Friday, January 18, 2013

The First Steps

Even before deciding on going for #3, I had seen the fantastic medical care that Japan has to offer. Theo has very knowledgable, kind, and caring doctors (who all seem to speak English at least understandably) and I am always impressed by how quickly and how often he gets ultrasounds of his kidneys or MRIs of his spine when they are needed. In Canada, we often had to wait 6 months for these kinds of tests whereas here, the neurosurgeon was genuinely apologetic when he told me they only had an opening for an MRI the next morning! So, going into this pregnancy I already knew that whatever doctor I found was most likely going to be skilled and that I would have more ultrasounds than my other two pregnancies combined.

After confirming that I was pregnant with a home pregnancy test (they are really easy to find at drug stores here and cost me something like 500 yen for 2 tests) and by the fact that I felt like puking every second, night and day, I started doing some research into hospitals and clinics in our area. Our choice of a clinic was really based on two factors: 1. I wanted to be able to communicate, at least on a fairly reasonable level, with the doctor in English, and 2. I wanted it to be close to our home so that I could bike or walk to appointments and have a short trip when in labour. We don't own a car and don't intend to buy one so this wasn't really just a preference, but a necessity. Having a 40 minute taxi ride at 3 am while in labour is the kind of thing that I would never voluntarily choose. Optimally, I would like to have a very low intervention birth with a midwife, preferably at home, but there are no English speaking midwives in our area and home births are basically unheard of so that option was automatically off the table. It was initially a bit disappointing to realize that I just had to settle for a birth that was most practical and not what I really hoped for, but I have come to realize over the past two pregnancies and births that when it comes down to it, labour is unpredictable and painful no matter what and it is actually over fairly quickly. It is usually just one really bad day in your life that fades away almost instantly with the birth of your baby, no matter where and who delivered it. The pregnancy, however, lasts a long time and if you can have a low stress pregnancy by actually being able to communicate well with your doctor, understand anything that is of concern, and have quick appointments then you are pretty well off.

Through asking around and the internet, I was really fortunate to find a clinic that has a few English speaking doctors and nurses and is only about a 20 minute bike/10 minute car ride from our house. A wonderful Japanese friend of ours made an appointment for me when I was about 10 weeks along, which is when they advise you to come in to confirm your pregnancy. She also came with me to the first two  appointments to help fill out all of the initial paperwork and make sure I knew what was generally expected of me during appointments. I was a bit surprised that they used ultrasound to confirm pregnancy instead of simply doing a blood test as they would in Canada. There are a lot of differences in the use of ultrasound during pregnancy in Japan vs. Canada and I think I will go into further detail about this in a future post. 

All your seat are belong to us! 
Once the doctor was satisfied that I was  pregnant, she filled out a slip of paper with the estimated due date and asked me to come back in two weeks for all of the routine blood tests, initial height and weight checks, and such. With this slip of paper, I  was able to go to city hall and register my pregnancy. This allows you to obtain a Boshi Techo, or Mother  and Child Health Handbook, and book of coupons to supplement the cost of each doctor's appointment during the pregnancy. I also recieved a little dangly tag for my purse which is supposed to serve as a non-verbal message to people on trains and buses that I am pregnant and that they should give up their seat to me if none are available. Either people have no clue what this little sign means, or they just refuse to acknowledge it, because no one has ever given up their seat to me on a full train. Even now when I am very obviously pregnant, people just pointedly ignore me and sit tight as I seethe internally and try to keep my balance when the train rocks. No, I am not at all bitter about this :)

It was all very quick and easy (with the help of my friend) to get a doctor's appointment when I wanted one, register this pregnancy, and get all of the necessary books and coupons. In total it cost me about 4,000 yen (about $41.50 Canadian) to complete these first steps, which is already more than I paid for my other two pregnancies and births combined, but pretty inexpensive in the grand scheme of things.

More about doctors appointments and the Japanese health insurance system to come...

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