Giving Birth in Japan

Marine Corps Air Station (MCAS) Iwakuni is the only Marine Corps installation on mainland Japan. We are located on the southern end of the main island of Japan, sandwiched between beautiful mountains and the Seto Inland Sea. We are 600 miles from Tokyo, which means we are about six hours (by train) away from the nearest Naval Hospital (Marine Corps bases do not usually have hospitals on site). This was one of my biggest concerns when I arrived in Japan 28 weeks pregnant. Luckily I was not the first person to have a baby while stationed here.

There are three delivery options currently available for woman stationed at MCAS Iwakuni: US Naval Hospital Yokosuka (near Tokyo), Dr. Shoji at Iwakuni Hospital, or the Iwakuni Clinical Center. Deciding where to deliver my baby took some serious consideration.

Again, USNH Yokosuka is a six-hour train ride away, so women have to travel to the hospital around 36 to 37 weeks pregnant and stay at the “Storks Nest” until their baby arrives. Even though it would be an American birth experience, I opted out because I have a 1-year-old daughter who would not do well waiting around in a hotel room for me to have a baby. I also did not have family in Japan to help, so there would be no one available to watch her once I went into labor. This solidified my decision to stay local, so I could be close to my daughter and so my husband would not have to travel far and risk missing the delivery.

Deciding to stay local meant I would be having a Japanese birth experience. As intimidating as that was, the base clinic provided me with a Japanese nurse to help set up my appointments and go over my birth plan so the language barrier was not as high. Between the two local options, Iwakuni Clinical Center would have provided a “hospital birth” setting in a relatively new facility. However, Dr. Shoji has been delivering babies for American moms from MCAS Iwakuni for over 45 years, so I decided to go with him. This made me feel more comfortable knowing that he and his staff were at least familiar with Americans and their needs. In fact, Dr. Shoji has so many American moms delivering at his facility (about one baby per week) that he has adopted some American birthing practices such as painless delivery (Yes, please!) and allowing the father in the delivery room during birth.

Full disclosure: The Japanese birth experience was like nothing I could have ever imagined. I had to constantly remind myself that just because something is different, does not mean it is wrong.

Tatami Room

One of the biggest differences for me in having a baby in Japan versus the United States was that I labored in a tatami room. Tatami is a type of mat made of rice straw and used as a flooring material in traditional Japanese-style rooms. It is customary to remove your shoes before entering these rooms so the tatami is not damaged.

There was a small bed and a reverse-rocking chair in the room that I assumed was for helping with labor. There was little to no intervention from the nurse while I was in this room, which is why I never really knew what the chair was for. If you like the freedom of walking around and getting into different positions, then this is the room for you. I, however, like to have instructions and support. My husband was no help, he napped on the small bed while I rocked in the rocking chair until I could no longer take the pain and requested that the nurse come check on me.

Suffer Silently

Japanese women must have a very high pain threshold because not all hospitals in Japan offer epidurals or any other pain-relieving drugs. Dr. Shoji offers an epidural, but only because it has been requested so many times over the years by his American patients. As it got closer to the time for me to push, I was escorted from the tatami room to the delivery room. There, I was offered an epidural and gladly accepted it!

Quickly, I realized that I was given a low-dose or “walking epidural” and basically had little to no pain relief for the entire delivery. I do not recall ever being in so much pain in my life. I tried to focus on my breathing and grit my teeth through each contraction, but I became more vocal each time. One nurse was tasked with shushing me every time I got too loud. I couldn’t believe it. It was almost midnight, and I was pretty sure we were the only people in the hospital, why did I have to be so quiet?

I have recently learned that in Japan it is thought that a woman’s ability to deliver her baby without pain medication displays the mother’s strength and responsibility; it also creates a stronger bond between mother and baby. Japanese women also are expected to experience labor and birth quietly. I repeat: Japanese women are expected to experience labor and birth quietly! Screaming and shouting from a mother in labor will be met with a request to be silent from a nurse or attendant. Reminder: Just because something is different does not mean it is wrong!

Length of Hospital Stay

Another big difference is the amount of time mother and child stay in the hospital after birth. It is typical for Japanese women to stay at the hospital for five to seven days after giving birth. I stayed at Dr. Shoji’s for five days and just like the time I spent laboring in the tatami room, I was left alone with little to no intervention. In fact, it was almost 24 hours after my delivery before a nurse came to check on me. They did, however, check on my newborn son frequently. Rest is considered to be very important for recovery. There were several times that I had been asleep in my room when a nurse came in and she quickly left so as not to disturb me. I appreciated the extra rest, but I was also not accustomed to this kind of treatment.

I felt like five days was a very long time, especially since I had a 1-year-old daughter at home, and I desperately missed American-style food. Don’t get me wrong, the hospital food was very impressive. They brought me several large portions with each meal, and I could barely finish all the dishes. However, after a few days I was no longer excited about eating steamed rice and soup for breakfast, lunch and dinner.

When it finally became time for us to leave the hospital, I was in total disbelief by the whole discharge process …. in that it was non-existent. After passing my iPhone back and forth with the nurse using Google Translate, I learned that I could leave any time I wanted. No need to sign anything or check in with the doctor. I remember sitting around for hours in the U.S. hospital with my firstborn waiting for the doctor to discharge us and then waiting for the nurse to take off the security tag around her ankle. Nope, not in Japan. We gathered up our stuff and made a beeline for the door. 

Overall, I am glad I opted to give birth at the Japanese hospital. It was a unique experience that I will always be able to share with my son. However, if I happen to become pregnant again during our tour here, I will definitely be taking a train up to the Naval Hospital.