Choosing a birth centre in Japan

Posted by in Mary's blog, Mike's blog

When we travel, we spend time meticulously pouring over hotel/ryokan reviews so that we can make informed decisions about where we spend our vacation time.  To our surprise, finding a place to give birth has been kind of similar, except instead of comparing amenities like onsens and breakfast, we have been comparing medical interventions and child care philosophies…

The standard stay at a birth centre here is around 1 week, which in contrast to the 20 hours we spent at Grand River Hospital in Kitchener when the Bunny was born is FOREVER.  Choosing the right place is important not only because Mary and the baby will be trapped there for a while, but also because different medical establishments have some very, very differing policies that have the potential to make the first week of our new baby’s life outside the womb extremely unpleasant.

We have been seeing an obstetrician throughout the pregnancy who works out of a small office with no birth centre.  He refers parents to other places when they are far enough along, and recently we had to choose where exactly we wanted him to refer us to – and so the quest to find the right birth centre began.

Our first step was to contact the good people at Japan Healthcare Info (JHI) so we could get some tours arranged.  There’s a giant pile of money that gets exchanged after childbirth, and whichever birth centre we choose gets paid.  They have incentives to make good impressions and provide great experiences for families who use their services.  We wanted to see what Fukui city has to offer!

JHI contacted 5 places on our behalf.  One was full, one didn’t want to deal with us because they didn’t want to have a translator in the delivery room (read: discriminated against foreigners), and we visited three others.  Some birth centres have English speaking obstetricians, but none of them had English speaking nursing staff to take us on a tour so we got some help from one of our bilingual friends.

We readied a birth plan and a long list of questions, but in the end we discovered that we could make quite a few decisions with the answer to only ONE question: “Do you do kangaroo care at this hospital?”

We encountered two opposing philosophies of post-natal care at the places we visited.  Kangaroo care is (as far as we understand) a practice that emphasizes lots of skin-to-skin contact, breastfeeding, and keeping infants close to their parents as much as is possible.  We’re tempted to call this approach “normal” because it’s what we understand to be good practice in child-rearing.  The other philosophy, we call it “the Japanese way” – it seems to be the complete opposite of kangaroo care (aka “normal”).  Let’s compare:

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We didn’t know about any of this when we went for our first tour.  We had heard about the Japanese way, and we had hoped that we could find a birth centre that would allow some exceptions to their policies for cultural differences.  The first thing we saw on our first tour was a baby nursery.  The tour guide (nurse) explained to us that having our baby in our room was NOT an option, but their nursery was equipped with closed circuit video camera so we could tune into the “baby channel” to check on our new baby!  This was supposed to be a selling point.  To us, we were looking at a prison.  This clinic was willing to consider letting us have custody of our baby as soon as day 2 of his life (their normal policy is day 4), but they wouldn’t budge on giving us any access to the baby on day 1.  Their 2nd selling point:  We would be “allowed” to have some brief moments to take photos immediately after the birth before our baby would be whisked away into their prison nursery.

The other two places we visited both use kangaroo care.  When we spoke with their nurses, they were each prepared to sell us on the idea of kangaroo care – we told them that they didn’t have to because we were already on board.

Some other issues arose that influenced our final decision:

  1. During labour, constant fetal monitoring (regardless of the baby’s health) is popular here.  Epidurals are quite rare and “natural birth” without pain medication is encouraged.  We saw a horrible setup in one clinic we visited that featured a small “labour room” which was separate from the delivery room.  The labour room had a small bed…and that’s it.  Because of the fetal monitor equipment, moms-to-be need to lie in that bed and grit their teeth during painful contractions – no pain reduction techniques that require freedom to move were permitted.  Scary!
  2. One hospital feared the illnesses that small children tend to spread around and has an outright ban on siblings entering mommy’s room.  The hospital was willing to arrange brief meetings between the Bunny and the baby at their nurses’ station…but that’s it.
  3. Another hospital told up about some variation in their prices that depends on the time mommies get admitted during labour.  If it’s at nighttime or on Saturdays, we pay an extra ¥20 000.  On Sundays and national holidays it’s an extra ¥40 000!  Other places most likely have similar arrangements.
  4. The standard stay at these places is 5-7 days.  We haven’t gotten anyone to agree to budge on that point (let us go home sooner)…yet.

After we exhausted all of our carefully crafted questions and investigated all of the policies we could think of, we chose a hospital that has a fluent English-speaking obstetrician, a fluent midwife and a dedicated volunteer medical interpreter to fill in wherever else needed (on Friday mornings).  This hospital took the time to answer everything we asked (they had the right answers too), their staff has been super-kind, they promote kangaroo care, AND they have a brand-new wing opening 3 weeks before baby’s due to arrive with a sparking new, state-of-the-art (we hope) maternity ward.  We’re going to Fukui-ken’s Saiseikai Hospital!