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 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):
|Hospital Name (English)||Hospital Name (Japanese, click for link to homepage)||Post Code||Address||Tel|
|Kin’ikyo Sapporo Hospital||勤医協札幌病院||003-8510||北海道札幌市白石区菊水４条１-9-22||011-811-2246|
|Kitami Red Cross Hospital||総合病院北見赤十字病院||090-8666||北海道北見市北6条東2丁目1||0157-24-3115|
|Asahikawa Medical College||旭川医科大学医学部付属病院||980-0803||北海道旭川市緑ヶ丘東２条1-1-1||0166-68-2483|
|Kurokawa Ob/Gy Hospital||黒川産婦人科医院||020-0013||岩手県盛岡市愛宕町2-51||019-651-5066|
|Tohoku KoaI hOAPIRn||東北公済病院||980-0803||宮城県仙台市青葉区国分町2-3-11||022-227-2211|
|Yamagata City Hospital Saiseikan||山形市立病院済生館||990-8533||山形県山形市七日町1-3-26||023-625-5555|
|Japan Red Cross Medical Center||日本赤十字社医療センター||150-0012||東京都渋谷区広尾4-1-22||03-3400-1311|
|Yokohama City University General Medical
|Ishii Daiichi Sanfujinka Clinic||石井第一産科婦人科クリニック||434-0042||静岡県浜北市小松4468-5||053-586-6166|
|Sugita Sanfujika Clinic||杉田産婦人科医院||400-0046||山梨県甲府市下石田2-7-17||055-228-8334|
|Nishikawa Ladies Clinic||西川レディースクリニック||507-0054||岐阜県多治見市宝町3-98||0572-25-3800|
|Obstetrics & Gynecology Yamada Clinic||山田産婦人科||445-0813||愛知県西尾市若松町38||0563-56-3245|
|Gokiso Ladies Clinic||こぎそレディースクリニーク||466-0027||名古屋市昭和区阿由知通3-10||052-732-9733|
|Ueda City San’in||上田市産院||386-8601||長野県上田市常磐城5-6-39||0268-22-1573|
|Toyama Prefecutural Central Hospital||富山県立中央病院||930-8550||富山市西長江2-2-78||076-424-1531|
|Takaoka Saiseikai Hospital||済生会高岡病院||933-8525||富山県高岡市二塚387-1||0766-21-0570|
|Shiratsuka Clinic, Tsu Health Coop||津医療生協白塚診療所||514-0101||三重県津市白塚3568-4||0592-32-0749|
|Mie Chuo Medical Center||国立病院機構三重中央医療センター||514-1101||三重県久居市明神町2158-5||059-259-1211|
|Kakogawa Municipal Hospital||加古川市民病院||675-8611||兵庫県加古川市米田町平津384-1||0794-32-3531|
|Maizuru Kyosai Hospital||国家公務員共済組合連合会
|Okayama Medical Center||国立病院岡山医療センター||701-1192||岡山市田益1711-1||086-294-9911|
|Tottori Prefectural Chuou Hospital||鳥取県立中央病院||680-0901||鳥取県鳥取市江津730||0857-26-2271|
|St. Mary’s Hospital||聖マリア病院||830-0047||福岡県久留米市津福本町422||0942-35-3322|
|Morishita Maternity Clinic||森下産婦人科医院||812-0025||福岡県福岡市博多区店屋町8-10||092-291-0328|
|National Hospital Organization Nagasaki
|Kumagai Obstetrics & Gynecology||くまがい産婦人科||870-0254||大分県大分市横塚2-4-5||097-592-1000|
|Kumamoto Municipal Hospital||熊本市立熊本市民病院||852-8505||熊本県熊本市湖東1-1-1||096-365-1711|
|Kamiya Hahatoko Clinic||かみや母と子のクリニック||901-0301||沖縄県糸満市阿波根1552-2||098-995-3511|
|National Kyushu Medical Center||国立病院機構九州医療センター||810-8563||福岡市中央区地行浜1丁目8番地1号||092-852-0700|