Japan to initiate free birth and more for prospective parents

Giving birth remains expensive in Japan. Pregnancy, childbirth and postpartum costs are not covered by health insurance, and parents have to pay up to approximately 520,000 yen ($ 5,000 USD) on average unless complications warrant medical procedures, such as cesarean deliveries, under insurance purview. Instead, insurance reimburses parents in the amount of 42,000 yen ($ 4,000 USD) per childbirth, once claims are submitted. Expecting parents need ample cash handy before babies arrive.

Yet, nearly 40% of the Japanese workforce do not enjoy full-time employment with benefits that include maternity/paternity leave. The ratio is even higher for women: 53% of them are employed on a short-term contract base. How can they cough up 5k per child, let alone all other costs until their children graduate from college, without a safety net?

Community-based support systems

Some municipalities have subsidized some of the childbirth-related costs to an extent, such as check-up fees during pregnancies or diapers for newborns. Tokyo’s Shibuya-ward provides a grant of up to 100,000 yen ($1,000) from the firstborn and above, while Nerima-ward sends a gift of 100,000 yen when the third child is born and thereafter.

In December 2022, the Kishida administration decided to allocate 50,000 yen ($500) when women report pregnancies to the authorities and an additional 50,000 yen when they report childbirth. The distribution of these cash incentives will be managed through municipal governments, with a view to creating support networks at the local level. The Tokyo metropolitan government has announced to top up the national subsidies, doubling their amounts.

There are other types of grassroots assistance towards childbirth beyond financial and material means. Though not covered by insurance, either, expecting mothers are turning to midwives who offer holistic approaches, inclusive of psychosocial support, optional home delivery and infant care. Some of them have commented on their experiences with these midwives as ‘a wholesome experience,’ compared to the more standardized OBGYN practice.

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Will it entice young families to have children?

While childbirth costs are one of the concerns, especially for those with uncertain incomes, the declining birthrate stems from deeper dissatisfaction with the state of affairs in Japan.

According to a survey conducted by the Nikkei newspaper in March 2023, the main reason for remaining childless (that is, 27% of women now in the 50s) was the lack of hope for the future of Japan. One-third of the respondents answered that they have never wanted to, and never will, have children, because they do not earn enough, because women sacrifice too much for it and husbands are not supportive enough. They also express pessimism about political and social change, while identifying wage increase as the utmost solution. Another survey targeting the young people in the 20s reveals that while the vast majority of them (more than 70%) would like to have children, only a quarter of them feel that Japan is a family-friendly country.

For expecting parents, worrying about whether they can afford the arrival of a child should be the last thing on their minds. With additional subsidies on offer now, childbirth may be cost-neutral if their career prospects are promising. For the majority of women, however, it is not the case, and what is made available is nowhere near the burden they are forced to bear. If Japan is serious about reversing its declining demography, childbirth should be free, and much more needs to change, including the cost of education, gender parity and job creation.