being said, I am very grateful to have had the level of care I received even if it did lack an empathic component at times. I also enjoyed a very nice ‘fancy mother’s lunch’, alone in my room because of restrictions, which is something that many hospitals do for new mothers. With a wine glass (for sparkling water) and cheesecake for dessert, it did take some of the sting off of not being able to go home. Japan does get some things right.
Home time
As I sit and write this with my daughter sleeping beside me, I think excitedly about being discharged tomorrow. It feels like it’s been much longer than 5 days, although this probably has a lot to do with the lack of sleep! I also think it hasn’t yet hit me that we have a child – a whole human who came from us. That’s pretty amazing.
Right now spring is in the air, the plum blossoms are out, and it feels like the perfect time to be starting our journey as a new family together.
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