Childbirth and parenting

Chapter 4 Childbirth and Parenting 1 Procedures Related to Pregnancy Notification of pregnancy and issuance of a maternal 1-1 and child health handbook (boshi kenko techo) • Once you learn of your pregnancy, report it to your local municipal office as soon as possible. • The office will provide the following to those who report their pregnancy: i. A maternal and child health book (boshi kenko techo) ii. Tickets for receiving subsidized prenatal checkups iii. Consultation with public health nurses and other professionals iv. Introduction of parents’ classes (mothers’ /fathers’ classes) * The maternal and child health handbook records the entire health history of the mother from pregnancy to birth, and of the child from infancy to early childhood, while providing guidance for the parents or guardians on childrearing. It is designed to allow parents or guardians to make notes of and manage information, and to enable healthcare professionals to make notes of and view information. * In January 2023, we launched our “Maternal and Child Health Handbook Information and Support Site” with information on childcare and related topics. (Maternal and Child Health Handbook Information and Support Site) https://mchbook.cfa.go.jp 1-2 Prenatal health checkups • During pregnancy, you must take even greater care of your health than usual. Please receive regular prenatal checkups and manage your health according to the advice of doctors, midwives, and other healthcare professionals. • It is best to receive prenatal health checkups with the following frequency: i. Once every four weeks from early pregnancy until week 23; ii. Once every two weeks from week 24 to week 35; and iii. Once a week from week 36 until childbirth.

4 Childbirth and Parenting Home visits by a public health nurse, midwife, or 1-3 other healthcare professional A public health nurse, midwife, or other healthcare professional will visit you at your home to provide you with help and guidance on the following matters; i. Guidance on home life or meals; ii. Consultations about uncertainties or concerns you may have about pregnancy and childbirth; and iii. Consultation regarding childcare for newborns and infants * There is no fee for these visits. For details, please contact your local municipal office. 1-4 Parents’ classes (mothers’/fathers’ classes) The municipality holds parental classes on pregnancy, childbirth, parenting, nutrition, and other relevant topics. These classes are also an opportunity to meet and talk with other expecting parents.

4 Childbirth and Parenting 2 Procedures after Birth 2-1 Notification of birth If you gave birth to a child in Japan • A notification of birth must be submitted by the mother or father. • This notification must be submitted within 14 days of birth. • Submit the notification of birth to the municipality where your child was born or the municipality of the person submitting the notification. (1) Documents required for notification of birth • Birth certificate • For other necessary documents, contact the municipality to which you are submitting the notification. (2) Other procedures If a status of residence is not obtained for the child within 60 days of birth, the residence certificate may be deleted, and the child may not be able to receive administrative services such as national health insurance and child care allowance. For details, refer to Chapter 1, 2-4, “Acquisition of status of residence.” 2-2 Notification of the childbirth to home countries If neither of the parents have Japanese nationality, your child cannot obtain Japanese nationality even if he or she is born in Japan. In such a case, it is necessary to perform the procedure to report the birth of the child to your home country. For details, please contact the embassy or consulate (general) of the father’s or mother’s country in Japan. In addition, acquire a passport for your child.

4 Childbirth and Parenting 3 Childbirth Expenses and Allowances As pregnancy and childbirth are not illnesses, they are not generally covered by health insurance. C-sections and other surgical procedures are covered by health insurance as exceptions. 3-1 Lump-sum allowance for childbirth This is a system for paying out 500,000 yen to cover the expenses for delivery when the mother is enrolled in health insurance or the national health insurance. However, if the delivery is not covered by the Japan Obstetric Compensation System for Cerebral Palsy, such as when the duration of pregnancy is less than 22 weeks, the amount paid is 488,000 yen. There are two types of payment in this system. i Direct payment With this method, the medical institution requests and receives the lump-sum allowance for childbirth on the mother’s behalf. As the lump-sum allowance is paid directly to the medical institution, you do not have to pay the full amount of the childbirth expenses at the payment counter when leaving the hospital. ii Proxy recipient With this method, when requesting the lump-sum allowance for childbirth from the Health Insurance Association or other association you are enrolled in, you can entrust medical institution where your child will be born to receive the allowance so that the lump-sum allowance is paid directly to the medical institution. 3-2 Childbirth allowance If you are enrolled in health insurance yourself and must take a leave of absence from work without pay, you will be eligible to receive a childbirth allowance for the duration you were absent within the period starting 42 days before birth (the due date) (98 days for multiple births) and ending 56 days after birth. In principle, you are eligible to receive the amount equivalent to two thirds of your wages per day as childbirth allowance during your maternity leave from your health insurance. However, if you receive wages from the company for which you work during your leave, and the amount you receive from the company is greater than the childbirth allowance amount, you are not eligible to receive the childbirth allowance. If the actual date of birth is later than the due date, you will be also eligible to receive a childbirth allowance for the delayed period.

4 Childbirth and Parenting 3-3 Childcare leave benefits (provision during childcare leave) (1) Benefits during childcare leave If you are enrolled in employment insurance and take childcare leave to care for a child who is less than one year of age (one year and two months if certain conditions are met or one year and six months or two years if certain other conditions are met) and meet the following requirements, you will be eligible to receive childcare leave benefits by applying for the benefit at Hello Work, in principle. (For the first 180 days, you will receive the amount equivalent to 67% of your wages prior to the start of the leave. After that, you will receive 50% of your wages prior to the start of the leave.) • Requirements for receiving the benefits i. That you have worked more than 11 days per month or more than 80 working hours per months as the bases of wage payment for 12 months or more during the two years prior to the start date of your childcare leave. ii. That you meet certain conditions such as your wages during childcare leave drop to less than 80% of the wages you made when starting your leave. iii. There must be 10 or fewer working days per month during the period of leave (or if more than 10 working days, the number of working hours must be 80 hours or fewer) Childcare leave benefits generally apply even when leave is split into two periods. * In the case of a temporary worker (employee with a fixed-term contract) In addition to the conditions mentioned above, a temporary worker (an employee with a fixed-term contract) needs to satisfy the condition that it is unclear that the employment contract will end before his/her child turns one year and six months old (two years old if the childcare leave starts after the child is one year and six months old due to reasons such as the child being unable to enter daycare) at the start of the childcare leave.

4 Childbirth and Parenting (2) Childcare leave at birth benefits If you are enrolled in employment insurance and take childcare leave (childcare leave at birth) to care for a child by the time eight weeks passes since a child is born by specifying the period up to 4 weeks and meet the following requirements, you will be eligible to receive childcare leave benefits by applying for the benefit at Hello Work. (You will receive the amount equivalent to 67% of your wages prior to the start of the leave. The number of days for which childcare benefits at birth shall be included in 180 days when benefit rate of 3-3 (1) Benefits during childcare leave is 67%). • Requirements for receiving the benefits i. That you have worked more than 11 days per month or more than 80 working hours per months as the bases of wage payment for 12 months or more during the two years prior to the start date of your childcare leave. ii. That you meet certain conditions such as your wages during childcare leave drop to less than 80% of the wages you made when starting your leave. iii. That the maximum number of working days is 10 days or less (in the case where such number exceeds 10, the working hour is 80 hours) (however, in the case where the leave period is less than 28 days, the number of days/hours for which you can work shall become less in proportion to such days of the leave period.) Additionally, even in the case where childcare leave at birth is taken by dividing, you are eligible to receive childcare leave benefits up to twice. Other than the above-mentioned, in the case of the leave that falls under any of the following i and ii, you shall not be eligible to receive the benefits; i. The third time or later of childcare leave taken for the same child. ii. The portion of paternity leave taken for the same child exceeding a total of 28 days. * In the case of a temporary worker (employee with a fixed-term contract) A temporary worker (an employee with a fixed-term contract) needs to satisfy the requirement that it is unclear that the employment contract will end during the period from the day following the day on which eight weeks has elapsed to six months. 3-4 Child allowance The child allowance is paid to ensure a stable home environment and the healthy development of the children. This allowance is paid when the child and the person raising the child are both living in Japan. (1) Eligibility Person raising a child until the first March 31st after their 18th birthday (2) How to receive the child allowance • Submit an application for the allowance to your local municipality.

4 Childbirth and Parenting • In principle, the allowance is paid starting from the month following the month in which the application is submitted. • You need to submit the new application when a new child is born or when you move to another municipality (3) Amount Eligible child (*) Monthly amount per child First child, second Under three years old 15,000 yen child From three years old Until the end of the first fiscal year 10,000 yen after reaching 18 years of age Third child and From 0 years old subsequent children Until the end of the first fiscal year 30,000 yen after reaching 18 years of age * Children who are a financial burden until the end of the first fiscal year after reaching the age of 22 are referred to as the first child, second child, third child, and so on, in order of birth. (4) Payment timing As a rule, child allowance is paid altogether once in 2 months (April, June, August, October, December, and February). 4 Parenting 4-1 Postpartum Care Services We provide physical and mental care and childcare support to mothers and babies immediately after discharge from the hospital. • Implementation methods and locations i Residential: You can stay at a hospital or maternity center to receive care and support. ii Day service: You can visit a facility during the day to receive care and support on an outpatiet basis. iii Outreach: A staff member will visit your home to provide care and support. The details vary depending on the municipality, so please contact your local municipality for more information.

4 Childbirth and Parenting 4-2 Checkup of infants Your municipality provides the following health checkups for free: • 18-month-old checkup • 3-year-old checkup • Depending on the municipality, checkups may be provided for infants of other ages. * Checkups include tests of development, height and weight measurement, and parenting consultations. For details, contact your local municipality. 4-3 Vaccinations There are some illnesses that can be immunized against with vaccinations. There are two types of vaccinations. i. Vaccinations recommended by the municipality These vaccinations may be provided for free. For details, contact your local municipality. ii. Voluntary vaccinations available by request For these vaccinations, you will pay out-of-pocket. Consult your doctor before giving your child vaccinations. 4-4 Medical expenses for children If you are enrolled in a health insurance, you pay 20% of the medical expenses for children up to age six prior to the start of elementary school. Depending on your local municipality, medical expenses may be free until the end of high school or additional aid may be provided. 4-5 Facilities for preschool-aged children • There are different types of facilities for children up to age six prior to the start of elementary school, such as daycare centers, kindergartens, and centers for early childhood education and care. • Fees for daycare centers, kindergartens, centers for early childhood education and care, are free for all children aged 3 to 5. (1) Day care center (Hoikujo) • These facilities care for children in lieu of parents and guardians who are unable to provide care at home for work or other reasons. • Regular daycare services are eight hours a day, and some daycares also offer after-hours services such as evening and holiday daycare services. • Some day care centers offer hourly care services in which children can be left there on an hourly basis in the event of urgent business or a short-term part-time job, for example.

4 Childbirth and Parenting Non-registered daycare facilities This is the general term for facilities that care for children and that have not been approved according to the Child Welfare Act. The following are examples of non-registered daycare facilities: • Non-registered daycares (Muninka hoikujo) • Daycares for customers at department stores • Day nurseries (Takujisho) • Baby hotels • Babysitters etc. (2) Kindergarten (Yochien) • Kindergartens are school for children from age three until they start elementary school. • The standard time for education is four hours a day, but childcare services is available at some kindergartens until evening or night, or from early morning, depending on the circumstances of parents and guardians such as working. • Kindergartens focus on learning through children’s voluntary play. • Some kindergartens also offer consultation services related to child-rearing for parents and guardians in the local community or open their schoolyard to the public. (3) Center for Early Childhood Education and Care (Nintei Kodomoen) • Centers for early childhood education and care combine the functions of both kindergartens and daycares. • Centers for early childhood education and care can be used regardless of whether parents/ guardians work or not. • They also have other functions for all households with children such as consultation activities to help with the anxiety of parenting and providing a place where parents and children to get together. 4-6 After-school Children’s club (Hokagojido-club) • For elementary school children whose parents or guardians are not at home during the daytime for work or other reasons, after-school children’s clubs are available. • In these clubs, after-school child care workers etc. are staffed to offer an appropriate place for playing and spending time after classes. • Some municipalities also offer after-school children’s classes, which provide different types of learning and interactive activities for elementary school age children.

4 Childbirth and Parenting 4-7 Family Support Center • The Family Support Center is an organization that consists of the members described below. The Center acts as a go-between to help members support each other. i. Parents who need assistance in watching infants or elementary school children ii. People who want to provide assistance • Examples of support are as follows. i. Taking children to and from daycare facilities etc. ii. Watching children after daycare facility hours or after school iii. Watching children while parents or guardians go grocery shopping or run other errands • The procedure for using such support is as follows. i. Contact the nearest local Family Support Center and register to become a member. ii. Apply for use of the support. iii. A Family Support Center advisor introduces you to a member who will provide you with assistance and acts as a go-between for you and that person. iv. Pay a fee to the person who provided assistance after the assistance. 5 Consultation services for pregnancy, childbirth, and child-rearing 5-1 Children and Family Centers, etc. Municipalities have consultation services (such as children and family centers) where pregnant women, parents raising children, and children can consult about concerns related to pregnancy, childbirth, and child-rearing, as well as problems related to family and school life, and receive support. Public health nurses can provide consultation on matters before and after childbirth and on the growth and development of infants and toddlers, and counselors can provide consultation on child-rearing as well as offer support for a variety of concerns. For more details, please check the website of your municipality. 5-2 Regional Child-rearing Support Centers Municipalities have established places where parents and children can interact at local facilities such as public facilities, childcare centers, and children's centers (regional child-rearing support centers), and provide childcare consultations and information on child-rearing. For more details, please check the website of your municipality.