1 From pregnancy to birth Pregnancy Visit to your local municipal administrative office Submission of the Notification of Pregnancy 1-2 (1) Receive a Maternal and Child Health Handbook and a Health Check Application Sheet 1-3 (1) Health check-up A pregnant woman can have health check-ups at medical institutions. 1-3 (2) Home visits and advice by midwives/nurses Birth 1-3 (4) Mother's classes, parent's classes 2-1 Submission of a birth notification Visit your local municipal administrative office within 14 days after the birth When necessary, receive from the office a certificate of the acceptance of the birth notification 2-2 Acquisition of nationality for newborn infants Who submits it? Either parent of the child Necessary documents 1. A birth notification 2. A birth certificate 3. Seal or signature of the submitter 4. Maternal and Child Health Handbook 5. National health insurance card (only its members) (1) In cases where either of the parents is a Japanese national (2) In cases where both parents are foreign nationals Acquire the status of residence for the child Register the child as a resident
2 Childcare When you wish to apply for childcare benefits 3-2 Lump-sum payment of childbirth and childcare 3-3 Maternity allowance (in the case of maternity leave) offered to members of health insurance programs/national health insurance programs offered to members of health insurance programs 3-4 Child allowance 3-5 Subsidy programs particular to municipalities Medical services for children 4-1 Health check-ups for infants and children 4-2 Immunizations (vaccinations) 4-3 Special exceptions for medical costs for infants and children Enrolling a child to a nursery school Childcare support 5-1 Accredited nursery schools Non-accredited nursery schools Apply at your local municipal administrativ e office Necessary documents 1. Residence Card or special permanent resident certificate, etc. 2. Copies of: certificate of withholding tax; and income tax return 3. Material and Child Health Handbook (to be brought at the interview) When a child is left without a guardian during the daytime When a child is temporarily left without a carer during the daytime 5-2 Children s clubs (gakudo clubs) 5-3 (1) Temporal daycare 5-3 (2) Family support center
3 Child birth and childcare are part of major events of life. The following pages are spared for explaining necessary procedures and support services available for the phases of pregnancy, birth and child raising. 1 Pregnancy Pregnancy and birth accompany huge responsibilities for the borne child. Ideally, you and your spouse should spend the phases of pregnancy and birth in an optimum environment for the sake of the child and for yourselves. When you realize you are pregnant, you must immediately file a pregnancy notification with your local municipal administrative office. In Japan, municipal authorities issue the Maternal and Child Health Handbook (boshi kenko techo) to each pregnant resident and offer classes where pregnant residents can learn the knowledge and techniques to be used for the phases of pregnancy, birth and childcare. 1-1 Discovery of pregnancy When you become pregnant, you are expected to file a pregnancy notification with the administrative office of the municipality where you live. The place to file it with differs among municipalities. You can learn about specifics at your municipal administrative office. When you have filed a pregnancy notification, you will receive the Maternal and Child Health Handbook.
4 1 Pregnancy 1-2 Maternal and Child Health Handbook (Mother and child health handbook, boshi kenko techo) (1) What is the Maternal and Child Health Handbook? This handbook records results of health check-ups of the mother and child and growth of the child. It also presents various health services such as health check-ups and vaccinations. The first page of the handbook has a space for a certificate for completing birth notification. The pages that follow consist of contents shown below: Issues related to mother s health * Nutrition advice during pregnancy * Record of health check-ups during pregnancy * The states of birth and development after the birth * Record of body weight during pregnancy and after the birth * Record of attendance at mother s (parent s) classes, etc. Issues related to child s health *Guardian s observation of the child s growth and record of regular infant/child health check-ups * Infant/child body growth curve * Child height and weight growth curves * Record of vaccinations * Record of sickness, etc. (2) Maternal and Child Health Handbook written in languages other than Japanese Some municipalities issue the Handbook in versions of English, Chinese, Korean, Portuguese, Spanish, Thai, Indonesian, Tagalog, etc. Please enquire about non-japanese versions at the time you file your pregnancy notification. The Boshi Hoken Jigyodan Co. (Maternal & Child Health Enterprise Co.) also issues some non-japanese versions for a fee. Handling organization Address Telephone number and URL Available languages Boshi Hoken Jigyodan Co. (Maternal & Child Health Enterprise Co.) Yushima, Bunkyo-ku-Tokyo Telephone: URL: Japanese, English, Portuguese, Tagalog, Chinese, Korean, Thai, Indonesian, Spanish (2 languages jointly written)
5 (3) Others A book entitled From Pregnancy to Childcare How to Prepare for Childcare in Japan is issued in the eight languages of Japanese, English, Chinese, Korean, Portuguese, Spanish, Thai and Vietnamese. A copy costs 1,575 yen (excluding the postal fee). Video versions are also available (only the English version is on DVD). For further details, please contact AMDA International Medical Information Center. Inquiry Address Telephone number and URL AMDA International Medical Information Center, Tokyo AMDA International Medical Information Center, Kansai Poste restante Kabukicho Post Office Shinjuku-ku Tokyo Poste restante Osaka Chikkou Post Office Minato-ku Osaka City Osaka Prefecture Telephone: URL: Telephone:
6 1 Pregnancy 1-3 Maternity health check-ups/ Health advice (1) Maternity health check-ups During pregnancy, you are advised to take ample nutrition and rest, and undergo regular health check-ups. Depending on district you live in, you can have a number of medical check-ups free of charge or at reduced rates. To receive this service, please use the application card for the check-ups, which is handed to you at the time you receive your Maternal and Child Health Handbook. (2) Visits and advice by midwives/public-health nurses Each municipality arranges a midwife or public-health nurse to visit the households of pregnant residents to help them learn about lifestyle during pregnancy, preparation for birth and other aspects, taking a case by case approach. For further details, please contact your local municipal administrative office. This service is free of charge and offered at the request of doctors, as well as of pregnant persons themselves. (3) Midwifery institutions For persons who face difficulties in giving birth at their own expenses due to economic reasons, there are opportunities to enroll in public-fund designated midwifery institutions to give birth there. To apply for this service, applicants are required to visit the municipal administrative office before birth. (4) Mother's classes, parent's classes Each municipality holds classes to offer daily knowledge and skills related to pregnancy, birth and childcare. Eligible participants are pregnant residents and their families. Participation is free of charge.
7 2 Birth notification (birth registration) and acquisition of nationality When a child has been born, the parents have the doctor prepare a birth certificate. Even if the parents are non-japanese, any child born in Japan is required to be registered with a birth notification pursuant to the law for family registration. When the child s nationality is other than Japanese, a number of applications is required, such as an acquisition of status of residence (see B Status of residence, 2-8 Acquisition of status of residence). 2-1 Birth notification (birth registration) When a child is born, a birth notification must be filed with the local municipal administrative office within 14 days from the birth (including the date of birth), regardless of the child s nationality, since the law for family registration is applied to non-japanese people staying in Japan as well, as a territorially applicable rule. You are advised to decide the child s name and prepare necessary documents beforehand. Necessary document Where to file with/contact By when By whom (submitter) 1. Birth notification (available at municipal administrative offices and hospitals) 2. Birth certificate (added on to the birth notification) 3. Seal of the submitter (if no seal has been prepared, the submitter s signature can replace it) Municipal administrative office located at the place of birth or where the submitter lives Within 14 days including the date of birth Parent of the child 4. Maternal and Child Health Handbook 5. National health insurance card (to be shown only by members) When your child was born in Japan, please report it to your home country as well. Detailed procedures must be enquired at the embassy or consulate of your home country. Upon necessity, please obtain a certificate of acceptance of birth notification from the municipal administrative office.
10 2 Birth notification (birth registration) and acquisition of nationality 2-2 Acquisition of nationality for newborn infants Nationality is a very important element for the child s future. Regardless of what nationality is taken, necessary procedures must be duly fulfilled. It is advised to thoroughly consult the embassy, the family registration section of the municipal administrative office and the legal affairs bureau before your child is born to confirm documents necessary for the procedure. (1) In cases where either of the parents is a Japanese national When the parents are married and either one of them is a Japanese national, the child can obtain Japanese nationality. A child s nationality is determined upon birth. Therefore, when the mother is of non-japanese nationality and not married, the child cannot obtain Japanese nationality unless his/her father recognizes the child before birth. For the child with a Japanese parent to obtain the nationality of the other parent, the same procedure is required as in the case of a child with both parents having that nationality. Further details must be obtained from the embassy or consulate of your country located in Japan. (2) In cases where both parents are foreign nationals When both parents are foreign nationals, their child cannot obtain Japanese nationality even if she/he was born in Japan. The child will obtain nationality pursuant to the law of his/her parents country (countries). Specifics are different among countries and you are advised to confirm what procedures are to be undertaken and what documents are necessary at the relevant embassy or consulate in Japan. Parents nationalities Married; one of them is Japanese Both are foreign nationals Child s nationality Japanese Foreign Procedure 1. Submit the birth notification at the local municipal administrative office 2. For the nationality of the non-japanese parent, enquire at the embassy or consulate located in Japan Enquire at the embassy (embassies) or consulate (consulates) of the parents nationality (nationalities) located in Japan
11 2 Birth notification (birth registration) and acquisition of nationality 2-3 About recognition Recognition, or ninchi, is an act of establishing a legal parent-child relation between a child born to unmarried parents and his/her father. A father wishing to recognize a child must make certain procedures at a municipal administrative office pursuant to the family registration law. For details please enquire at your local municipal administrative office.
12 2 Birth notification (birth registration) and acquisition of nationality 2-4 Choice of nationality When a child has obtained two nationalities including Japanese, his/her parents submit a notification of nationality reservation at the time they submit the birth notification in Japan. In Japan a person is not permitted to maintain two nationalities (dual nationality) and is required to choose either of them before reaching the age of 22.
13 3 Cost of childbirth and benefits Normal births are not covered by health insurance programs and therefore incur significant expenses including regular health check-ups during pregnancy. Parents also must file a birth notification within 14 days after their child is born. This part is to help parents to know expenses and procedures they need for the birth of their children. 3-1 Health insurance and cost of delivery Normal births are not considered sickness and therefore not covered by health insurance programs. Parents are advised to prepare necessary expenses beforehand. Typically in Japan, a mother stays at the hospital for about ten days for a birth, at the cost of at least 500,000 yen. However, by making an application at the reception counter of the health insurance one contributes to, a childbirth-childcare lump sum will be paid (expenses will be paid directly to the medical institution).
14 3 Cost of childbirth and benefits 3-2 Lump-sum payment of childbirth and childcare If a parent has contributed to the national health insurance or corporate health insurance programs, she/he can receive a lump-sum payment of childbirth and childcare when her/his child has been born. In principle, the amount is 420,000 yen. For further details, please enquire: at the counter for national health insurance at your local municipal administrative office in the case of national health insurance; and the prefectural branch of the Japan Health Insurance Association supervising your employer in the case of health insurance. (See F Medical, 4-2 Health insurance)
15 3 Cost of childbirth and benefits 3-3 Maternity allowance (in the case of maternity leave) If you have taken a leave for birth and are left unpaid by your employer during that time, you are entitled for a maternity allowance during the period from 42 days (in the case of multiple pregnancy: 98 days) before the date of birth (when the actual birth was after the scheduled date, the scheduled date is applied) through 56 days after the date of birth. Amount receivable: about two-thirds of the standard daily payment per day multiplied by the period of the leave for birth. When you are paid during that time, but less than the amount of the maternity allowance, you are eligible to receive the difference.
16 3 Cost of childbirth and benefits 3-4 Child allowance When a child is born, even if he/she is a foreign national, and has been registered on the resident record register (juminhyo), an allowance is provided for the child in accordance with the law related the payment of child allowances. (Please refer to I Other welfare, 1-1 Child allowance)
17 3 Cost of childbirth and benefits 3-5 Subsidy programs particular to municipalities Some municipalities offer congratulatory cash to new-born residents, others present congratulatory gifts with a record of birth, while third focus on low income households to deliver either powdered baby milk or fresh milk until their children become one year old. To find out services of your area, please enquire at your local municipal administrative office.
18 3 Cost of childbirth and benefits Various allowances Allowance Details Conditions Procedures, contact Lump-sum payment of childbirth and childcare Maternity allowance Others In principle, the amount is 420,000 yen. Two-thirds of the standard daily payment Congratulatory cash, gift, etc. for birth Recipients must be contributors of either national health insurance or health insurance programs 1 Recipients must have contributed for a health insurance program consecutively for one year or more 2 When retired from the job, recipients must give birth to their children within six months after retirement National health insurance: local municipal administrative office Health insurance: employing office or prefectural branch of the Japan Health Insurance Association At the company that employs the recipient or prefectural branch of the Japan Health Insurance Association Programs differ among municipalities, details must be asked about at local municipal administrative office
19 4 Medical Health check-ups and immunization services are available for infants and children to help them grow healthily. Newsletters from municipal administrative offices, which carry information on these services, must be carefully followed. 4-1 Health check-ups for infants and children (group check-ups) Regular check-ups are in place for children at the age of three to four months, eight to ten months, 18 months, three years and so on, covering the diagnosis of growth and development, measurement of height and weight and childcare consultation. Specific dates and conditions are different among municipalities and must be confirmed at local municipal administrative offices. 4-2 Immunizations (vaccinations) Vaccinations are done via injections etc. to prevent infections and occurrence of diseases and alleviate symptoms and expansion of problems. Vaccinations pursuant to the Vaccination Law are free of charge. It is important to gain immunity against diseases. Any matters which are unclear or which you are concerned about should be confirmed with your home doctor, local municipal administrative office or public health center. 4-3 Special exception for medical cost for infants and children If you have contributed to a health insurance program, you bear 30% of the total medical costs incurred as a general rule. For medical services applied to your children who are below compulsory-school-going age (up to the first March 31 after a child's 6th birthday), you bear 20% of the total costs incurred. Also, each local administrative district (prefecture, city, etc.) has its own infant and child medical expenses support programs.
20 5 Childcare In Japan childcare facilities are in place for children who are unable to be looked after at home. There are also systems to temporally house and look after children and facilities to support parents to know and help each other. 5-1 Accredited nursery schools (Ninka-hoikusho, Ninka-hoikuen) (1) What is an accredited nursery school? Nursery schools (hoikusho, hoikuen) cater to children ranging from babies a few months old to children before entering school, who are unable to be looked after at home due to the work or illness of their parents. Nursery schools consist of public and private entities, while private entities further consist of those approved by the local municipalities (ninka) and those not (ninka-gai). Among nursery schools, public schools and accredited private schools draw many applicants, while these schools impose a number of conditions on applicants which they must satisfy, which means not everyone can enroll. Public schools and accredited private schools charge fees for user parents, depending on their household income. The basic service is eight hours a day (from 7:00 to 18:00), while some facilities look after children until around 20:00 as an extended care service (encho hoiku). Non-accredited nursery schools (ninka-gai hoikujo/hoikuen) charge a single level of fees regardless of the income of user parents. Materials you need to apply for public and accredited nursery schools Residence Record (juminhyo) (of the whole household) A photocopy of withholding tax and filing of income tax return At the interview after application: Maternal and Child Health Handbook
21 5 Childcare (2) Enrollment procedures Local municipal administrative offices handle the applications for accredited nursery schools. Application for enrollment in a nursery school Applicants must visit the municipal administrative office of the area where the nursery schools they wish to enroll in are located. Some municipalities prepare a list of nursery schools within their districts, which may help them choose schools. Some municipalities also accept multiple applications from single applicants. Documents that must be submitted vary among municipalities. However in general, they include: an application form; report on situations of the family and children; copies of certificate of withholding tax and income tax return; and document to prove the household is not able to look after the child(ren) at home. Applications are accepted any time but some municipalities set limits for enrollments of April. Details must be confirmed at local offices. Necessary documents Where to submit / enquire 1. Application form for nursery school enrollment 2. Report on situations of the family and children 3. Document proving difficulties of Municipal childcare at home (employment administrative offices certificates for the parents, etc) 4. Copies of certificate of withholding tax and income tax return, or taxation certificate etc. Accepted period Any time, however some municipalities set deadlines for enrollment of April. Please make sure to confirm it. Screening A section in charge at each municipal administrative office screens applicants, with priorities given to those with a higher level of difficulty in home childcare (NOT on a first-come, first-served basis). A meeting is hold to match the number of vacancies at each school and applicants, thereafter deciding preliminarily accepted applicants. Notification of Applicants receive a notification of whether or not they are preliminarily accepted (some municipalities do not preliminary notify unaccepted applicants). acceptance Interview and decision for enrollment Entry into nursery school After the notification, an interview and explanatory meeting is held at the accepting nursery school. Items parents must prepare for use at school are also explained.
22 (3) Non-accredited nursery schools Non-accredited nursery schools are facilities that do not satisfy the state standards for their size and the number of enrolled children. The ways of operations and details of facilities differ significantly among such facilities. Some of them receive subsidies from local municipal administrative offices and are deemed equivalent to accredited ones. Many of non-accredited nursery schools are small-scale and for children of younger ages.
23 5 Childcare 5-2 Children s clubs (gakudo clubs) Children s clubs (gakudo clubs) serve as places of living after school for school children (after-school children), generally below the age of ten, whose parents are away from home during the daytime due to work or other causes. These services, made pursuant to the children s welfare law, are offered at children s centers (jidoukan), vacant classrooms at school and other places. These facilities are promoted by local municipalities or social welfare corporations. There are about 18,000 such facilities nationwide. Further details must be sought at local municipal administrative offices.
24 5 Childcare 5-3 Others (1) Children s short-stay programs (ichiji hoiku) As children s short stay programs, nursery schools accept children on temporal basis to help their parents who temporally have difficulties looking after children at home due to consecutive work assignments for one to three days, hospitalization for sickness, child-delivery or nursing of elderly family members. Fees differ among municipalities. (2) Family support centers Family support centers cater to their members who need assistance for childcare and who are willing to offer such assistance in membership mutual help systems run by municipalities. These centers temporally accept children when their parents need medical attention, nurse their family members or to take a break. These services cost about 600 yen per hour (different among municipalities), but they are available whenever the members need them. To use these services, you need to sign up for membership beforehand. For further details, please contact your local municipal administrative office.
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