Health & Medical Care / H001-07

First steps during pregnancy and childbirth

When you learn you are pregnant, see an obstetrician/gynecologist and ask your municipality about pregnancy notification, the Maternal and Child Health Handbook and prenatal checkups. Check delivery facilities, costs and workplace arrangements early.

Last updated: October 9, 2026

Illustration of pregnancy and childbirth

Decision flow when unsure

You know or suspect that you are pregnant

↓

Have you visited an obstetrician/gynecologist?

↓

Yes
Check pregnancy notification, the maternal handbook and prenatal care guidance

No
Visit an obstetrician/gynecologist and ask when to be examined

Notification procedures, prenatal checkup subsidies and childbirth costs vary by municipality and health insurer.

Three things to remember

Medical facility

Confirm pregnancy and plan future appointments

Maternal and Child Health Handbook

Ask your municipality how to obtain it

Childbirth preparations

Check delivery facilities, costs and work arrangements

First steps

Visit an obstetrician/gynecologist
Confirm the pregnancy, gestational age and estimated due date.

Ask about pregnancy notification
During early checkups, the doctor may confirm fetal heartbeat and due date and explain notification. Around eight to ten weeks is one example, not a nationwide waiting rule. Follow your doctor’s advice and contact your municipality. You will receive the maternal handbook and prenatal checkup vouchers or subsidy tickets. Procedures and coverage differ by municipality.

Maternal and Child Health Handbook
Check issuance procedures and prenatal checkup subsidies.

Childbirth preparations
Review delivery facility, costs, employment and insurance.

1. What is the Maternal and Child Health Handbook?

This important handbook records pregnancy, childbirth and children’s health. It is used for prenatal checkups, delivery, infant checkups and vaccinations.

The handbook format was updated from April 2026.
Ask the municipality where you are registered about how to receive it, multilingual materials and digital guidance.

2. Prenatal checkups

Important: examinations early in pregnancy are not automatically covered by health insurance.

Confirmation of a normal pregnancy and regular prenatal checkups are generally not covered by public health insurance, so early appointments may require payment. Prenatal vouchers and subsidy tickets issued with the maternal handbook can cover eligible checkup costs. You may still pay for tests outside coverage or costs over subsidy limits.

On the other hand, if a pregnancy-related disease or abnormality requires treatment or tests, public health insurance may apply. The same visit may involve insured treatment, self-payment and municipal subsidies. Check with the facility beforehand. Subsidy amounts, ticket formats and treatment of visits before vouchers are issued vary by municipality.

Nationwide general principles checked against official materials October 12, 2026:Ministry of Health: maternal health management Q&A／Children and Families Agency: prenatal checkups。

What to check	Details
Where to receive care	Your planned maternity clinic or hospital
Checkup fees	How to use your municipality’s vouchers and subsidy tickets
Giving birth away from home	Whether subsidies work outside your city or prefecture
Language	Interpreter, multilingual materials and language support

3. Choosing a hospital for childbirth

Important clarification:Confirmation of pregnancy and routine prenatal checkups may require self-payment. Whether visits before receiving municipal vouchers can be subsidized or reimbursed later depends on your municipality. Ask your insurer and delivery facility about the childbirth lump-sum allowance and direct payment procedure. After birth, check birth registration, your child’s insurance, child allowance and any necessary residence procedures.

Delivery reservationsSome regions or facilities require early booking.

CostsNormal delivery is generally treated differently from insured medical care. Check the childbirth lump-sum allowance.

Emergency readinessCan the facility handle high-risk pregnancy or cesarean sections?

LanguageConfirm interpreter or foreign-language support.

4. For people who work

Tell your employerNotify your employer at an appropriate time and discuss work adjustments.

Maternity leaveConfirm eligibility and procedures with your employer.

Childcare leaveCheck eligibility, benefits and return-to-work timing.

Health problemsIf your doctor provides instructions, consider the maternal health communication card.

5. Important points for foreign residents

Residence card and address	Check maternal and child health services in your registered municipality
Health insurance	Prenatal checkups and normal childbirth are treated differently from insured medical care
Childbirth lump-sum allowance	Check eligibility and how to apply with your insurer
After-birth procedures	Check birth registration, insurance, immigration and child allowance in order

Notes by residence and work situation

Technical interns / specified skilled workersAfter confirming pregnancy, speaking early with your employer and, where applicable, supervising organization or registered support organization may help with medical care and workplace adjustments.

International studentsContact your school’s international support desk, but ask your registered municipality about pregnancy notification and checkup subsidies.

EmployeesAsk HR early about maternity leave, childcare leave and social insurance benefits.

Self-employed people and dependentsSince employer benefits may not apply, check municipal assistance and your insurance and pension benefits individually.

Check official sources

Children and Families Agency: Maternal and Child Health Handbook Maternal and child health handbook information support site

Official information checked October 12, 2026: the handbook format effective April 2026, pregnancy notification and subsidies for prenatal care. Reference:Ministry of Health: Childbirth NABII. Notification requirements, checkup subsidies and arrangements for giving birth away from home vary by municipality. Confirm amounts, documents, eligible facilities and checkup timing locally.

Pregnancy and Childbirth in Japan