Having a baby in Tokyo: a gentle orientation
Expecting in Tokyo and not sure where to start? Here's a calm overview of how the system supports you — the Mother & Child Health Handbook, subsidised checkups, and the paperwork that comes with a new baby — and who to ask for the details.
Having a baby in a new country can feel daunting, but Tokyo's maternal-and-child health system is well organised and used to supporting families of every background. This guide is a gentle map of how things generally work — not medical or step-by-step advice. For anything about your health or your baby's, ask your doctor or midwife; for any official procedure, your ward office (区役所 ku-yakusho) is the place to go, and many publish information in several languages.
Step one: the Mother & Child Health Handbook
Once a clinic confirms your pregnancy, you report it to your ward by submitting a pregnancy notification (妊娠届 ninshin todoke). In return you receive the Mother & Child Health Handbook (母子健康手帳 boshi kenko techo, often just 'boshi techo'). It's a small but important booklet that records your pregnancy, the birth, and your child's checkups and vaccinations in their early years — keep it with you for appointments. Many wards can offer the handbook or companion leaflets in languages other than Japanese; ask at the counter what's available.
Subsidised prenatal checkups
Together with the handbook, your ward gives you a set of checkup coupons (受診票 jushinhyo) — vouchers that cover much of the cost of the routine prenatal checkups recommended through your pregnancy. You hand them in at your clinic or hospital. Some wards also invite expectant parents to a friendly interview with a public-health nurse or midwife when you register, which is a good moment to ask any questions.
Choosing where to give birth
Families in Tokyo give birth in different settings — a large hospital, a smaller maternity clinic, or a midwife-led birth house (助産院 josan-in). Popular places book up early, so it's worth deciding and reserving soon after your pregnancy is confirmed. Which option fits you is a conversation for your doctor or midwife, who can advise based on your health and circumstances.
Paperwork after the birth
A new baby brings a short run of admin, and it helps to know that different offices handle different parts. Your ward office (区役所) is where you file the birth notification (出生届) within 14 days, add your baby to your health insurance, and apply for the child allowance (児童手当 jido teate). As a foreign family there are two more places to visit: your country's embassy or consulate, which registers the birth with your home country and issues the baby's passport; and the Immigration Services Agency, which handles the baby's residence status (visa). Rather than walk you through each form here, we'll point you to the offices that do this daily — your ward office, your embassy or consulate, and Immigration can each tell you exactly what to bring and in what order for your situation.
- Keep your boshi techo and checkup coupons together in one place — you'll reach for them often.
- Ask your ward, early, which materials and consultations are available in your language.
- Reserve your birth place soon after confirming the pregnancy; the good ones fill up.
- Note the 14-day birth-notification deadline before the baby arrives, while life is calmer.
- When you're unsure, ask: a doctor or midwife for health, the ward office for procedures.
- Can I get the Mother & Child Health Handbook in English or another language?
- Often, yes — availability varies by ward. Larger wards tend to stock several languages, and many offer multilingual leaflets even when the handbook itself is in Japanese. Ask at your ward office or health centre what they have.
- Do the checkup coupons make prenatal care free?
- They cover a large share of the cost of recommended routine checkups, but not necessarily everything, and they generally apply only after the handbook is issued. Confirm the specifics with your ward and your clinic.
- Where do I handle the paperwork after my baby is born?
- It depends on which step. The birth notification (due within 14 days), adding the baby to your health insurance, and the child allowance are all done at your ward office (区役所). Registering the birth with your home country and getting the baby's passport are done at your embassy or consulate, and the baby's residence status (visa) is handled by the Immigration Services Agency. Each office can tell you what's needed for your case.
- Tokyo TIPS — Pregnancy and Childbirth (multilingual overview) (opens in a new tab)
- Shinjuku Ward — Mother & Child Health Handbook (boshi techo) (opens in a new tab)
- Suginami Ward — pregnancy notification & handbook (opens in a new tab)
- Koto Ward — birth notification (shussho todoke) (opens in a new tab)
Related guides
Related guides
Stretching your yen in Tokyo: a frugal-living guide
Tokyo can feel expensive, but everyday life here is full of quiet ways to spend less — cheap set meals, half-price stickers in the evening, 100-yen shops, budget phone plans, and free parks and views. Here's a friendly starter map.
Understanding Japanese Work Culture: What to Expect at Your Tokyo Workplace
A warm, practical orientation to everyday Japanese workplace norms — punctuality, hierarchy and keigo, group harmony and nemawashi, exchanging meishi, nomikai, the hanko, and attitudes to leave and overtime. Plus where to turn, free and in your language, if a real work problem comes up.
LGBTQ+ Life and Support in Tokyo
A warm orientation for LGBTQ+ newcomers to Tokyo: community and Pride events, the Shinjuku Ni-chome neighbourhood, counselling and helplines, and the same-sex partnership certificate that a growing number of wards now offer.