Giving birth in Japan as a foreigner: costs, the ¥500,000 grant and English hospitals

Giving birth in Japan as a foreigner costs about the same as for a Japanese resident, and you get the same support if you are in Japan’s public health insurance. As of October 2026, a normal delivery cost about ¥520,000 on average in FY2024, and your insurance pays a ¥500,000 lump-sum grant per baby, often straight to the hospital. Your city adds a mother and child handbook and prenatal checkup vouchers (14 checkups in Tokyo’s Edogawa City; the number varies by city). Visa type and permanent residency don’t matter.

What happens from pregnancy to birth?

The paperwork after the birth (birth registration, the baby’s residence status, passport) is covered in our guide on registering a baby born in Japan to foreign parents.

How do I get the mother and child handbook in English?

After a clinic confirms the pregnancy, you file a pregnancy notification (妊娠届出) at your city or ward office. You then receive the mother and child health handbook (母子健康手帳, boshi techō). It is the record of your pregnancy, the birth and your child’s early health.

Many cities hand out bilingual versions. Yokohama, for example, offers the handbook in 7 languages: English, Chinese, Korean, Spanish, Portuguese, Vietnamese and Nepali. Ask for your language at the counter.

What Yokohama asks you to bring:

• your My Number Card, or your My Number notice or a residence record showing your My Number, plus ID
• your clinic card (診察券) from the clinic that confirmed the pregnancy

Since April 2025 Yokohama also accepts the notification online through My Number Portal (マイナポータル), but you still collect the handbook in person within 14 days. See our My Number Card guide if you don’t have one yet.

What do the prenatal checkup vouchers cover?

To cut the cost of routine checkups, your city gives you checkup vouchers (妊婦健康診査受診票) with the handbook. In Tokyo’s Edogawa City, the booklet covers:

• 14 prenatal checkups
• 4 abdominal ultrasounds
• 1 cervical cancer screening

Each voucher covers a fixed amount. You may still pay something extra, depending on the tests the clinic does. The number of vouchers and the amounts differ by city.

Giving birth near family elsewhere in Japan? This is called 里帰り出産. Edogawa partly reimburses checkups at clinics outside Tokyo, but only for clinics in Japan. Checkups abroad are not covered.

How much does it cost to give birth in Japan?

The health ministry’s figures for a delivery without insured medical treatment, for FY2024 (April 2024 to March 2025), from an October 2026 ministry committee paper based on direct-payment claims:

The delivery cost leaves out private-room charges and “other” items. A normal delivery isn’t covered by health insurance, so each hospital sets its own price. If you need medical treatment, such as a C-section, that part goes through insurance with your usual copay.

To compare hospitals, the ministry’s site 出産なび (birth-navi.mhlw.go.jp) lists 2,097 facilities with their average costs and services, including whether they offer epidurals. It is in Japanese only.

How does the ¥500,000 childbirth lump sum work?

The childbirth and childcare lump-sum grant (出産育児一時金) comes from your health insurance, not your city. The rules, from the health ministry and the Japan Health Insurance Association:

• ¥500,000 per baby in most cases (twins: paid per baby). It is ¥488,000 if the facility is not part of the obstetric compensation system (産科医療補償制度), or if the birth is before 22 weeks of pregnancy. The ¥500,000 is ¥488,000 for you plus ¥12,000 that covers the facility’s premium for that system.
• You must be in Japan’s public health insurance at the birth, and the pregnancy must have lasted 85 days or more. Stillbirth and miscarriage after 85 days count.
• A dependent spouse in company insurance gets the family version (家族出産育児一時金).
• Claim within 2 years from the day after the birth.

If you are not in Japanese public health insurance, the grant doesn’t apply and you pay the hospital in full. To check who must join, see National Health Insurance for foreigners.

Direct payment: you pay only the difference

Under the direct payment system (直接支払制度), you sign an agreement with the hospital and it claims the grant from your insurer. At discharge you pay only the amount above ¥500,000. If the birth cost less, you claim the difference from your insurer. The Japan Health Insurance Association says it sends that form about 3 months after the birth.

Clinics that don’t use direct payment may offer the receipt agent system (受取代理制度). You apply to your insurer before the birth, and the clinic receives the grant for you.

What if I just left my job?

The Japan Health Insurance Association still pays the grant if you were insured continuously for at least 1 year and give birth within 6 months of leaving that insurance.

What if I give birth in my home country?

You can still claim if you are in Japanese insurance at the birth. Ota City’s National Health Insurance asks for:

• the birth certificate and hospital receipt, originals with Japanese translations
• your passport with the exit and entry stamps
• the household head’s bank account details, and a signed consent to checks

Ota City says it has tightened checks after fraudulent claims and may contact the hospital abroad. Payment takes about 1.5 months. Direct payment isn’t available for births abroad.

Is childbirth becoming free in Japan?

Not yet. The Health Insurance Act amendment (健康保険法等の一部を改正する法律, Act No. 31 of 2026) was promulgated on 5 June 2026, but its childbirth part is not in force. According to the health ministry, the new system will:

• set a nationwide price for a standard delivery and pay it from insurance straight to the hospital, so the mother pays nothing for the standard delivery
• add a fixed cash payment to every pregnant woman (出産時一時金) to help with other costs, such as copays for insured treatment
• keep amenities, such as celebration meals, as self-paid extras that hospitals must price openly

The childbirth part starts on a date set by cabinet order within 2 years of promulgation. As of October 2026, the ministry aims to settle the amounts around December 2026. Once it starts, hospitals can choose to stay on the current ¥500,000 grant system for the time being.

Until the new system starts, the ¥500,000 grant applies. If your due date is in 2027 or later, check the health ministry’s page before you choose a hospital.

What maternity pay do employees get?

If you work and are in company health insurance, you can get the maternity allowance (出産手当金) while you are off work without salary:

• Period: from 42 days before the birth (98 days for twins or more) to 56 days after. If the baby is late, the extra days are covered.
• Amount: two-thirds of your standard daily pay, based on the last 12 months.
• If your employer pays part of your salary, you get the difference.
• Leaving the job: you can still get it if you were insured for at least 1 year and were entitled on your last day of coverage.

It is a company health insurance benefit: the National Health Insurance pages we checked don’t offer it. For leave rules and childcare leave pay, see maternity and childcare leave in Japan.

Pension and premium breaks for the self-employed

If you pay national pension yourself (category 1), you pay no premiums for 4 months around the birth: from the month before the due month (6 months for twins or more). Those months count as paid. You can apply from 6 months before the due date. National Health Insurance members also get a premium reduction around childbirth, for births from November 2023. Ask your city’s NHI counter.

Can I get an epidural in Japan?

Yes, but plan ahead. Epidurals (無痛分娩, mutsū bunben) are not routine in Japan: 13.8% of births in FY2023 used one, according to a health ministry committee paper. Not every hospital offers them.

• Find a hospital: the Japanese Association for Labor Analgesia (JALA) has a search of hospitals that offer epidurals. It cites a survey by the Japan Association of Obstetricians and Gynecologists (日本産婦人科医会) of about 700 facilities nationwide, but lists only those that registered and met its criteria. 出産なび also shows which hospitals offer them.
• Cost: the epidural is charged as a separate fee, apart from insured care. Ask each hospital for its price.
• Tokyo subsidy: Tokyo pays back up to ¥100,000 per epidural delivery at designated hospitals, for births from 1 October 2025. You must have received your handbook from a Tokyo city or ward and stayed registered in Tokyo. Apply online within 1 year of the birth. The page is in Japanese; the call center is 0120-620-620 (weekdays 9:00 to 17:00).

How do I find an English-speaking hospital for childbirth?

Start with the search tools and phone lines in our English-speaking hospital guide. Then check the delivery hospital’s cost and epidural options on 出産なび.

At the first visit, ask three things:

1. Do you use the direct payment system for the ¥500,000 grant?
2. Do you offer epidurals, and at what extra cost?
3. Can a doctor or midwife explain things in English, or should I bring an interpreter?

If family is coming from abroad to help, see bringing parents to Japan.

This page is general information, not medical advice. Your doctor or midwife, your insurer and your city office decide your case.

More guides

• Registering a baby born in Japan to foreign parents
• Child allowance and childbirth payments
• Daycare (保育園) for foreigners
• Maternity and childcare leave