Breast feeding at a Baby-Friendly Hospital in Japan

Has your wife already chosen her Obstetrics & Gynecology (Ob/Gy) Doctor in Japan? Have you met him? (I use “him” as unfortunately the vast majority of Ob/Gy’s in Japan are males) Did you go along to help scrutinize him? Call me paranoid but we went and interviewed 4 different doctors before we decided on who we wanted to deliver our baby. It’s astounding how different one Doc’s perspective can be to the next.

This is the sixth installment in a series about my personal experience of being pregnant in Japan (or perhaps I should say, of my Japanese wife being pregnant). I decided to start writing this series when I realized that there must be a significantly large population of gaijin dad’s out there who are making all of the mistakes that I have and wished there was a bank of information somewhere to save them some of the pain. In that respect, this installment might be most relevant to Dad’s who haven’t even gotten pregnant yet or are in the early stages. If you’re too far along in the pregnancy, it’s likely that your wife has already decided on which hospital she wants to use. That could be fine, but I don’t want you to overlook how important such a choice can be. With a bit of balanced information from an international perspective you might want to rethink your priorities. There doesn’t seem to be very many independent, balanced sources of information for Japanese people, let alone gaijin parents so hopefully I can shed a little more light on the Japanese hospital situation here. If you haven’t already, you might like to catch up on the first, second, third, fourth and fifth installments of the series before reading on.

Although it might seem painfully obvious, choosing the right hospital is a very important decision in your wife’s pregnancy. Most people just focus on the size of the room, the kind of food that is served and the price but there are a whole lot of other things that you need to take into consideration when choosing a hospital for delivery. Although the private health system is almost non-existent in Japan, Ob/Gy is one of the few areas where you have a pretty wide choice and certainly don’t have to rely on the large scale 総合病院 (general hospitals / Sogo Byoin) if you don’t want to. There are thousands of tiny Obstetrics & Gynecology clinics (called 産婦人科 / sanfujinka) dotted around the country which specialize in nothing but pregnant mothers. Many of them have a limit on the number of patients (often a single digit one) and so can provide a very personal service compared to what you might have expected if you have ever needed emergency treatment at a regular hospital in Japan.

Although you often have to pay up front in cash for Ob/Gy services in Japan (remember, credit cards generally aren’t accepted in Japanese hospitals at all), the Japanese government will give you a cash payment of 350,000 yen per child as long as either you or your partner are working in Japan and paying some sort of government insurance. (While it’s nothing to celebrate, you are actually even eligible for the cash in the case of a miscarriage as long as the fetus reaches 85 days or more!). While most clinics structure their fees so that you are charged spank bang 350,000 yen, some in remote areas with aging populations are proactively charging less (so that you can profit from the birth) in order to attract young couples from the cities. By the way, if you’ve recently had a baby and you haven’t applied for the government subsidy, it’s called “出産育児一時金” (Shussan Ikuji Ichijikin) and you can apply for it up until 2 years after the date of birth of your child.

Check out the price. Check out the size of the steaks they serve you to celebrate the birth of your child, but more importantly check out the philosophy and policies of the doctors, nurses and midwives. And this doesn’t just refer to being organic or having/not having an epidural. If you need a list of questions to ask, there is a great template in the book, “The Expectant Father” that I introduced in part two of this series (it is still my favorite book on this subject matter by the way). But if you’re hoping to breast-feed your baby exclusively, I recommend that you add the following few questions for Japan:

• What percentage of children born in your hospital last year drank formula at least once?
• Under what circumstances will a baby be fed formula? (especially focusing on if nurses ever feed babies formula without consulting the parents)
• Do you have, or can you recommend a lactation consultant?
• If the mother is deemed to have a low supply of milk or the infant is not putting on weight fast enough, what countermeasures do you recommend and after how many weeks?

One of the big problems is that although many hospitals claim that they are all natural/back to basics, or that they encourage breast feeding, this often means little more than them giving private breast massages to your wife for the few days after her delivery. The reality is that many of these doctors were educated a long time ago and aren’t up to date with the most recent academic thought and they are more likely to trust what they hear from the visiting salesmen from the major pharmaceutical companies (who also, strangely enough, leave plenty of samples of their products). Hell, it is so hard to keep a hospital profitable in Japan that you don’t have time to do your own extra research.

So, I ask you this question? Who do you trust more? The quack down the road from you who operates a small scale clinic that is only viable because of government subsidies and strategic bribes from pharmaceutical companies? Or the World Health Organization (WHO) and UNICEF? Yes, there is a better way of judging how reliable your Ob/Gy really is.

It turns out that WHO and UNICEF have developed a global criteria for what they consider to be a Baby-Friendly Hospital (BFH), under the BFHI (Baby-Friedly Hosptal Initiative), which encourages and recognizes hospitals and maternity centers that offer an optimal level of care for breastfeeding babies, which includes protecting, promoting and supporting breastfeeding.

The BFHI Ten Commandments
of Breastfeeding

The concept stemmed from the fact that (almost) all Mothers use a hospital when giving birth to their baby and almost all of those Mothers are heavily influenced by the practices of that hospital and the teachings of their Ob/Gy and/or midwife that delivers their baby. If the hospital is so focused on the bottom line that they skimp and cut corners when it comes to education or even worse give misinformation to their customers due to a lack of continual independent education then there can be serious repercussions for the long-term health and welfare of the babies born there. Pretty simple, eh. Well WHO and UNICEF have now designated over 20,000 hospitals in 152 countries as being Baby Friendly Hospitals. How many do you think exist in Japan? 48. Yep. Japan has less than one quarter of one percent of all of the BFH’s in the World. What are the criteria that the WHO and UNICEF use to judge hospitals? It turns out that they have 10 simple rules for becoming a BFH and they center on making your birth natural and giving your baby the best chance it can have for a healthy birth and to reduce the probability of allergies and other medical risks developing in later life. They cover everything from giving the child a chance to bond with it’s mother on the breast immediately after the birth to not accepting free or low-cost substitutes for breast milk (ie. Powdered milk). You can read the details for yourself on their official website entitled, “The Baby-Friendly Hospital Initiative” which also has a link to all of the 10 commandments of breastfeeding. Perhaps most interestingly, it gives you an insight into what so many of the world’s hospitals are messing up.

Perhaps you might think that BFHs aren’t for you, but please let me try one more time to convince you. We were lucky enough to find a BFH that also met our other needs (including geographical) and I’m convinced that it made a huge difference in terms of emotional support and acceptance (from the midwives to my wife and I) and was key to a flawless entry to the world for my child. Before you finalize your hospital, please see if there are any Baby Friendly Hospitals near your home. If there is one, give them a visit and find out how they’re different to your current hospital. You might be pleasantly surprised.

Below is a list of all of the BFHs in Japan (as at July 2008). As far as I know, this is the only English language list of Japanese BFHs. As you’ll notice, the biggest problem is that there just aren’t that many BFHs to choose from (Damn, even Burma has more!) but by spreading the word to your local Ob/Gy you might be able to help change that. If there are any readers out there who have actually been to one of these BFHs, we’d love to hear your thoughts in the comments section (at the very bottom) so other gaijin parents can benefit, too.

List of Baby-Friendly Hospitals (BFH) in Japan:

(Click on the Japanese name to jump to the homepage of each one):

The “Mercury Food Chain” – From the ocean to your baby

Everyone knows that pregnant women should avoid fish and definitely shouldn’t eat raw fish… right? Or at least I thought that was “a given” until I started discussing what my wife and I might eat on our next date in the big smoke. Well, it turned out that we were to have sushi and that I had no say in the matter.

There is no better topic than pregnancy for old wives tales to prevail and the list of different foods that you can and can’t eat seems to be not only the longest, but the most contentious when it comes to the cross-border battle of who’s “common sense” was to prevail. While it is hard to prove most wives tales either right or wrong, but I assumed that something as important as food must have a “right” answer.

This is the fifth installment in a series about my personal experience of being pregnant in Japan. Although I hope that the observations have value for gaijin of both sexes, I’m intentionally writing this series from my own perspective – a Gaijin Father / Japanese Mother. (You might like to read the first, second, third, and fourth installments before reading on. And sorry to those expecting Father’s who were wondering what had happened to the series – you’ll know what caused the sudden blackout for me, right after your child is born!)

As I mentioned in part part two, my wife and I have tried to do our research about pregnancy in both English and Japanese in order to avoid bias toward one culture versus the other. Perhaps the biggest contradiction I noticed between the two banks of knowledge was how fish is treated. While every English book (and website) has numerous warnings peppered across at least 2-3 different chapters of the book telling you that you must reduce your intake of oily fish (example), Japanese books as a rule actively encourage pregnant Mum’s to eat as much fish as they can. To make matters worse, neither side of the debate writes anything that isn’t true. It’s just that the rationale employed by each culture is so different, that a Martian would be forgiven for thinking that perhaps they were referring to entirely different species.

So how can there not be misinformation if both sides are arguing opposing points, you ask? Rather than lying, it seems that most authors take the approach that “simple is best” and (almost always) fails to mention some key facts about fish/seafood when describing what it’s readers should unilaterally do. The typical English book talks about the high mercury levels found in many fish, especially tuna, which can affect the neural development of your fetus severely if ingested in excess. On the other hand, Japanese books focus on the healthy properties of fish, especially blue fish and recommend that you should eat fish regularly in order to increase your intake of DHA and other Omega 3 & 6 fatty acids. In reality – although contradictory – they are both correct.

So that brings me to my next question. Why don’t we ever hear both sides of the story? I guess in the English books, authors are just leaning on the conservative side and recommending against something that isn’t easy to measure. Who wants to take the risk of being sued by a pregnant Mother who misinterpreted your recommendations? Surely there is a limit to how far they should be allowed to play on our fear though? On the other hand, it’s no surprise that the Japanese, who are amongst the longest living, biggest consumers of fish in the world aren’t too worried about the side-effects of over consumption of fish. Or are they? Well it turns out that the Japanese government is (good on ‘em!). Even though it is rarely mentioned in Japanese books about pregnancy, the MHLW (厚生労働省) actually announced recommendations for pregnant women to reduce their intake of various types fish for fear of mercury poisoning. How many times have you been shocked to hear from well educated Japanese friends that they had no idea that tuna consumption could be unsafe for their unborn baby?

It boils down to the fact that too many books on pregnancy in Japanese are designed to sell. They are supposed to be fun, easy to read and almost always “edited” by a magazine publisher as opposed to being “authored” by a medical professional. Given that being a pregnant mother in Japan is stressful enough with your hubby doing overtime until the middle of the night, the last thing a pregnant Mum wants is to read that she can’t even eat fish. Half of the mags out there will focus pages upon pages on fish recipes.

It’s worth showing your Japanese spouse the MHLW’s “水銀を含有する魚介類等の摂食に関する注意事項” (Translation: Warning on Intake of Seafood Containing Mercury) as she probably won’t discover it herself unless she is reading a University level textbook on nutrition. It was announced first in 2003 and updated again at the end of 2005 to double the number of fish that could potentially have high levels of ethyl-mercury. The ministry regularly updates their official site and has a pretty good FAQ about the guidelines titled:魚介類等に含まれる水銀について (Translation: Memo on Mercury Levels in Seafood). Their most recent effort in publicizing the guidelines is in this PDF called 「これからママになるあなたへ　お魚について知っておいてほしいこと」 (Translation: A message for all expectant mothers – A few things you must know about fish (found on MHLW’s page here).

Before I go into the details, you’ve got to forgive me for reproducing the first paragraph here:

魚介類（クジラ、イルカを含む）は、良質なたんぱく質や、血管障害の予防やアレルギー反応を抑制する作用があるDHA(ドコサヘキサエン酸)、EPA(エイコサペンタエン酸)を多く含み、またカルシウムなど栄養素の摂取源で、健康的な食生活を営む上で重要な食材です。
Translation: Seafood (including whales and dolphins) is a good source of good protein, DHA (which is known to reduce allergies and vascular damage) and EPA. It is rich in calcium and other nutrients and so is an essential item of any healthy lifestyle.

Sure. I hear you. What is written is totally correct and English books should remind their readers about it more often. But did they really have to make that reference to whales and dolphins in the very first sentence? Anyway, after that strong fish advocating opening, the document goes on to recommend a reduced intake of various fish during pregnancy. It’s worth scanning the list below as the kind of fish you see in a Japanese supermarket are totally different to what you’ll see in other parts of the world. The biggest drawback of ordering an English book on amazon.com is that all of its examples will be about fish that you find in US supermarkets. I’m pretty sure you’ll agree that there are at least a few items on the Japanese list that aren’t on the US list and vice-versa:

The bigger the Tuna are, the more likely they are to have high mercury
levels in their fat (Photo: Tsukiji Fish Market, Tokyo Japan)

Not more than two 80g servings per week:

• キダイ (Yellowback Sea Bream)
• マカジキ (Striped Marlin)
• ユメカサゴ (Rockfish)
• ミナミマグロ（インドマグロ） (Southern Bluefin Tuna)
• ヨシキリザメ (Blue Shark)
• イシイルカ (Dall’s Porpoise)

Not more than one 80g serving per week while pregnant:

• キンメダイ (Splendid Alfonsino)
• ツチクジラ (Baird’s Beaked Whale)
• メカジキ (Swordfish)
• クロマグロ(本マグロ） (Bluefin Tuna)
• メバチ（メバチマグロ） (Bigeye Tuna)
• エッチュウバイガイ (Finely-striate Buccinum) – better known as 白梅貝（シロバイガイ)
• マッコウクジラ (Sperm Whale)

Not more than one 80g serving per fortnight:

• コビレゴンドウ (Short Finned Pilot Whale)

Not more than one 80g serving every two months:

• バンドウイルカ (Bottlenose Dolphin)

Large side of Tuna showing the oily toro underbelly
(lighter colour, on right) – Tuna was not included
in the original guidelines for pregnant women, but
was added later on

Interestingly, when the first version of these guidelines were released back in 2003, the list was only half as long and didn’t refer to any kinds of Tuna. As the general rule of thumb, in the West people are encouraged not to eat large pelagic fish like tuna, shark and swordfish. I guess the new Japanese list is matches reasonably well with Western recommendations, but I would love to hear the real story as to why tuna wasn’t in the original version, and how it came to be included). As the focus on this article is on health and pregnancy in Japan, please direct any comments about Whale and Dolphin eating to our dedicated thread here. For or against whaling, the Japanese guidelines are a fascinating look into Japanese society when you consider that the MHLW have actually gone out of their way to point out that Minke Whales (the ones that the Japanese do the most “research” on) are safe to eat during pregnancy as they have low ethyl-mercury levels. (You can see the government list of official mercury levels by fish here for more details).

While I’m at it, let me briefly list the other risks that most tin foil hat wearing English books (and no Japanese books) will have you worrying about every time you see fish on your wife’s plate. Most of the references to poisoning will at the very least lead to gastroenteritis which is dangerous as it can cause dehydration from vomiting and diarrhea (Source: “What to Eat When You’re Expecting”).

● Some fish caught in lakes and rivers are high in Dioxins and PCBs (e.g. blue fish, lake trout). This, once again, seems to be a US-specific issue based on research into US lakes and rivers. I don’t know enough about Japanese estuaries, but if you happen to live near either Yokkaichi (四日市) or Minamata (水俣), I’d probably avoid as much of the local catch as possible as a precaution.

● Raw shellfish (if contaminated) can cause hepatitis-A, cholera or gastroenteritis.

● Some fish found in warm tropical waters (eg. Sea Bass, Grouper (yum!) and Red Snapper) can be a cause of Ciguatera poisoning. The risk is particularly high when there is a “red tide” (a rapid increase in the amount of blooming algae in the Ocean). (more details). Don’t think that just because you live in Japan that this isn’t related. Because Japan imports a lot of its fish, it’s worth trying to find out where your fish was caught.

● If you don’t refrigerate (or freeze) your fish immediately after catching it, normal bacteria can create large amounts of a toxin that will cause Scombroid poisoning. Tuna and Mahi-Mahi are two examples of common culprits.

● If I haven’t written enough to make you totally paranoid… While we’re on the topic: raw meat (especially pork, lamb and venison) may contain “Toxoplasma Gondii” which can blind the fetus or damage its nervous system and may cause schizophrenia (more details). And soft cheeses may have Listeria and raw eggs might have salmonella. (This must be the record for the most Wikipedia links in one paragraph!)

A lot of these worries center around the consumption of raw seafood. Japanese pregnant women have been eating raw fish for centuries without any problems (Just like you’d never hear a Doctor in Thailand or India advising pregnant mothers not to eat spicy foods!). Why? I can think of at least two good reasons. (1) They’re used to it. Anything that you eat on a regular basis, is unlikely to be a shock to your system if you consume it while you’re pregnant. Perhaps more importantly, (2) the Japanese food distribution network is designed specifically to cater for raw fish. Because there isn’t that much consumption of raw fish in the West, fish are generally treated more roughly by supermarkets and distributors.

Whale on Sale – Most whale and dolphin meat contain high
levels of Mercury (Photo: Tsukiji Fish Market, Tokyo Japan
Note the “whales of the world” poster in the background)

At the end of the day, if the customer is going to deep fry the fish then who really cares how long it has been sitting out, thawing under the sun. You’d never get away with that at a supermarket in Japan. In fact eggs are a great example. Have you ever compared the length of egg used by dates in Japan with those in the West? Eggs in the West are generally “good for consumption” for at least one month longer than Japanese eggs. Why? Because a lot of Japanese eggs will be eaten raw and supermarkets can’t take the risk of salmonella and other creepies having their way. If you have any friends in the Japanese supermarket trade, it is a very interesting dinner conversation topic to ask them about how they treat their eggs (compared to say Walmart in the West).

To be very clear, if your wife is Japanese and living in the West, you should definitely discourage her from eating raw fish, eggs, meat etc while she is pregnant as the quality just isn’t the same as back home. But if you’re living in Japan, then you are probably doing your unborn baby a disservice by not eating fish. If you take the Western approach of not eating any fish because its all too complicated and overwhelming then you miss out on a valuable source of DHA which in recent studies has been linked with a lower rate of premature births (source: “Your Pregnancy Week by Week”). Common Japanese fish like Sardines (イワシ)、Mackerel (サバ)、Herring (ニシン)、Salmon (サケ)、Pacific Saury (サンマ) are all good sources. Omega-3 fatty acids are thought to promote neural development and so are particularly important in the 2nd and 3rd trimesters when the brain is growing at its fastest. (By the way, the best vegetarian source of Omega-3 fatty acids is from flax seed (linseed). We used flax seed oil in our cooking and ate eggs from hens which were fed flax seed. They’re pretty hard to find but available in some large International Supermarkets). Perhaps, even more important for Gaijin Daddy’s out there, recent research suggests that a high DHA intake can help reduce the chance of post-partum depression (reference) so make sure you keep eating fish after bubs joins you at thedinner table too!

Pregnant women (and their paranoid husbands) should be presented with both sides of the story and given enough information to chose themselves. Unfortunately there are very few books or websites that do so (in either language). The best that I have found so far is the Environmental Defense Fund. Make sure you download their pocket seafood selector (here) which has a brilliant chart that tells you which fish are high in fatty acids, which are likely to be high in mercury, and hence which are the most sensible items for your dinner table. Print out a copy and keep it in your wallet so you have it handy when you go shopping. Good luck!

Call me paranoid, but I’m really worried about what my wife eats these days. This is the fourth installment in a series about my personal experience of being pregnant in Japan (or perhaps I should say, of my wife being pregnant). Although I hope that some of the observations have value for gaijin of both sexes, I’m intentionally writing this series from my own perspective – a Gaijin Father / Japanese Mother. There is no topic better than pregnancy for old wives tales to prevail and it seems that the topic of food – what you can, can’t or shouldn’t eat – really takes the cake when it comes to misconceptions in not only Japan but every country in the world. Especially when it comes to something as important as the health of your (or your wife or your baby’s) body, these stories really play on your conscience. But surely there must be one single, factual answer out there? I really wish that there had been a resource out there to tell me at the beginning what was right and what was wrong. I don’t necessarily achieve that here, but hopefully I can shed some light on the contradictions you will run up against when comparing notes with your Japanese partner. (Before going ahead you might like to read the first, second and third installments of this series first.)

One of the things that has consistently surprised me is the huge difference in nutritional information found in Japanese books vs. English books. I’m a firm believer that all human beings are the same and that we all require the same fundamental building blocks of life. While recommended intake for normal (non-pregnant) people differ from person to person a little bit according to your BMI, I personally have been amazed at the sheer scale of the difference in recommendations between our two cultures. According to Wikipedia, the average height of Japanese women is about 8% smaller than in the West (US, UK, etc). There is even some research out there suggesting that Asian babies weigh 6% less than Western babies when born. But does a 6-8% difference justify a vastly reduced vitamin intake?

So for those of you who are wondering what on earth I’m talking about. Take a look at the chart below. I put together these “recommendations” from comparing about half a dozen books in each language. Almost every book of the same language had pretty similar recommendations so I’m quite confident with the figures.

As you can see, there is only one vitamin (vitamin E) that has a common “recommended intake.” How can this be? It turns out that most countries around the world have specified limits and guidelines set by their local health authorities for both normal intake and for pregnant women. In Japan it is the MHLW (Ministry for Health, Labour and Welfare, 厚生労働省). I didn’t learn all of the answers that I wanted reading their homepage, but I did get a little bit closer to understanding some of the differences.

I tried to focus my study on one of the bigger, easy to understand vitamins. Let’s be honest, are we ever going to know whether there was 1.2 mg or 1.6 mg of Vitamin B2 in the Okra we had for okazu with our rice tonight? But, I figure that something as in your face as Calcium must be important enough (and easy enough to measure) to make it worthwhile looking into in a bit more detail.. At the end of the day, the baby will suck its calcium needs from the maternal skeleton if it’s mother’s intake is inadequate so you don’t have to worry about the baby, but if you’re worried about osteoporosis (骨粗しょう症, kotsusoshosho) in the Mother then this is a good time to be drinking a lot of milk (and reading this article). One of the reasons why women are more prone to osteoporosis than Men is because they never really make up the calcium that they lost during pregnancy.

At the end of the day, all I really wanted to know was how many kire (servings) of Tofu should my wife be eating every day. Could it be true that Japanese women needed less calcium than Western women? Well, according to research published by the MHLW (link), the average intake of calcium for a typical Japanese female is a mere 528 mg. Unfortunately, Calcium is quite difficult for the body to absorb and depending on your intake of Vitamin D and magnesium, on average only 10-50% is absorbed by the body – leaving you with less than 250mg/day. But wait, there’s more. The average person loses another 200-300mg of Calcium every day through their urine and sweat meaning that the average Japanese person’s Calcium intake is looking about as healthy as the national budget deficit.

To cut to the chase, Japanese people are not taking anywhere near enough calcium. The odds are that your wife wasn’t even taking enough to supply her own needs before getting pregnant. I’m guessing that the Japanese text books write 900mg there as a target knowing that even that will be hard for the average Japanese person to meet following a standard washoku (和食, Japanese food) diet. I guess the last thing you want is your pregnant wife stressing out about her diet as well. The best first step is to encourage her to eat as much as possible – is there any such thing as too much calcium? Anything with bones is good so bite your tongue, close your eyes and pick up half a dozen shishamo next time you’re shopping at the local Jusco.

There’s no point telling you about the obvious sources of calcium (milk, cheese and yogurt) because (a) their probably written up in your English books and (b) a lot of Japanese people just don’t like eating huge quantities of dairy products. Thankfully, there are a bunch of sources out there that you might find lined up on the shelf next to that shishamo (シシャモ, Japanese long-fin smelt) you bought at Jusco. Jako goes great on a daikon (大根, radish) salad (both good sources) especially with some goma (ゴマ, sesame seeds) sprinkled on top. and if you are tempted to cook a tuna pasta, make sure you chose the bones-and-all version. Everyone knows that tofu is a good source, but you might be pleasantly surprised to find out that seaweed (Wakame, Konbu, Hijiki etc.) is also an ally.

Vitamin D is important for absorption and some of the great Japanese mushrooms (not the magic ones) will do the trick: Shiitake, Kikurage, etc. It’s also present in a lot of fish, but unfortunately they are generally big ones (like Swordfish and Tuna) that you will want to avoid. Some of the safer options are sardine and mackerel. If you’re really adventurous then I hear that the liver of sea toad (あんこうの肝) is high in Vitamin D, too. hmmm…

The other thing you want to take together with Calcium (at a ratio of about 1:3) is Magnesium. It acts as natures glue for the Calcium when it enters your system. If you eat 玄米 (genmai, whole grain rice) at home then you probably won’t have much of a problem but otherwise there probably isn’t that much in your diet if you eat Japanese food at home. In the West the most popular source is Nuts. Soy beans are alright so try Tofu and Miso Soup. There is also magnesium in Katsuo so maybe throw a bit extra Katsuobushi in your dashi (broth) next time, too.

I’ve got something in common with Leslie Nielsen. While I’m pretty sure that I wouldn’t look as good as him in a full nude photograph, the photo does give you a hint. I, too, am pregnant (well.. actually, my wife is!).

Getting pregnant with our first baby was a huge change for our household. Only a few months into our marriage, and just learning the ins and outs of what it means to have an international marriage, a whole new perspective showed its face when we found out that my wife was pregnant. Marriage is all about finding common ground when you both have differing opinions and there is no topic better than children to bring out the best (and worst) of your compromising skills (see our Kokusai Kekkon Article). While I guess it shouldn’t come as a surprise given the huge number of wives tales that we have back at home surrounding the topic, Japan is host to its own long list of theories about what should or shouldn’t be done during child birth.

In addition to reading about the growth of my as yet unborn child in various books each week, I’ve found the entire experience to be an eye-opening one in terms of Japanese culture. Who would have thought that best practices about pregnancy could be so different from one country to another. The enjoyable part of the process has been that generally no one theory about childbirth is universally right or wrong and so finding “common ground” between our “theories” has become a hobby.

Throughout the process so far, my wife and I have gone to our utmost to refer to several sources in both English and Japanese to come to our own conclusions of what we want to do. The hope is that through this article/series, I can shed some light on the potential grey areas that future gaijin parents might also encounter. As a gaijin father to be, most of my comments will be directed towards the Gaijin Daddy/Nihonjin Mummy pattern but there is no reason why many of the realizations shouldn’t be relevant to couples of the opposite combination.

The odds that you (or your wife) are pregnant right now are probably pretty slim(*) , but bookmark the page as one day you might find it comes in handy. Personally, I’ve been amazed by how much information I should have already known way before I started to think about children (dedicated future mothers these days spend as much as a year in advance preparing their bodies and lifestyles for pregnancy!). If you have already gone through parenthood in Japan then please stop by, leave a comment and share your advice with me and other readers.

(*) unless you are a newly wed in Japan and then the odds are over 25% that yours was a “MAMArriage“!

For any couple’s first pregnancy, the most logical place to look for advice is at home. Most people form their views on what it means to be a good parent from looking at how they were brought up. Generally that is a mix of good, bad and controversial pointers, but it gives you a lot of material to work with. Because the world of pregnancy is one that is uncharted for most of us, it is probably the one time in our lives that we are most likely to turn to our parents for help. While sometimes you can turn to friends for advice, more often than not couples keep their pregnancy a secret for the first three months until they are certain that there won’t be a miscarriage (one in 6 conceptions end up as a miscarriage!) What do you do if you’re like me and your parents are back home? What do you do if your Japanese partner is living in a different city from his/her “home town” too?

It isn’t easy getting pregnant in a foreign country. I’m still going through the process so would love to hear words of advice from any stippy readers who have “been there, done that”. On the same token, if there is a particular contentious point in your pregnancy that you’d like more advice on, I’d be over the moon to look into it for a future episode. It’s about time there was a resource out there on the internet especially for bi-cultural couples, having their first baby in Japan.

This article is the first of a new series, “Getting Pregnant in Japan”. I am already writing the new instalments madly, but as I mentioned, give me some neta for research, or just some simple comments, and Ill try my best to include some clarification in the upcoming parts!

Update: Part Two of this series now available.