4. On giving birth, General Hospital or Small Maternity Clinic?

They say, expecting mothers should think very carefully on whether she wants to give birth in a General hospital or at a small maternity clinic. In my case, 
I actually didn't choose between the two prior to delivery. It just happened that when I consulted to obstetrician-gynecologists or OB-GYNs (In the first place, I was'nt expecting that I am pregnant), I looked for a clinic with female OB-GYN . And so I googled for nearby clinics and found "Kobayashi Sanfujinka or 小林産婦人科 " which is conviniently located 2 minutes walk from Tateishi station - next stop from the nearest station to where I live. It is also 20 minutes walk from our house.

Kobayashi Sanfujinka is a small private clinic runs by veterans OB-GYN couple (Doctors Kobayashi). The director of the clinic is the wife (Doctor Eiko Kobayashi ) - a veteran physician who had internship at St. Luke's International Hospital (聖路加国際病院) and worked at Keio University Hospital(慶応義塾大学病院) before establishing this clinic in July 1978.

I liked the clinic and impressed with Doctor Kobayashi (Eiko sensei) during my first check-up. I later learned that they also accomodates for child delivery (お産). The clinic actually, has, I think, 3-4 private rooms and 2 or 1 shared rooms which are all in the second floor.The check-up/consultation is held in the first floor. 

Although the check-up schedule for Doctor Eiko is only every Thursday morning, I still preferred this clinic because I wanted a female OB-GYN and that I can still go to work after check-up since the check up is by appointment thus less waiting time.

Actually, there is Japanese Red Cross Maternity Hospital (葛飾赤十字産院) close to our place - closer than Kobayashi Clinic. But reading from various blogs and online bulletin-boards, it seems that this general hospital is always crowded and you have to wait for hours and that you may not be able to choose the physician that you want because the doctors keep changing based on thier schedule.

I had my two children born at Kobayashi Clinic, so the doctors and most of the nurses and the guest female pediatrician knows us well already. This small clinic gives you a very at-home feeling! The building is old but clean and the food is really yummy and healthy! The doctor even gave me fresh flowers picked from her graden and gift for the baby! I also noticed that some foreigners come for check up and baby delivery here. Doctor Eiko sometimes talk to me in English, especially with some medical terms, but most of our conversation is in Japanese which is fine with me (I mean, in the first place, english speaking clinic/hospital is not what Im looking for).

The guest Pediatrician is only available every Thursday morning,also the Morinaga milk nutritionist and you can ask for advises without consultation fee from her. My children's 1st, 3moths, 6months, 12months and 18months check-up were all done in this clinic and also most of thier vaccines. After check-ups, the nurses would give infant drinks or baby food or sometimes hand towels.

Kobayashi clinic, If I remember it right has the following services and small tokens:

Maternity Check Ups

Even though they are private, the free coupons for maternity check ups from Katsushika city ward can be used. (Same as the infant/toddlers vaccine/check ups). 

- During check up (ultrasound), the nurses record the baby's movements into VHS, and the VHS is all yours, so even my hubby wasn't with me during the check-ups, he was watching it from the VHS later at home. Its amazing that you can see how your baby is growing through this VHS, well its black and white and is 2D. The clinic has no 3D ultrasound device :( (I had to go to a hospital n Chiba for this).

Maternity Aerobics/ Maternity Yoga

Held once a week and allowed only after checking body and baby condition. You have to deposit 10,000yen to sign up (but this 10,000yen will be reimburse when you pay for the hospital fee if you give birth there). You can attend from 20th week (I think not sure though), in my case I attended from 26th weeks when I took 1 month prior to the usual maternity vacation from work (In japan, its 8 weeks before scheduled delivery date). I had so much fun and made some friends. I think we were at least 15 preggies - dancing,  jumping, and bending at a small dancing room in Katsushika Symphony Hills. After maternitybics, we would go to a coffee shop near Aoto Station and would have an exchange of information regarding birth preparations and pregnancy.

Free classes on Maternity/Pregnancy

I think there were 3 sessions, though I remember attending twice only. The first session was a sort of introduction to pregnancy where preggies and husbands were sharing thoughts on how we feel about pregnancy. The second one that I and my husband attended was the demonstration on how the baby will come out and how to overcome the pain during the labor. The head nurse taught my husband how to massage my back and its timing.

Reflexology or Foot Massage few days after Giving birth

I don't exactly remember how long - maybe half to one hour of foot massage. But if feels good, really good! I slept during the massage - very relaxing!

Bakeries/Cakes

I don't exactly remember how many times - but there were special day/s where bakeries/sweets/cake with coffee will be serve at 3PM -  a light snack. Very at-home feeling!  

Gift for the baby and give aways

On the day before check out, the doctor came to my room and gave a very small token for the baby. I think we got stuff toy and a Bjorn bib. Also on the day of the check out, the nurses handed me a Harrods bag full of brochures (In Japanese) on child rearing, morinaga milk (the smallest can), pigeon 100ml glass bottle feeder, etc. She also gave me bandana (on my first time) that Eiko sensei has bought somewhere in Asia in her recent travel - to put on my hair while breast feeding the baby. She recommends to pony tail or cover long hairs as it can iritate the baby's face during breast feeding.

Private rooms

Although a bit old, it is clean and wide enough, has a toilet, sink, refrigerator inside.

Procedures
- When the doctor confirmed that I was pregnant, she asked me to come back after a month and told me to get "Boshi Techo (母子手帳) or Maternity Record" from the health center.
- There were at least two major examinations where I used the yellow colored coupon from the city ward - the pre-pregnancy check up includes HIV test, Hepatitis B test, etc while later check up- the examination is the typical one but the physician made sure I have enough iron - i remember they gave me iron vitamins and folic acid vitamins.
- On my 34th week, after paying for the deposit fee (保証金) and a sort of "Hospitalization Agreement(入院契約書)" which has to be signed by my guarantor (I think anyone can be and not necessary personally hand signature or inkan). They gave me a list of the things to bring to the hospital and brought them on the 36th week.
- The nurses taught me on breastfeeding and breast massage, taking a bath of the baby (both I and my husband on separate days) and they were very welcome to questions. The nurses were so kind too!

- There was an explanation/consultation from Morinaga nutritionist regarding milk feeding.

- The clinic provided me a schedule (and explanation) through out my stay in the hospital. My first was I think 7 days and my 2nd time was 5 days.
-After the baby is born, the nurses gaved my husband a list of what to do (like birth certificate registration at the city ward, applying for child allowance, medical card, etc)

- On the second day onwards, you have to take care of the baby, from 8AM (if I remember it right) to 9PM (or maybe 8PM). The clinic gave me a 6-months Morinaga baby diary where I can jot down the baby's conditions and observations- such as milk feeding time and length, bowel and urine activities. Nurse comes every 3 hours to deliver milk for the baby - they do encourage breast feeding first then use the milk if the baby doesnt want or can't suck yet. The routine was (1)change the diaper before feeding, (2)feed the baby and (3) then put back to crib lying on one side (and then on the other side on the next feed time). I remember they gave a laundry clip to remember which side was the previous one :D.

- When the nurses took blood sample for the baby's examination for "congenital metabolic disorders (先天性代謝異常等検査) ", they asked me if I want to know the baby's blood type too - they recommend it so that they can take blood at once and the baby will cry at once- so its two birds in one shot :D.
-On the day before the check-out, nurses explained to us what to do, schedules of vaccines, check-ups, etc
-On the day of the check-out, nurses game me some skin ointment for the baby, medicine to clean the navel of the baby, my baby's portion of "inunan" - it was dried and neatly placed in a wooden box with baby's name, and  footprint of the baby. Again, we had a snapshot with the doctors and nurses (they gave us copy afterwards) and if you allowed, they will display it in clinic's board and website (we'll we allowed ours).

What to bring to the clinic

  The clinic provided all the baby needs such as clothes(actually it was sort of bathrobe), milk (Morinaga's E-akachan because I have pollen allergy so they recommended this one), feeders and disinfectants (Milton tablet), diapers (Merries), wet cotton wipes, beddings, etc during our stay in the hospital. I just needed to prepare the baby stuffs for check-out.

  They also provided the maternity kit including napkins/pads, 1-2 maternity underwear, anti-bacterial wet tissues, etc ..

Here is the list of what they asked me to bring to the hospital - which I brought to the hospital 4 weeks before my due date.

Clothes

1. Pajamas -preferably with buttons in front

2. Breast-feeding bra (available at Aka-chan Honpo or other maternity shops)

3. Bath towels if there is no "koshimaki"

4. Maternity underwear (産褥 ショーツ)

5. Towels for taking shower

6. Sweaters

7. Slippers (to use inside the clinic)

Sundry Goods

1. Chopstick, Mugs

2. Toothpaste, toothbrush, face cleanser, etc ( There was a shampoo and body soap, just bring if you want your own brand)

3. Alarm clocks, Tissue paper, other you think you will need

Payments

As for the hospital fee, As I said, you have to pay for the deposit on the 34th week.
Fee, in general costs 400,000yen - to 470,000yen. My first cost us around 460,000yen and the second, I think 420,000yen.

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5 After the baby is born: PART 1: Legal matters: registration, passport/visa application,etc ..

After your delivery, the baby is now part of the Japanese society and thus to welcome the baby into the society, you need to make his stay in this country legal. :D

Please be reminded that Japanese citizenship (at born) is acquired by blood and not by the land of birth. So unless at least one of the parent is Japanese - your new born child cannot acquire Japanese citizenship.

There are at least five things you should do right after your baby's birth:

1. Register the baby at your city hall/ward hall (kuyakusyo) 's "syussei todoke" section.

Bring the birth certificate issued and signed by the hospital, mother-and-child-health record ( Boshi-techo) and the seal (inkan) of the person who will will apply for the registration. This must be done 14 days after the child is born. After the registration, you will noticed that the city/town hall pasted a copy of confirmation in the first page of the boshi-techo with a signature from the mayor. Also , take note of the following:
- Birth certificate may be issued only after you paid for all the occuring expenses in the hospital (the case of the hospital where I gave birth).
- Basically, it is either the father or the mother who can do the registration process. However, depending on the city/town you live, there may be other persons who can do this for you.
- Don't go to the Alien Registration section yet - make sure you do the registration at the "syussei todoke" section.

2. Apply Alien Certificate of Registration (ACR)

Once you finished the birth registration in (1), you can now ask for a copy of "juri syomeisyo(受理証明書)" or Birth Certificate ("出生公証書" ) from the same section(syussei todoke). Juri syomeisyo is a certificate that confirms that the baby has been registered at the city/town hall, while Birth Certificate is the exact copy of the birth certificate you submitted but with the city seal. You can use either of this certifications to apply for the ACR of the baby. The ACR that you will get will have no visa written on it yet and the ACR is quite big in size(unlike your ACR).

I recommend that you get at least 3 copies of Birth certificate as you will use this document for the application of passport and visa.

3. Apply for the baby's passport

Please confirm the requirements from the embassy of your country of origin. For filipino nationals, please see below reference I taken from the Philippine Embassy Consular webpage regarding application of new passport for new born.

4. Apply for the baby's visa

Once you have the baby's passport, you can proceed to apply for the baby's visa at the Immigration Office near to your city's residence. I don't exactly remember the documents that I submitted but generally, you would need to prepare the following:
(1) the baby's passport and ACR
(2) Birth Certificate with city seal (出生公証書)
(3) proof that you can support financially ( copy of Jutokusyomeisyo from the city hall - last 2 year)
(4) Employment certificate
(5) Proof of the parent and the child's relationship ( Gaikokujin toroku genpon kisaijiku syomeisyo - choose family)


5. Update the baby's ACR

Bring the ACR and the passport with visa at your city/ward hall's ACR section.

Reference to (3):
--------------------------- from Philippine Embassy in Tokyo ----------------------------
REPORT OF BIRTH (For a Child of Married Parents (Legitimate))As a basic rule, Report of Birth forms should be filled-up and signed by one of the parents who is a Filipino national.-Duly Accomplished Report of Birth application forms (available at the Consular Information Counter) (4 original copies)
-Child’s Birth Certificate (Shussei Todoke) (Original & 4 photo copies) and Maternity Record Book (Boshi Techo) – (Original & 4 photocopies) Both should have stamps of City Hall and Hospital
-Parent’s Marriage Contract from NSO(if married in the Philippines) or Report of Marriage (ROM) from Philippine Embassy (if married in Japan or outside the Philippines) (Original & 4 photocopies) -Mother’s Birth Certificate from NSO and Passport or Travel Document (TD) or Affidavit of Identity/Nationality (AIN) (if mother is NOT a Filipino, Passport or Driver’s License or Residence Card) (Original and 4 photocopies) -Father’s Birth Certificate from NSO and Passport or Travel Document (TD) or Affidavit of Identity/Nationality (AIN) or Driver’s License (if father is NOT Filipino, Passport or Driver’s License or Residence Card) (Original and 4 photocopies) -Affidavit of Legitimation – if the child was born before the parents were married and there was no impediment for them to get married at the time of child’s birth (form available at the Consular Information Counter) (4 photocopies) Affidavit of Delay / Late Registration (If report of Birth is filed beyond 30 days after birth) Basic Fees: ROB and Translation of Boshi Techo or Shussei Shomeisho US$50Affidavit of Legitimation US$25Affidavit of Delayed Registration US$25Note: Fees are payable in US Dollar or it’s equivalent in Japanese Yen. Please consult the Embassy for the current applicable rate.Appropriate fees would apply for ROM and TD/AIN if an application is made for these documents.

NEW PASSPORT (for those born in Japan and applying for the first time)-Duly accomplished passport application form, available at the Consular Information Counter or downloadable from the official Embassy website. -Three (3) passport-size photos -Report of Birth or ROB (if not yet applied for, see section on ROB)-please present original copy and submit one photocopy. -Report of Marriage or ROM of parents (if parents were married in Japan) or Marriage Contract of parents (if parents were married in the Philippines). If parents were married in another country, one (1) photocopy of Report of Marriage issued by Philippine Embassy or Philippine Consulate General in the country where the marriage ceremony took place. NOTE: ROM need not be submitted if the applicant’s parents are not married.-Photocopy of the following pages of passports of parents:
data page visa page page bearing the signature of the signing officer Passport Fee: USD$50Note: Fees are payable in US Dollar or it’s equivalent in Japanese Yen. Please consult the Embassy for the current applicable rate.Applicable fees would apply for ROB and ROM if these documents are applied for simultaneously.
----------------------------------------------------

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3. Baby stuffs preparation: what,where and when to buy? PARTI: Where to shop for Baby/Children's daily necessities and clothes?

As you may know, Japan is one of the most expensive cities to live in the world, and coincidentally, everything about the baby here is expensive. I mean really everything - from clothes, toys, milk, baby foods, nappy, etc. One thing I am happy about the babies here is that manufactures never stop searching for new discoveries for the comfort of the parent- one of my favorite is Pampers nappy indicator - A yellow indicator which stretches from the front to the back of the diaper turns green once the undergarment has been soiled. It was 4 years ago so at the present time, there should be more new stuffs.

Anyway, I would like to share some information on shopping infant/childrens daily necessities and clothes. The following are the biggest retailers of infant/childrens goods in Japan.

• Babies R Us/Toys are Us
• Akachan-honpo
• Nishi-matsuya

In Tokyo, you can also find Babies R Us and Akachan-honpo in most of the shopping malls like in Olinas-Kinshicho (Babies R Us), Ario Mall - Kameari or Nishi Arai ( Akachan-Honpo), Funabashi Lala Port, and so on. I find the stores of Nishi-Matsuya to be not so accessible - I think most of them are bit far from the train stations.

Personally, I find Babies R Us a bit expensive but they have wide range of imported products. Nishi-Matsuya clothes are very cheap- you can buy from as low as 380yen and they have wide selection of Cars(Pixar), Anpanman and Disney designed clothes at a very affordable price. It depends on your choice of clothes. As for the baby foods, milk, skin item, etc- I think Akachan honpo is cheap but it is also worthy to check the drugstores near to your place. I find Papaso drugstores’ price, particularly milk and baby foods, to be almost the same as Akachan honpo. Wise thing is to shop when these stores are on sale. Make sure to registered as a member you that they would send you fliers on this months/season’s sale and to gain points too.


Pictures: A Next Next clothes for infants, below is Nishi Matsuya Chain Store.
Online shopping service is available at Babies R Us/Toys are Us and Akachan-honpo. I did use these services to order infant water (for milk), diapers, wipes and other heavy stuffs when my elder son is still a baby and we have no car that time yet.

You can also check Ikea for their product line up for children. They have products from bedroom (beddings/baby cribs/curtains) to toys and kitchen utensils (bibs/mugs/plates/etc). I like their products as they are very colorful which you can seldom find in Japanese stores. Their toys are mostly made from wood - indeed a European style!

You may also want to check Costco where you can find baby/children clothes, diapers, wipes, milk, English books, toys,etc. Diapers are in bulk and I think only Pampers, Kirkland and Unicharm (Disney designed) are available. Clothes are usually Osh Kosh and Carters signatures and very cheap compared to Osh Kosh boutique in Makuhari Outlet - although design/style are one season older.

As for the baby's clothes, I also recommend the following boutiques:

• Uniqlo infants/kids - this is where I bought most of the infant clothes I used for my elder one - and still was able to use by my younger one. Mostly made of cotton and I find them durable with a sense of fashion. Very cheap too! Their infant clothes are usually 3pcs in 1 pack.
• Gap Kids - shop when they are on sale (usuallly after every season). You can find good stuff as low as 500yen!
• Next Next - a brand from UK and based in Omotesando. I think the price is almost the same as Gap or maybe cheaper but the style is completely different! I prefer girl’s clothes though. Their infant clothes are usually 3pcs in 1 pack and light in colors (gray, white, light pink, light green and light yellow). They also have my favorite color – purple, lavender – related color for girls!
• Ginza Isamiya - is a store name rather than brand because they sell Rag Mart, FO Kids signatures - same price range as Baby Gap but very durable clothes. When my elder one enrolled to nursery when he was 10months- i bought size 90 shorts as his pants - and 3 years later - he could still use them. They have branch near our place - their main branch is in Ginza (right beside Mitsukoshi).
• United Colors of Benetton - more expensive than all of the above but their summer clothes and accessories are really lovely! Their Omotensando mega-boutique has wide collection of children's clothes and accessories.
• Zara kids - Surprisingly they have wide selection for toddlers too. I have never bought here in Japan -as it was in Manila (Zara Rockwell branch) where we shopped, but a friend told me that when Zara Japan goes on sale - clothes could be as low as 500yen too.

I heard
COMME CA ISM
children clothes are also affordable – this is a family of five fox with COMME CA DU MODE FILLE and ARTISAN as its high-end brand, I have never bought clothes from them because they are mostly gray and black in color.

If you want to buy baby clothes of international brand, I recommend that you shop during the winter and summer sale. I always do my shopping at Mitsukoshi Nihonbashi because there are wide variety of children boutiques such as Ralph Lauren, Burberry, JPress, Chloe, Bebe, Miki House, Yumi Katsura, Familiar, Diesel and others.Celine is available at Ginza's branch, Tommy Hillfinger and other European brands could be found in Ebisu branch.

Make sure to grab a 10,000yen "fukubukuro" on Mitsukoshi's new year’s sale (especially Bebe, Castelbajac and Miki House) - You'll be surprised to know that the clothes inside the fukubukuro could be no less than 25,000yen worth of clothes. High-end brands like Ralph Lauren doesn’t have “fukubukuro” but a clearance discount for as low as 50%.

Happy shopping!

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2. Recommended readings/tools regarding Pregnancy

You can find many free tools and articles on the internet. There are many of them from naming the babies to detailed weekly development of the baby in the mothers womb (some website have 3D pictures of the baby!).

Also, when you get your boshi-techo from the city hall or city health office, you would have received pamphlets on pregnancy too. Although they are written in Japanese, I find them very useful so if you husband or your friend can translate them for you, the better.

You may also get some information from the hospital where you are taking monthly/weekly maternity check up.

You can also avail information on infants stores such as aka-chan honpo - they do provide pamphlets on what are the things needed for a certain period of time in pregnancy - written in Japanese too. Please be careful here though because the pamphlet contains some items that maybe nice to have but not necessarily must to have.  

Otherwise you can check the bookstores on pregnancy books. English books are available at kinukuniya bookstores, or if you can buy online - you can have a short stop at amazon.co.jp

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1. Becoming a "gaikokujin" mommy::外国人ママになる

Getting pregnant with our first baby was a big change for our household especially because it was only a few months into our marriage -the time when we were still learning the ins and outs of an international marriage in a foreign country.

Anyway, as soon as we confirmed that I was 2 months pregnant, we spent the following days reading about the growth of our as yet unborn child, gathering information on how to give birth in Japan, knowing the employee privileges from our respective companies and most of all, being a gaikokujin here - the legal processes we have to undergo.

The entire preparation process was a bit tiring but full of excitement and fulfilment. Also, I learned a lot not only about the general theories of pregnancy, but also the different practices of pregnancy in my own culture - the Filipino, my husband's - Bangladeshi and the country we live in - the Japanese culture. But in the end, we both agreed that theories on childbirth could be universally right or wrong and that finding the “common ground” between us is what matters most.

It wasn't easy getting pregnant, giving birth and rearing infant in a foreign country, but we were able to cope up, so if you are a gaikokujin expectant, just relax and enjoy waiting for the gift of life :D

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