By: Marley Phillips,
ANM Intern
Japan has the 2nd
lowest infant
mortality rate in the world. Japan. This is not some unpopulated country
full of billionaire babies, this is Japan. Japan is huge! Gargantuan, actually.
So let’s look into how Japan could have possibly achieved such an amazing feat.
Since Japan is the technology
capital of the world, there is a lot of emphasis on using technologies in
pregnancy. Ultrasounds are done at every appointment. Japanese women have a
visit at least every 4 weeks through 23 weeks gestation, every 2 weeks from 24
to 35 weeks, and every week after 36 weeks. That’s a total of 14 doctor’s
visits and a total of 14 ultrasounds. And this is a minimum. This was a little
surprising to me in light of the research
that has come about in recent years pertaining to ultrasound usage.
With
obesity rates at just 5% and smoking rates among women 15 years and older at
11%, the Japanese maintain an overall high level of health. The customary diet,
which is strictly monitored to only include the healthiest of foods for the
baby during pregnancy, can certainly only help the pregnancy and subsequent
baby thrive. Side note: the Japanese
do not cut out fish while pregnant (even raw fish) and actually encourage
eating it multiple times a week.
While these statistics are great, I
found something is my research that kind of shocked me, and apparently shocked
the citizens of Japan, as well. The (true) poverty rates were released for the
first time in a number of years, only to find that 15.7% of the Japanese
population is living below the poverty line. That’s not much lower than the
United States’ 17.1%. We frequently link poverty to things such as poor health and being uneducated; in
our country, that is often the case. However, if the U.S.A. strived to help women
be better educated about pregnancy and childbirth the way Japan government and
culture does, our women would make better, educated
decisions. Just a thought.
Prenatal Coupons |
Like Monaco,
Japan has a universal healthcare system that every citizen is entitled to.
Unlike Monaco, it does not cover prenatal or postnatal fees. However, when you
pay for your services out of pocket, the government will give you a “birth sum
allowance” of up to 420,000 yen ($4,417). I also found out via a YouTube channel
dedicated to birth in Japan that you get a ton of coupons redeemable for
prenatal visits and such. Pretty stinkin’ cool.
There
are 3 options for giving birth in Japan: #1) in a hospital, #2) in a maternity
clinic, and #3) in a birthing house. All of these places offer pre and
postnatal care to women. I should also mention, the minimum stay in any
Japanese birthing facility is 5 days for a normal birth. 5 days. Let’s allow
that to sink in for a minute… 5 DAYS. That is so amazing. In these 5 days, you
will be able to relax with your baby, learn some basic baby maintenance skills
such as bathing and swaddling,
and get breastfeeding support. (Oh yeah, those
guys LOVE to breastfeed! More on that later)
The hospital stay will
cost you anywhere from 450,000-470,000 yen ($4725-$4935). This is for a vaginal
delivery with no drugs, seeing as the Japanese don’t take too kindly to
epidurals and cesareans. If a woman wants either of these services, she will
have to request it very early in the pregnancy and find a hospital willing to
provide such services, which are few and far between in Japan. The cost of a
cesarean birth is in between 500,000 and 600,000 yen ($5142-$6170).
The maternity clinic is a physician
and midwife run clinic with fewer than 19 beds. This is a little more
expensive, but they are little more lenient about position, in room stay,
family, visitors, etc. Giving birth in a maternity clinic will cost roughly 480,000-550,000
yen ($5040-$5775), but you’ll have to pay an extra 2,000 yen ($21) to have an
adult stay with you. Not a big deal. They’ll also give you tons of goodies when
you leave, such as an audio recording of your baby’s first cry, a copy of your
baby’s footprints, and pictures of your baby’s birth, and a certificate of your
baby’s blood type. And, just for a good laugh, check out this Hello
Kitty Maternity Hospital.
Last,
but certainly not least, there’s the birthing
house. These little houses are run completely by midwives who will conduct
your prenatal and postnatal appointments and, of course, catch the baby. Water
births are very popular at birthing houses, and they also have plenty of
accessories to help make birth comfortable such as a stool shaped like a horse
shoe so that you can sit for the birth, and a rope hanging from the ceiling so
that you may hold on to squat during delivery. The cost is 496,000 yen ($5208)
and 40,000 ($40) extra for a water birth. For the midwives to attend home birth
is anywhere from 480,000-500,000 yen ($5040 -$5250).
Now
let’s talk about breastfeeding. If you’re reading this post, you probably
already know breastfeeding is so much better for a baby than anything else that
a baby could possibly be fed. If
you didn’t know, do some research. I have seen some conflicting stories about
breastfeeding in Japan. Apparently the hospitals are not very BF friendly. But
the Japanese society is so dang supportive of breastfeeding that the lack of
hospital support usually won’t deter mothers from at least exclusively breastfeeding
for the first month. Exclusive
breastfeeding rates in 2010 at one month were 51.6%. At 3 months, 56.8%.
The rate of any amount of breastfeeding was 95.4% at one month and 86.8% at 3
months.
The last topic I want to touch on is co-sleeping.
Sleeping with a baby is the norm in Japanese culture. Most children sleep with
the parents until around age 6. This may be in the bed or on a separate mat or
sleeping surface beside the bed. The Japanese technically sleep on futons, but I digress. Japan has one of the
highest co-sleeping rates in the world, yet one of the lowest SIDS rates in the world.
Interesting, huh? See James McKenna for
some interesting research about co-sleeping and much, much more.
So, here it is, a country
comparable to the United States that has an extraordinarily low infant
mortality rate. And this is how they’ve managed it. Japan has many of the same
social and national issues that our great country has, yet they’ve seem to
overcome them for the betterment of their mothers and babies. Maybe we, as a
society and as a government, can look to Japan as a guide in implementing
maternal education and providing better care to improve America’s staggering
infant mortality rate.
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