Pregnancy and Childbirth in Japan: The Boshi Techo and What Newcomers Do
Updated: 2026-08-27
Quick answer
If you are expecting a baby in Japan, one of the first practical steps is to report your pregnancy at your city or ward office. When you submit the pregnancy notification (ninshin todoke), the office issues you a mother-and-child handbook called the boshi techo, along with a set of prenatal checkup vouchers. That handbook becomes the thread that runs through your whole pregnancy, your delivery, and your baby's early health records.
From there the path is gentle and step by step: choose a clinic or hospital for your prenatal care and birth, keep a regular checkup rhythm, and after your baby arrives, register the birth and add your little one to health insurance. None of it has to be done in a single day, and your ward office and medical team are there to guide you. This article is a warm overview, not medical advice, so please always follow the specific guidance your doctor and local office give you.
Reporting your pregnancy and getting the boshi techo
Once a pregnancy is confirmed, usually by a doctor, you report it to your city or ward office by submitting the pregnancy notification, the ninshin todoke. Many offices handle this at the health or childcare counter, and some accept it online, so it is worth checking your local website first. In return you receive the boshi techo (母子手帳), the mother-and-child handbook that records your pregnancy progress, checkup results, and later your baby's growth and vaccinations.
Alongside the handbook, the office typically gives you a booklet of prenatal checkup vouchers that help cover part of your regular appointments, plus leaflets about local support for expecting families. Requirements and exactly what you receive can vary by municipality, so ask your ward office directly for the checklist that applies to you, and mention if you would like materials or explanations in another language, as many areas can help.
Choosing a clinic or hospital
Early on, you will choose where to receive your prenatal care and, in many cases, where to give birth. Some people go to a smaller obstetric clinic for regular checkups, others to a larger hospital, and some clinics handle checkups but refer you elsewhere for the delivery itself. Popular facilities can fill their birth slots months ahead, so it helps to start looking and booking soon after your pregnancy is confirmed.
When you compare places, think about distance from home, the languages the staff can support, whether they offer the kind of birth experience you hope for, and how they handle appointments and questions. A short visit or phone call can tell you a lot. Your doctor and your ward office can both point you toward suitable options, and if anything about your situation needs special attention, raise it early so the right care is arranged.
The rhythm of prenatal checkups
After you have chosen a clinic, your pregnancy settles into a rhythm of regular prenatal checkups. These appointments become more frequent as your due date approaches, and at each one your care team checks how you and the baby are doing and records it in your boshi techo. Bringing the handbook and your voucher booklet to every visit keeps everything in one place and makes each appointment smoother.
The exact schedule and what happens at each visit are decided by your medical team, not by an article, so follow their instructions and ask them anything you are unsure about. If you ever feel something is not right between appointments, contact your clinic rather than waiting for the next scheduled date. Keeping your handbook up to date and easy to find is one of the simplest, most useful habits during these months.
After the birth: registration and insurance
When your baby arrives, there is a short run of paperwork that brings them officially into the system. The main one is the birth notification, the shussei todoke, which is submitted to a city or ward office within the period set by law, usually together with a birth certificate section completed by the doctor or midwife who attended the birth. Your local office will explain exactly which counter to visit and what to bring.
Around the same time you will add your baby to health insurance and look into the child-related registrations your household needs, such as those tied to residence and health services. Your boshi techo continues here too, holding your baby's early checkups and vaccination records. Daycare and school enrollment are separate journeys with their own timing, and we cover those in their own articles, so for now focus on these first registrations and lean on your ward office when a step is unclear.
Staying reachable through the whole journey
So much of this journey now reaches you by phone and app. Clinics call or message to arrange and confirm appointments, ward offices send notices and reminders, and results and follow-ups often come to a local number or an online portal that expects one. If your only contact is an overseas number or an inbox you rarely open, it is easy to miss a time-sensitive message during exactly the months when you most want to feel settled and reachable.
That is why sorting out a Japanese phone number and mobile data early is one of the kindest things you can do for future-you. Setting up a local line no longer means a long store visit: with Rakuten Mobile you can apply online with your residence card, and an eSIM can activate the same day once that card is in hand, so you can be reachable before your first prenatal appointment. With a live number and data running, the clinic, the ward office, and every reminder can all find you, and you can keep your focus where it belongs, on you and your baby.
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