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Maternity culture in Japan
No pain, no gain
THE Mejiro Birth House in a northern district of Tokyo is eerily quiet: no babies crying, no wails of women in labour. That, explains Yuko Hoshino, the chief midwife, is because it is empty. Only four to six babies are born there each month, compared with 14 to 16 a few years ago. The problem is not just Japan’s low birth rate. “Fewer women want a natural birth today,” she says ruefully. “They go with doctors in hospitals rather than with midwives in birth houses.”
The culture of maternity in Japan is slowly becoming more like the rest of the rich world, but several practices differ. Women are generally treated as fragile during their pregnancy. But during labour itself they are expected to suffer. Painkillers are doled out sparingly, if at all. Doctors say growing numbers of women are keen to have an epidural (an anaesthetic injected into the spine), but few obstetric centres, hospitals included, offer them, and almost never outside normal working hours. The payment of ¥420,000 ($4,053) that the national health-insurance scheme makes towards the cost of having a baby would not typically cover one, anyway.
For most women, however, the issue is neither the cost nor the longer time it takes to recover after an epidural. Local Buddhist tradition holds that women should embrace the pain of natural childbirth. The experience is said to prepare them for the challenges of being a mother and to encourage bonding with the baby. Yoshimi Katsube, who is 35, says her parents criticised her when she told them she would be having an epidural at the birth of her first child. Nonetheless, she plans to have one again when the baby she is now expecting is born.
More fathers attend births than used to be the case, but many still don’t come into the delivery room. “My husband will come to the hospital, but we have yet to decide whether he will come into the room,” says Mayuka Yamazaki, who is expecting her first child this month. “I am not sure if I want him to see me like that.”
In most countries, the received wisdom about what women should do in pregnancy relies as much on the local culture as on science. Expectant mothers in France drink wine and eat pâté, for instance; their American counterparts see this as one step short of infanticide. In most places pregnant women would be steered away from raw fish, but not in Japan. The main obsession, however, is with body temperature. While Western mothers-to-be are advised not to get too hot, those in Japan are told to keep warm. They happily bathe in hot springs but avoid ice cream and chilled water. Restaurants offer blankets to pregnant women, even in the height of summer.
One element of the standard advice for pregnant women in Japan is worrying, however. The country has a high and rising proportion of underweight babies, defined as 2.5kg or less at birth. In 2015 9% of babies were underweight. One reason, says Zentaro Yamagata of the medical department of University of Yamanashi, is that women do not put on enough weight during pregnancy. Doctors advise their patients to put on no more than 6-10kg, compared with 11-16kg in Britain.
The government, which is keen to push up the fertility rate from the current 1.5 children per woman to 1.8 to slow the shrinking of Japan’s population, might ponder all this. The causes of Japan’s demographic decline are many and to some degree intractable. But making childbearing a less forbidding experience could not hurt.
n. 递送，交付，分娩
