Running Head: JAPANESE PREGNANCY TO POSTPARTUM

Japanese Pregnancy to Postpartum

Aja Laine Elmore
Kapiolani Community College

JAPANESE PREGNANCY TO POSTPARTUM

Hawaii is often referred to as the melting pot of the pacific because of its racial and cultural
diversity. I was most interested in researching Japanese culture and beliefs regarding pregnancy,
childbirth, and the postpartum period because of Hawaiis large Japanese population. As an
individual with Japanese heritage, it was imperative to focus on traditional and modern Japanese
practices to properly educate others in practicing culturally competent care.
Pregnancy
There are many differences between Japanese and Western culture which are obvious in
their treatment of pregnant women. When pregnancy is confirmed, women are given a Mother
and Child Handbook to log every health visit from pregnancy to first grade (Kishi, et al., 2010).
Additionally, pregnant females receive a government issued stipend following the birth of their
child. Typically, this stipend is for 300,000 or equal to one months salary- which ever is
greater. This stipend is usually able to cover the costs of the hospital stay and delivery.
Nationwide, mothers are also provided with six weeks of paid maternity leave before their due
date and eight weeks of paid leave after birth (Japan Maternity, 2011).
During pregnancy, nutritional concerns vary quite extensively from those that are
standard in Western culture. Doctors generally advise pregnant woman to maintain a natural diet
that allows them to obtain most prenatal vitamins and nutrients from fruits and vegetables
(SeonAe, Fetters, & Maeda, 2000). In the United States, pregnant women are advised against
consuming raw fish and caffeine but in Japan these are not limited. Raw foods in the form of
beef and poultry are advised against and folic acid is still encouraged in the first trimester.
Warmth is a key concept during Japanese pregnancy. Cold energy is avoided and warm energy is
encouraged. Dark foods considered to have cold energy (e.g. eggplant) are generally avoided
as the womb is meant to be warm (Ivry, 2010). Advised weight gain is also significantly different

JAPANESE PREGNANCY TO POSTPARTUM

than the accepted Western standard. Generally, doctors recommend a weight gain of 7 to 12 kg
throughout pregnancy. This amount of weight gain is believed to be attributed to quicker and less
complicated birth as well as fast weight loss for the mothers following delivery.
Warmth is a common key that is referred to throughout pregnancy and pregnant women
are told to wear long sleeves and conservative clothing to maintain a warm womb. The Maternal
and Child Health handbook give instructions on keeping their bodies warm at all times (Ivry,
2010). I spoke to a neighbor who gave birth to her daughter in Japan and asked her thoughts on
the subject. In response, she said that she would be ridiculed for not being completely covered,
even in the summer months. Eventually she began carrying an extra pair of socks with her to
doctors appointments to avoiding criticized (personal communication, February 16, 2016). The
reason behind this belief is that wearing socks keeps the pressure point above the ankle that
connects to the uterus warm.
For a woman who is trying to conceive, some practices believed to help fertility include
stepping over a placenta, warming the body, sharing a bed with a postpartum woman and eating
the leftover food of a postpartum woman. Morning sickness is not typically talked about and
activities that involve stress or concentration are discouraged. The epinephrine released due to
maternal mental stress is is believed to harm the fetus therefore rendering mentally strenuous
activities unsafe (Ivry, 2010).
Childbirth
The emphasis on a natural state is reflected into the labor and delivery as well. Birth is
traditionally a natural process and many women prefer a drug-free and midwife-assisted
delivery. In Japan, many hospitals do not provide epidurals (Suzuki, Horiuchi, & Ohtsu, 2010).

JAPANESE PREGNANCY TO POSTPARTUM

Pain is often managed very stoically and woman are discouraged from crying out due to pain.
Pain is normally alleviated using non-pharmacologic techniques including focused breathing,
movement, massage, and acupuncture (Ivry, 2010). My neighbor relayed a story from her own
birth experience with me:
The pain was worse than any pain I have ever experienced. I wanted to cry out but my
midwife kept telling me gambatte kudasai, meaning please persevere. I was taught that
birth is not a disease and that the pain would be over once the baby was delivered so I tried
to stay quiet. (V. Katayama, personal communication, February, 16, 2016)
Cesarean births are considered very difficult and not a popular decision but women
consider doctors orders to be very important and are generally agreeable. Doctors are addressed
as sensei and are not typically questioned therefore, the mode of delivery is typically determined
by physicians and not laboring women (Engel, 1989). Fathers are not typically involved in the
delivery of the child.
Postpartum
Following delivery, mother and baby stay in the hospital for an average of 5 to 7 days.
This longer hospital stay allows the mother a period of time for ansei, or peace and quiet, to rest
and adjust (Engel, 1989). In the United States fathers or desired visitors are welcome to stay
overnight with the patient but in Japan this is frowned upon. The strict mother-baby
hospitalization allows medical personnel to focus on mother and baby and facilitates a closer
bond between the two. The health of mother and baby are of high importance and public health
nurses frequently visit new mothers. This has been effective in the early detection of postpartum
depression and other postpartum issues. Satogaeri shussan, meaning going back home, occurs
after discharge when new mothers move back into their parents home (Ivry, 2010). Typically,

JAPANESE PREGNANCY TO POSTPARTUM

this move occurs around the eighth gestational month. New mothers tend to stay in their maternal
home for up to eight weeks postpartum. In the maternal home, mothers adjust to caring for their
baby as well as rest and recuperate. During this period, the mother of the postpartum woman
typically cares for the infant.
Newborn Care
Babies receive the same care that we are used to in Western culture and a series of
vaccines and screening procedures are given (Ivry, 2010). Bathing the infant is acceptable and
wet diapers are changed when soiled. According to the Seattle Choeizan Enkyoji (2011),
Oshichiya, a traditional Japanese naming ceremony, occurs roughly a week after delivery. The
extremely intimate event typically involves only the childs parents and grandparents. Children
are presented with shodos- ornamental name plates- during the ceremony. To symbolize purity,
the child is dressed entirely in white. Breastfeeding mothers are the minority in Japan and breastfeeding outside of the home is considered shameful. Because weight gain during pregnancy is
discouraged, many women who attempt breastfeeding are unable to produce enough milk for the
infant.
Japanese culture varies extensively when compared to Western practices we may be
accustomed to. As future nurses, it is necessary to take such differences into consideration and
apply them to provide culturally competent care.

JAPANESE PREGNANCY TO POSTPARTUM

References
Engel, N. (1989). An american experience of pregnancy and childbirth in japan. Birth, 16 (2),
81-86. doi:10.1111/j.1523-536X.1989.tb00867.x.
Ivry, T. (2010). Embodying culture: Pregnancy in japan and israel. New Brunswick, New Jersey:
Rutgers University Press.
(2011). Japan maternity and child care leave. Japan Payroll & Benefits. Retrieved from
http://www.japan-payroll.com/japan-maternity-leave/
(2011). Japanese buddhist rituals for babies and children. Seattle Choeizan Enkyoji. Retrieved
from
http://seattlebuddhist.org/baby-rituals.html
Kishi, R., McElmurry, B., Vonderheid, S., Altfeld, S., McFarlin, B., Tashiro, J. (2010). Japanese
womens experiences from pregnancy through early postpartum period. Health Care for
Women International, 32 (1), 5771. doi:10.1080/07399331003728634.
Nakamura, Y. (2010). Maternal and child health handbook in japan. International Medical
Community. Retrieved from
https://www.med.or.jp/english/journal/pdf/2010_04/259_265.pdf
SeonAe, Y., Fetters, M., Maeda, Y. (2000). Japanese couples childbirth experience in Michigan:
Implications for care. Birth, 27 (3), 197-198. doi:10.1046/j.1523-536x.2000.00191.x.
Suzuki, R., Horiuchi, S., Ohtsu, H. ( 2010). Evaluation of the labor curve in nulliparous Japanese
women. American Journal of Obstetrics and Gynecology, 203 (3), 226.
doi:10.1016/j.ajog.2010.04.014.