lifestyle

A Japanese woman’s experience giving birth in U.S.

37 Comments
By Fran Wrigley, RocketNews24

Receiving any kind of medical treatment in a foreign country can be a daunting experience. And when one of the writers from Pouch gave birth to her second child in the United States, where she was living at the time, she was naturally expecting the procedures to be different from her native Japan. But there were a number of things that shocked, amazed and downright confused her about giving birth in the U.S. – not least the incredible cost incurred.

A little background info for you: Japan has a comprehensive national health system which is basically compulsory for all citizens, as well as people living in Japan for more than one year. Once enrolled in this program, you only pay 30 percent of the cost of any medical fees, which are in themselves fairly cheap compared to some countries. And when a woman in Japan gives birth, she receives a special childbirth allowance of 420,000 yen. If she’s lucky and has an uncomplicated birth, it’ll probably be covered by the allowance.

The United States, by contrast, has some of the highest childbirth costs in the world. A 2013 report by health analytics company Truven found that the price paid by insurers for childbirth costs in the US doubled between 2004 and 2010, and by 2012, the average amount paid was $10,000, rising to $15,000 for a caesarean.

In 2010, our Japanese writer Mrs A was pregnant and living with her husband and son in the United States, where she would give birth to their second child. The family had no significant medical history, so their health insurance costs in the U.S. had been relatively low – after employer contributions of 50 percent, the family was paying $400 a month. She was amazed, therefore, that after delivering her baby in hospital, her medical bills came to:

Laboratory services $67.90 Bed and meals $1,833.26 Perinatal services $4,420.35 Pharmacy $697.56 Supplies $771.32

Add in the $1,299.35 she paid for epidural anaesthesia, and that’s a grand total of just over $9,000 for one 24-hour stay in hospital.

It wasn’t just the cost that surprised our writer. In Japan, it’s common for new mothers to stay in the hospital for four to five days, resting and recuperating after the birth as well as receiving help and advice from staff on how to feed and care for their baby. Compared to her first pregnancy in Japan, therefore, the in-and-out approach at the American hospital was a shock to the system:

“Maybe it’s my age, but only staying in the hospital for 24 hours was tough. We were told it was possible to stay another night, but we have another young child, so decided to go home. But it was difficult for me even to walk to the car … When I saw the bill, though, I was glad I didn’t stay two days in the hospital!”

She felt that new mothers in the United States had to do more for themselves, rather than being looked after:

“I had to go and get my own medicine from the pharmacy. And for newborn screening (the baby’s routine check after three days), I had to choose a paediatrician and take the baby there myself. It was all very challenging.”

Thankfully, Mrs A’s medical insurance actually paid her costs, so she said she only ended up having to pay out about 50,000 yen (US$417). “I was lucky,” she acknowledges:

“The amount your insurance pays out depends on the individual. I heard of several Japanese women who were already pregnant when they moved to the US for their husband’s work – they had to pay the entire cost themselves. One woman was in hospital for four days – her medical costs, including a caesarean, came to 4 million yen ($33,500).”

Despite cultural differences and the money-related horror stories, Mrs A says she felt that overall, the experience of childbirth in the United States was actually a more positive one:

“I guess I felt more at ease in Japan, but as for the actual delivery of the child I think the United States was better. The treatment and service was just so good. The only problem was the bills – every time a new one came, I’d get super nervous.”

For some mothers, there is one other advantage to giving birth in the US that adds value to the equation: citizenship. “It’s difficult to get a green card these days. But if you pay 4 million yen, you at least get American citizenship for your child.”

Read more stories from RocketNews24. -- Nine reasons why Japanese men hesitate to say “I love you” -- Fukushima Mother to Reporter: “I Wish My Daughters Were Never Born” -- “I think I love you…”: Romantic confessions from around the world

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37 Comments
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It is not true and applicable to all Japanese woman. Usually giving a birth in U.S is much higher than in Japan. The article should explain more such as co-payment system by husband company and geographic information as well.

2 ( +5 / -3 )

We can compare having a baby in Japan with NZ and their are some big differences with the main one being cost. In NZ all costs are paid by the state and that includes all drugs and treatment. Equally important though is that, as this women mentions, service is just so much better in NZ. In Japan you're always being rushed (consultations take 5-10 minutes while in NZ 30 minutes to an hour) and staff are just so much more personable, kind and friendly.

0 ( +7 / -7 )

igloobuyerFeb. 14, 2015 - 08:18AM JST

We can compare having a baby in Japan with NZ and their are some big differences with the main one being cost. In NZ all costs are paid by the state and that includes all drugs and treatment. Equally important though is that, as this women mentions, service is just so much better in NZ.

Swings and roundabouts. Never on the face of the earth has there been a nation so badly inflicted with periodontal disease as New Zealand, a combination of bad diet and out of financial reach public dentistry.

Yet in Japan, dentistry is available and affordable and public health extends to education on healthy lifestyles.

I like the Japanese health system, the attitude of doctor's is another thing, and overall I think it is up there with the best in the world.

2 ( +7 / -5 )

I like the Japanese health system, the attitude of doctor's is another thing, and overall I think it is up there with the best in the world.

The Japanese system is not without fault. Because the government imposes cost controls on everything from services to pharmaceuticals there are problems with getting advanced or specialized care.

Not to mention that doctors here make money on volume and not quality of care. For a simple ear infection, (example) it can take literally months of visits to the ENT specialist to be "cured". The excuse given is that they use the weakest medicine available because of beliefs that the body will build up immunities to stronger medications and in the future IF the patient gets another infection the medicine will not work. (That is basically a quote, word for word, from a doctor here when treating my child).

My daughter got a similar infection in the states and was "cured" in less than 1 week and zero follow up visits.

Yes the system here has a lot in it's favor, but it does have a dark side too. And it's going to get worse as the elderly keep using more and more resources.

6 ( +8 / -2 )

There is also a monthly cap of ¥80,000 yen for medical treatment costs - once your 30% reaches that amount then you pay no more for that month.

1 ( +3 / -2 )

The way it works is that hospitals in the US set exorbitant prices but then provide the insurance companies (who actually pay 100% of the bill) with an 80-90% discount. It's only people who are not in the insurance market that get stuck with an outrageously high bill and most simply never pay it.

The majority of insurance in the US is provided by employers and it benefits them since the employee is usually willing to accept $10,000 less in salary in exchage for what they think is $10,000 worth of medical care... in reality the employer and the insurance company are pocketing the remaining $8000-$9000.

4 ( +6 / -2 )

There is also a monthly cap of ¥80,000 yen for medical treatment costs - once your 30% reaches that amount then you pay no more for that month.

Take a look at this link and the chart included, it is rather educational for those interested, and it's in English too.

http://www.mhlw.go.jp/bunya/iryouhoken/iryouhoken01/dl/01_eng.pdf

1 ( +2 / -1 )

For those of you in the U.S.A. seeking medical care: You can usually get the same or nearly the same prices as big insurance companies by simply negotiating the cash price before hand. If you pay estimated costs up front many providers will accept that. Medical providers have to write off a large percentage of charges for those who can't or won't pay bills after services are provided. So, when you offer to pay up front they are happy to deal with you. If you have cash you can save a lot.

3 ( +3 / -0 )

Thankfully, Mrs A’s medical insurance actually paid her costs, so she said she only ended up having to pay out about 50,000 yen (US$417). “I was lucky,” she acknowledges:

==> She had very good insurance and amazing also is how low her initial charges were $9,000+. I would expect charges somewhere between $20-40K => reason many are now doing home births because they cannot afford that and the typical family insurance plan is $1000-2000 a month.

0 ( +2 / -2 )

Healthcare in the States is treated as a luxury item. A Roll Royce Insurer will have private facilities and leave no concern unanswered. Or, if the Ford policy is provided, and not at small cost, it's more like The Union Stockyards of Omaha. Health is a luxury, it's very expensive and that is the way it has to be. Otherwise the Socialists win.

-6 ( +6 / -12 )

`KC, I am hoping that's sarcasm.

3 ( +5 / -2 )

Darn right giving birth in the US adds value to the equation- us citizenship. Mrs. A's child could never lose its us citizenship, even upon return home to Japan.

1 ( +4 / -3 )

Gary RaynorFEB. 14, 2015 - 08:36AM JST

Swings and roundabouts. Never on the face of the earth has there been a nation so badly inflicted with periodontal disease as New Zealand, a combination of bad diet and out of financial reach public dentistry. Yet in Japan, dentistry is available and affordable and public health extends to education on healthy lifestyles. I like the Japanese health system, the attitude of doctor's is another thing, and overall I think it is up there with the best in the world.

Wha..? I'm guessing you said that out of spite since there NZ does not have a high rate of "periodontal disease". Dental health and general care is publicly funded and of a very high quality. It must be said though that NZ does have high obesity rates and infant mortality rates among Polynesian populations. Japanese health system is pretty good but like I said it can be expensive and very impersonal.

-4 ( +2 / -6 )

UK9393, it's either humor or the rope. Sadly, profit driven models of Healthcare have made indentured servitude a necessary evil in the States. Apparently, the idea that good health is a common goal for all members of a society hasn't made it across the pond. You know, because of Socialism.

1 ( +5 / -4 )

Japan is the safest place in the world to give birth. Not necessarily the most comfortable for the mother, but certainly the best for infants.

-13 ( +1 / -14 )

Thankfully, Mrs A’s medical insurance actually paid her costs, so she said she only ended up having to pay out about 50,000 yen (US$417). “I was lucky,” she acknowledges:

So, basically, this whole article is a bunch of nonsense. While it lists thousands of dollas in expenses related to child-birth, this woman ended up paying only abouy $400. How much would her 30% of her costs in Japan have been.

“The amount your insurance pays out depends on the individual. I heard of several Japanese women who were already pregnant when they moved to the US for their husband’s work – they had to pay the entire cost themselves. One woman was in hospital for four days – her medical costs, including a caesarean, came to 4 million yen ($33,500).”

Uh, duh, that's why they call it "insurance" -- you can't insure a pre-existing condition. That would be like getting in a car accident and then calling a company and try to buy insurance. Either the writer, or the woman, or both, are competely clueless about medical insurance and it shows.

3 ( +11 / -8 )

My little boy. Half Japanese was born in Australia 3 months premature. The ambulance, hospital, 3 months in the neo natal clinic plus our 3 day transition stay in the hotel suite of the neo natal clinic were all free. FREE. Add to that we were given a 3000 dollar bonus just for having a child. Today he came 28th out of 60th in the 1.2km school marathon. Junior High.

4 ( +5 / -1 )

Japan is the safest place in the world to give birth. Not necessarily the most comfortable for the mother, but certainly the best for infants.

I had one child born in the US, and two in Japan. The hospital stays in Japan were far more comfortable for my wife in Japan than in the US. She stayed 7 days in the hospital and was in a private room, wonderful nurses and doctors, and Mom and babies were well taken care of.

In the US, due to costs, it was in and out in 2 days, the people were nice, but in comparison, Japan was far better for my wife and baby to recuperate than in the US.

THere is really no comparison, because of the differences in the systems and services. Apples and oranges really.

2 ( +3 / -1 )

Apples and oranges really.

Yeah, that's true. I have however heard all the horror stories about Japanese maternity clinics from both foreign and Japanese mothers (for example, being yelled at by a nurse for gaining more than 5 kilos, and being made to cry by a nasty midwife, amongst others). I think we can both agree that all mums-to-be have a right to be coddled, though!

-2 ( +3 / -5 )

Whatever the case, people have to take these kinds of articles with a grain of salt, and keep in mind that they are personal experiences in ONE nation, and should most certainly not be applied to all other nations or everyone's experiences in total. Cost, for example, may be higher in the US than in Japan, but even with monthly insurance premiums BOTH are extremely high due to nations where the health care costs are included in income taxes. In Canada, for example, it would be absolutely free -- regardless of length of stay and/or any complications, and also you don't pay a monthly premium for health insurance. So in that regard Canada is much, MUCH cheaper than Japan for medical stay/visits, etc.

The length of stay is a little more relevant in terms of generalizing, however, as in Japan people tend to stay for very long periods of time for not so serious problems. If there are no problems with delivery a woman is generally released from the hospital within 24 to 36 hours, but I have friends here who stay from a week to 10 days, and of course longer if there are complications. Not saying one is better than the other, although with costs coming into the equation shorter is better if money is an issue.

In any case, I'm glad the woman had her baby safely and saw some positives to go along with the negatives in her situation. It can indeed be daunting to visit the doctor and/or hospital in a foreign country with very different language and customs, and I would imagine having a baby pretty much has to top the list of stresses in that department.

0 ( +5 / -5 )

US citizenship is worth the pain!

4 ( +7 / -3 )

How much would her 30% of her costs in Japan have been.

jerseyboy, read the article :

"when a woman in Japan gives birth, she receives a special childbirth allowance of 420,000 yen"

That pretty much covered everything for my 2 kids.

3 ( +4 / -1 )

Medical care in the US is notoriously high primarily because of 2 factors:

1) The insurance premiums paid in the event of lawsuits 2) By law, they (hospitals) cannot turn away any patient (irrespective of their immigration status) who comes through emergency

On the contrary, in Japan, hospitals can turn away patients for whatever reason, and I have heard of cases where patients have died because they did not have any hospital to accept them.

From this perspective, America is a humanitarian country.

3 ( +6 / -3 )

US citizenship is worth the pain!

What pain? She got anaesthesia, and ended up paying $417. OK, we ended up profiting around 400 for our 2nd child in Japan, but only because we didn't get anaesthesia or a private room. Not really sure the point of this article? I've seen more interesting blogs from Japanese women pregnant in the US who are surprised they are fed junk food like hamburgers and french fries, and get yelled at by their nurses to drink up their milkshakes.

1 ( +4 / -3 )

when a woman in Japan gives birth, she receives a special childbirth allowance of 420,000 yen

That's not universal - depends on your location in Japan, some areas get less than half that.

-1 ( +4 / -5 )

Slightly off-topic.

For some mothers, there is one other advantage to giving birth in the US that adds value to the equation: citizenship. “It’s difficult to get a green card these days. But if you pay 4 million yen, you at least get American citizenship for your child."

Read a recent article that many Chinese women travel to US territories to just give birth as the child will get citizenship and the family could later emigrate.

Sounded quite like a business with tour operators selling hotel/hospital packages paperwork assistance and more.

Only having one son so can't compare various location but out maternity hospital In Tokyo was great, looking back my wife said she wouldn't take a private room again though.

0 ( +1 / -1 )

1) The insurance premiums paid in the event of lawsuits 2) By law, they (USA hospitals) cannot turn away any patient (irrespective of their immigration status) who comes through emergency

You definitely do not want to be going into the hospital emergency room after the clinics close in the USA ==> that is when all the uninsured come storming in. =These uninsured are usually asked to go to the clinics first when open.

An urgent care clinic and the ER are a bit different...my Dad went to the ER with suspected ( later confirmed) pneumonia. The did a blood test, took an X-ray and then he was sent to a room on the ward. $3,000 and change. The emergency room is expensive. Because you had one inexpensive experience does not mean that those who complain about the ER are exaggerating.

You definitely want to goto the clinic first if it is open. I would say $3000 for the emergency room visit is typical now and in fact low for this situation. A CT scan would have been ~$3000 itself. Always call your health insurance company first before going to a clinic or especially the emergency room.

0 ( +0 / -0 )

If you are a part of the national health insurance program in Japan and if you are more than 4 months pregnant, you will receive 420,000 yen per child regardless of the type of insurance (kokumin or other).

0 ( +2 / -2 )

how about the affordable care act, well-known Obama care, does it have any effect on these kinds of issues?

0 ( +1 / -1 )

jerseyboy, read the article :

"when a woman in Japan gives birth, she receives a special childbirth allowance of 420,000 yen"

That pretty much covered everything for my 2 kids.<

Exactly kickboard; I was about to write this one. Sometimes they tend to ignore the part that shows the benefits of Japan.

2 ( +2 / -0 )

It"s ME: "Read a recent article that many Chinese women travel to US territories to just give birth as the child will get citizenship and the family could later emigrate"

You're referring to the so-called "anchor babies" 'problem' given the 14th Amendment that grants citizenship to any baby born in the US (regardless of the fact that both parents can be non-American). It's not quite as easy as you make it out to be, although there is indeed a 'birth tour' industry. A couple of points, though. First, there are far more Mexican and other South Americans who seek to do this than Chinese. In the case of such people if their pregnancy is in the later stages and clearly noticeable, they stand a good chance of being turned down by immigration officers at ports because -- and whether it's actually the case or whether they don't want an "anchor baby" -- they can legally refuse them entry if they think the visitor risks becoming a ward of the state who could not pay any sudden medical costs if need be. There's another 'risk' for would-be parents: if their intent is to go to the US to have the baby for the reason that the baby could get citizenship, they are very, VERY unlikely to declare as much, in part because they could be refused entry (see above), but also because while it's not illegal, it's kind of a grey area. So, if it is discovered the woman is pregnant (and for Chinese going to the US who want to give birth there they would have to go at six months pregnancy at the earliest to give birth within the visa period, and at six months it's usually noticeable) and she has not declared it, she can technically be turned away for 'concealing the pregnancy', which in turn would also effect the chances of getting a visa later. So again, a couple would have to declare they are pregnant, and if it's within the visa period that the possibility of giving birth on US soil exists, they can be turned away at ports... tricky. Finally, there has been an act introduced to get rid of the automatic birthright to a child born of two non-American parents, although I don't believe it has gone through yet.

Have read up on this a bit because I had this chat with someone a little while ago when we were talking about one reason why my wife and I might leave Japan if we choose to have kids (neither of us is Japanese so it presents some problems). Even temporarily in the event of an emergency the child could not receive Japanese citizenship, and that led to talks about how it works in other nations, etc. etc.

If you REALLY want to try and score citizenship for your child by giving birth 'overseas', try timing it for an emergency birth on an international flight over Europe -- you can get multiple nationalities depending on the flight path, company, airspace, etc. haha.

I didn't know about the 420,000 allowance for childbirth here in Japan, so thanks for that (should have, but I didn't), though I know some areas have cut back on other allowances in lieu of rewards for second or third babies, like in Osaka (you get 100,000 for a third child), and that if there are complications with the pregnancy The National Health Insurance Plan covers it but does not cover the birth if there are no complications.

-4 ( +2 / -6 )

So, what's the big deal with this article? Her US insurance covered the cost of the childbirth right?

1 ( +1 / -0 )

My experience giving birth in Japan it wasn't financially crippling but I feel traumatized by my experience. I was in an extremely painful and difficult 9 hour labor. My son was weak when he was born. I was just told to deal with the pain because all the clinics in my town refuse pain medicine. I wasn't even allowed to spend time with him outside of an annoying nurses eye sight where she criticized my every attempt to breast feed him and would slap my hand away and grab my breast and put it in his mouth. They bottle fed him while they kept him from me and now he doesn't like to breast feed so I spend every waking hour pumping milk to put into a bottle.

I have to say American hospitals have more kindness and care in them than japanese ones but that's just my experience only. On a side note there were two women at my clinic that I wished had stayed with me at all times there because they were more understanding toward my situation and did every thing they could to make things easier for me. Those women were Angels.

1 ( +2 / -1 )

usagitosaru, I wouldn't recommend an epidural unless absolutely necessary. It will increase the risk of having to undergo a vacuum or forceps delivery, which may result in lacerations / bruising for both the mother and baby. With all due respect, you have not had a baby in America, so you have nothing to compare it to. To be fair, I'm sure most Japanese mothers would be terrified at the prospect of having a baby in a foreign country.

1 ( +2 / -1 )

I don't know anyone who stays in the hospital more than 24 hrs after giving birth, unless there were complications or caesarean birth was called for. I wish I could have stayed 2 days simply to rest. But insurance costs are out of control. Can't argue with that.

0 ( +0 / -0 )

With all due respect kick board I am an American with family and friends who gave birth in American hospitals and watched them give birth perfectly fine and most were thinking me insane for not finding a place that did over pain relief. Epidurals are not the only method of pain relief either. I was terrified of having a baby in a foreign country and the pain does not ease that pain. Like I said above. It's only my opinion everybody has different experiences.

0 ( +0 / -0 )

All this money spent and the US only ranks about 50th in the world. People should question why.

-1 ( +0 / -1 )

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