Amy is originally from Toronto, Ontario, Canada. This is her 2nd time living in Japan. The first time was in Matsuyama, Shikoku where she lived for 2 years.
Amy’s family is Japanese-Canadian and her husband is Japanese. Today she lives with her family in Sapporo, Hokkaido where she has been living since June 2019.
Here are some extracts of Amy’s birthstory:
I came to Japan planning to have a baby here. I have been interested in birth culture for many years, and had been gathering information about giving birth in Japan for some time. Anecdotal information from Japanese mothers, some of whom gave birth in Toronto and some who gave birth in Japan and information online. Hopefully this podcast is helpful to women who are similarly looking to gather information by hearing others’ birth stories.
About Epidurals
I was well aware that epidurals are not standard practice for giving birth in Japan. I knew this before moving to Japan again, so in a way I had decided for myself long ago to try to have a natural, unmedicated birth experience. However, I was still slightly interested in exploring the option of epidural early on in my pregnancy.
In Canada, most of the women in my life who have given birth used an epidural and encouraged me to get one. It’s almost a given, to get an epidural done for childbirth, and they are definitely more readily available there.
In Japan, you must select the hospital in which you’ll give birth quite early on, and your choice may be dependant on if you want to have an epidural or not. I was told that there was a hospital in my neighbourhood in which epidurals are more readily available, but that the hospitality was better at Sapporo Maternity Women’s Hospital.*
The word “hospitality” may seem like a funny word to use for a hospital stay for childbirth, but in Japan, since the typical hospital stay is 5 days, with food that is usually quite delicious, it really is like staying somewhere.
At the Maternity hospital it’s not just an issue of if they are available or not. It is more finite than that- only certain doctors can administer epidurals, and if you plan to get one, then you have to reserve the date and time. Early on in my pregnancy, when I inquired about it, I was told that the time slots were all totally booked up around the time of my due date. So, at that point my vague considerations of getting one went away, and I confirmed my decision to give birth without one.
I believe that it’s better to decide early on, and to stick to your decision and build confidence in your decision throughout your pregnancy. This helps for mental preparation as well.
Anyways, Sapporo Maternity Women’s Hospital is one of the nicer (and more expensive) birth hospitals in the city, and since selecting it, I met 4 other mothers who also gave birth there.
About Amy’s Birth Plan
I had prepared a basic birth plan myself, based on a format my sister used in Toronto, before receiving a template from the hospital. I wrote a bilingual birth plan, with the help of my Japanese husband. Also, prior to that, I had been studying birth terms and birth-related kanji myself. I found my bilingual Boshi Techo to be extremely helpful as well.
The basic questions/topics in the birth plan were:
Preferences for Normal Labour and Birth
How can your birth partner/ staff help during labour? (If a birth partner is even allowed during this time)
preferences for managing labour pain
List of fears/ issues/ concerns
Preferences for breastfeeding
How can your birth plan be implemented/ what preparation can be done now?
Preferences for postpartum period in hospital
...further questions I had:
can I eat and drink while in labour?
is there a time limit for labour? How long will I be allowed to labour without any
interventions?
can I move around during labour/ can I change positions, or try to push on all fours?
How often are foreceps/ vacuum-extraction used?
What is the episiotomy rate at the hospital?
Questions I didn’t write preferences for, but that others may want to consider:
preferences for unexpected events
preferences for newborn care
I updated my birth plan once or twice throughout my pregnancy, after discussing it with the hospital staff, but towards the end, I condensed it to 1 page. My thinking was that if it was in my file, and a doctor who I had just met on the day of labour were to read it- then 1 page only would be preferable.
How Amy prepared for birth
I have been interested in birth for a long time, so it’s something I’ve been thinking about for many years. I’m always interested in hearing other mothers’ birth stories. After I found out I was pregnant I began researching more.
(As I mentioned before, I had been gathering information from Japanese mothers who I had met in Canada, as well)
I read a few books about birth prior to, and during pregnancy.
Ina May’s Guide to Childbirth- Ina May Gaskin 2003 (1940-) Loved this book!
Grandmother of modern midwifery, pioneer in the field. She was one of the founders of The Farm a world-famous midwifery centre located in Tennessee. The book opens with many positive birth stories, highlighting the diversity of experiences. It talks about birth as a spiritual process.
especially: thinking of birth in a natural way- what conditions do women primally desire to give birth, The Sphincter Law, experiencing joy and physical pleasure during birth, (among many other interesting topics).
Childbirth Without Fear - Grantly Dick-Read 1942 Dated, but still inspirational!
(foreward by Ina May Gaskin) Grantly Dick-Read 1890 - 1959 British obstetrician advocate of natural childbirth. The book is quite dated and contains Christian/ heteronormative views, but the book’s encouragement to face childbirth without fear is timeless. Especially useful: the concept of the “fear-tension-pain cycle”.
Both of these books encourage natural, unmedicated childbirth. They were both very helpful and inspirational. Both books talk about the physiology of birth and talk about reducing pain by reducing fear and therefore physical tension.
Also: Childbirth in the Age of Plastics - Michel Odent 2011. [read this long ago]
I attended 2 prenatal classes at the hospital and 1 prenatal yoga class. The classes weren’t especially helpful. But one interesting thing they mentioned was Sophrology, which, in Japan, is the concept of mindful breathing and relaxation for childbirth. It’s similar to the concept of hypno-birthing. Basically using mindfulness, mental imaging, and positive non-judgemental thinking to encourage relaxation.
During pregnancy I was perhaps too focused on thinking about the labour and delivery part of the birth process. I was fearful of the intensity/pain of labour, and at the same time, excited to finally see what it was really going to be like for me, and to have the incredible experience of giving birth, to finally know what it’s actually like, for me.
What was one of the most surprisingly things?
The frequency of transvaginal ultrasound exams. In Canada, unless there is an issue, it is mostly transabdominal exams.
For care of newborns, I was surprised that the recommendation was to bathe them every day (I thought this was excessive) and to submerge the body (up to the neck). My family in Canada, and, I believe, many North Americans, believe it’s best to keep the belly button/ umbilical cord stump totally dry for at least a couple weeks, until it’s fully healed and comes off.
Some people may be surprised about the heso-bako (belly button box) where you keep the umbilical cord stump after it comes off the baby’s belly button. I knew about this custom already in Canada, and I like the idea. Our hospital provided us with the little wooden box.
Extracts of Amy’s labour …After a short time, and a couple more cervical checks, I was told it was time to push. I was totally in disbelief since it felt too soon to me. I didn’t feel mentally ready to face the pushing time yet, and I didn’t feel physically ready to push either. But, they insisted I start trying. I was told to look towards my belly button and breathe out without making noise. They told me when to inhale, and when to exhale and push.
I was totally in shock, in shock that it happened so quickly, and that it hurt less than I had imagined. As soon as my baby girl was born, I realized I am capable of giving birth again. She was born at 1:49pm, so the total time from first contractions to birth was about 8 hours (only 3.5 hours since checking into the hospital).
Then we were left alone with our baby for about an hour, where we soaked in the first moments of meeting her and becoming a family of three. I enjoyed skin to skin time, and we tried breastfeeding right away. Not much happened, but she had a good latching instinct.
My doctor told me the midwife thought about performing an episiotomy, but my doctor knew I was really against it, so she insisted that the midwife not do it. I was really appreciative that my doctor advocated for me. (In the end, I had 2nd degree tearing, which is the most common type).
I asked to look at the placenta after it came out. I was just a bit curious and a friend had suggested I ask to see it.
Extracts about postpartum care:
I was really looking forward to my postpartum hospital stay. I was disappointed that my husband wouldn’t be staying with me, and really sad for him that he’d be missing out on the first days of our daughter’s life.
One negative point: I was offered absolutely no pain relief for recovery. I had to ask for some painkillers and was given some, which I found to be somewhat ineffective.
The food was really amazing, there was a top floor restaurant where we’d go for meals. I’m not sure about what the atmosphere is normally like, but during the pandemic every mother had a table to ourselves, and we all ate silently. It was a bit eerie at first, a bit sci fi, but after I got used to it, I really loved this quiet mealtime. The meals were really well-balanced and usually had 3 drinks (milk, water, decaf tea).
Amy’s Overall advices:
Bring a pen and paper to appointments (I’m a visual person, and it really helps to draw something sometimes, it can make the doctors explanations clearer. Also, they can write down kanji or terms which you could look up later if you don’t understand at that moment).
Don’t overpack for the hospital. Your hospital may provide most of what you need! Check with them if they can supply a list of what they will provide/ what you should bring
Empower yourself with knowledge, do your research, talk to others who have gone through similar situations…but, after all that, only take others’ birth stories/ advice with a grain of salt. Ultimately everyone’s birth experience is different, and you will learn for yourself what the best approach for you and your baby will be.
Advocate for yourself, ask all the questions you want, and express your preferences, but at the same time, try to have trust in the Japanese system of maternal care. Japan has some of the best maternal and infant health outcomes in the world.
Remember that it’s a good thing to be giving birth in a country where natural, unmedicated birth is the standard. For me, it was important to try to avoid the “cascade of interventions”, and I believe birth has become over-medicalized in many countries.
Of course, there are always unforeseen circumstances and things that cannot be controlled. But, I believe the birth process is a culmination of the labouring mother, the healthcare providers and all the experiences along the way to the birth. So, harmony and cooperation definitely contribute to a smoother birth process. To this extent, pregnant women can try to manifest their birth experience by going in with a positive mindset, open to adapting to the changing circumstances.
Most importantly, if you are pregnant in Japan, trust in your body, try to have faith in the Japanese way, and appreciate how wonderful it is to give birth here!
Check out Amy’s Instagram and webpage:
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