Adventures with Mindy

Last Friday was my last day of work- after getting a doctor's note to work a couple weeks past my official maternity leave start date I finally decided to let work go and ... well, I wasn't sure what I would do next. 

Very luckily for me, the first few days of my leave included hosting Mindy, a good friend and teaching mentor from home who was visiting Japan. Her husband was attending a conference in Tokyo and she decided to look me up while she was in the country. She even agreed to venture all the way down to Kobe so I wouldn't have to make the trip up to Tokyo. On top of everything, she rolled in like Santa Clause with a bag full of baby gifts from her, my mother (who will be reprising the SC roll in a few weeks when she arrives) and even from at least one kind person who I have never met! This will be one spoiled kid!

As luck would have it, Mindy also brought along one of her colleagues, Betsy, who recently started working in Tokyo and hadn't been this far south yet. Mindy stayed with Russell and I, and Betsy got a hotel downtown. We had Monday night, all day Tuesday, and Wednesday morning to play with. We decided to visit my school Wednesday morning and Kyoto Tuesday.

Mindy is always the life of the party. She's just one of those ideal travelers. She is up for absolutely anything, seems to enjoy everything - or at least see the humor in it - and just generally makes everyone around her happy. Betsy was an equally enthusiastic traveler and we all had a great time. While the visit went by way too fast, its also hard to believe we fit so much in! So much fun...

The first evening when they arrived, we walked from the bullet train station to my apartment and then had tea and cookies while I got showered with gifts. An excellent start to any visit in my humble opinion. We then went and got Betsy checked into her hotel before heading to the center of downtown for dinner - okonomiyaki. At that point Mindy and Betsy were tired, so we just called it a night. 

Day two we had all day, so we got up early and went to Kyoto. Our first stop? The must-see Kiyomizu temple. It was really fun. We ventured down into the pitch black basement of one temple which was said to mimic a womb and our birth back out into the light. It seemed appropriate. We washed our hands before entering the main temple, we also saw the two romance rocks, Mindy tried lifting the steel shoes and scepter at the entrance and we got our fortune from the temple- our fortunes were all lucky, but not SUPER lucky.  Towards the end of our stay, we stopped at a little restaurant in the temple to have some traditional matcha (tea ceremony-style green tea) and rice cake sweets. While we were there a thunderstorm suddenly rolled in and started dumping water. It lasted about 15 minutes, so we were sure glad to be under cover! We were lucky to have sat down before the rain because the cafe filled up fast! We chatted until the rain let up and then continued on. The last attractions at the temple were drinking from the temple waterfall for good luck and getting a good look at the underside of the famous, wooden deck, which is made without any sort of nails. I love Kiyomizu temple - there are just so many things to do in one place. 

Plus, there is a whole street of restaurants and souvenir shops as well as old traditional buildings ringing the temple. We did some souvenir shopping and then had lunch once we finished at the temple.

For lunch, we had delicious cold noodles and home made tofu. We took our time and just enjoyed the ambiance and good company.  

After lunch we were walking down an old street and the rain started again, so we hid out under the entrance for a small temple. Inside, the temple was decorated in these strings of what looked like upside down, four-legged octopus-shaped stuffed animals. I have seen them before here and there, but never so many, and I didn't know what they were. Mindy and Betsy braved the rain to go inspect the temple closer and saw that the central motif inside the temple were the three "hear no evil, speak no evil, see no evil" monkeys. 

The rain seemed to be slowing down, so we headed on down the road, but the rain wasn't finished. We pulled over under another awning and saw more of the stuffed shapes on strings. While we were wondering about them through the half closed door, the shop keeper opened up the door all the way (he had closed it partially to block the rain) and invited us in. He was an older fellow, and had handmade all the figures in the shop. He explained that they represented hanging monkeys- since monkeys can touch their hands to their feel. The chain of 5 monkeys (made out of traditional Japanese cloth) was suppose to be hung in your home to bring luck to your family. Apparently it's all related to a god in the shape of a monkey- and you see these hanging figures and the three monkeys at temples honoring that god. He was very friendly and shared maps of places in the neighborhood we should visit, the ancient layout of Kyoto, etc. We each ended up buying a string of monkey figures. 

After that it was past 4:00, so all the sights were closed. We ended up walking down a shopping street (and poking around) on our way to the subway, which took us back to Kobe. We met Russell in downtown Kobe and then we went to an izakaya (traditional Japanese bar with food) to get dinner and try lots of Japanese flavors. We ended the day with karaoke (Mindy seemed to enjoy herself in spite of being a little skeptical at first) and then we crashed for the night. 

Day three, Mindy and Betsy were planning to leave in the afternoon, but we went out to KSGU first to meet with some Oregon-bound students and so I could show them where I've been working. We spent about two hours with the students, then I showed off our in-house textbooks and took them for the admittedly short tour of the school. When it was time to go, though it was absolutely pouring rain- and the wind was blowing in from the bay, so the rain was pretty much horizontal. We ended up calling for a taxi instead which was the RIGHT thing to do. The taxi was hydro-planing at times, the rain was so heavy, but we had a very good driver and got safely back to downtown. There we went for lunch at a carousel sushi place and then when to have fancy siphon coffee. Something about narrowly missing being drenched in the street makes watching coffee bubbling up and back down a siphon an extra special experience. 

At this point, the rain was mostly finished, but Mindy and Betsy were getting a late start back to Tokyo. We went home to get bags, but when we got to the bullet train station there were lots of train delays and the line for tickets (which was also the line to change pre-bought tickets) was really long. It took quite a while for Mindy and Betsy to get to the front of the line. The lady helping them with tickets didn't speak much English, so they called me over to help. It turned out that there were a few complications. First, because the heavy rain had hit all up and down Japan, the train schedules were a mess. Second, because Mindy had a special tourist rail pass, she could technically only ride the slower Hikari bullet trains - not the top speed Nozomi trains. I assume that in order to get people moving and trains back on schedule the rail company was putting Nozomi trains through with higher priority and it wasn't clear when another Hikari train would be through. Mindy could forgo her pass and buy a Nozomi ticket at full price - but that was $150 and she would end up losing money on the JR pass she had bought (she was barely coming out ahead by using it for a round trip to Kobe from Tokyo). At this point they would be arriving in Tokyo so  late I suggested they just stay one more night with us and leave early the next morning. 

We checked a few other options, but they finally agreed to stay (I was so happy!), so we all returned to my place, dropped off bags and then went down to the grocery store to get dinner. We made a big salad, had cold noodles with dipping sauce, sliced up some white peaches and munched on giant grapes (which actually taste like grape juice - no joke). By this time it was almost 11pm, so we turned in.

At this point, with Betsy staying as well, we pulled out our last futon and every square inch of our living area was covered in bedding. We didn't have enough sheets, so we used blankets as bottom sheets and just sleep on top of them with no covers - which thankfully wasn't a big issue since the weather has been warm (cooler after the rain, though!). 

This morning we were out of the house by 6am and they caught their train and were on their way. I had plans to meet up with friends, both at work and in the city during the day, but it was sure lonely when I got back to our empty apartment.  

As I look back on the visit I am pleased with how well I could keep up with all the excitement. I had gotten used to sleeping long hours and taking naps - but we were on the go all three days and did a ton of walking - with no lack of hills and stairs, no less. I'll admit I suggested a lot more down time enjoying meals and relaxing in cafes between adventures than I usually do with guests, but that was a lot of fun, too. There are so many more places I wish I could have taken them, foods we could have tried and experiences we could have had... they definitely need to come back!

So much fun!

Maternity Benefits in Japan

I had two fairly long meetings today with my boss and the ladies from the finance department sorting out all the ins and outs of my upcoming maternity leave. I had no idea how much I didn't know.

Now, for the 7 or so dedicated readers out there (eg friends and family that haven't given up on me) this is going to be a long, dull post. The general summary I have explained before is basically still true.

This post however, is meant for any other expats here in Japan who just found out they're pregnant and want to know what to expect in terms of maternity leave. I'm going to get into a lot of the gritty details that really aren't that interesting unless you're planning your budget around them.

And here's what I found out...

First, its important to understand that maternity benefits are paid by insurance companies and the government - not the company / school you work for. I am also about to describe maternity leave for mothers working full time. I don't know what the system is if the mother is unemployed (thought I know there is some system in place for those mothers as well.)

6 weeks before the due date established by the hospital, mother's-to-be are eligible to begin their maternity leave. They can forfeit all or part of their leave if they have a doctor's note agreeing that they are healthy enough to continue working, but taking full leave seems to be pretty normal. Once leave starts, the employer no longer pays any sort of salary to the mother. Instead, insurance kicks in. The good news, is that insurance pays 80% (at least, mine does - I had originally heard 66%, so it may be variable depending on your insurance). The bad news is that you can't apply for that 6 weeks at 80% pay until the baby is born. After the birth, you fill out some paperwork and you get the 80% for however many days you were on leave (varying, of course, by when the baby decides to make his or her appearance). If your baby comes early - say after only 5 weeks of leave, you get 5 weeks at 80%, if he/she comes at 7 weeks, you get 7 weeks at 80%. Of course, that means a month and a half when you get no pay at all before you have a birth date to report. You get the money eventually, but you'd better hope you have a second income or some savings socked away to live on during your maternity leave.

So the baby arrives, you report the birth to the city (which involves taking the newborn in for visual confirmation) and you get a stamp in your mother/child book that confirms you do, indeed, have a baby. At this point you can apply for the pre-birth maternity leave, and your timer starts over for another 2 months at the same 80% rate. Since I had heard 66% pay, this was good news for me. However, the bad news is that, once again, you can't apply for the money until after the time has elapsed. So while you did just get paid for the 6 weeks prior to the birth, you have to live with no further pay for another two months. At which point you fill out more paperwork to apply for the post-birth 2 months of pay.

During this initial period of maternity leave, when you are still receiving the bulk of your pay, you are still accountable for your health insurance costs and your national pension costs. The way my university handled that, they figured out how much I would have to pay in insurance and pension for those months, and asked me to pay up front - before I start my leave. They will then pay this for me. I have a bit of sticker shock from the experience since I wasn't expecting it, but it does mean I'll have fatter checks when they do actually come through. Its a darn good thing I had some savings to raid.

As a side note, it was also pointed out that since the end of my post-birth 2 month stint comes right at the tail end of November, I am potentially very lucky. If the baby arrives before or on his due date, I only pay my pension and insurance through October. If, however, the baby takes his time and is a couple days late, causing the 2 month stint to end in December - even December 1st - we're going to have to pay one more month of pension and insurance. So here's hoping our kid has a better sense of timeliness than his dad or I do.

And that leads to the interesting stage after those post-birth 2 months end. At this point whoever is paying your maternity leave changes. The vague answer I got was that it changes from the insurance company to the government paying maternity leave. I'm not sure of the specifics. In any case, at this point things change a bit. The downside? Instead of getting 80% pay, you now drop to 50% of your original pay. This continues until the baby's first birthday unless you choose to go back to work. The silver lining? You don't have to pay insurance or pension during this period even though the mother and baby continue to be covered by insurance. In my particular case, Russell also happens to be covered by my insurance, and apparently he will stay covered as well - which was a big relief. I suppose the even shinier silver lining from my American readers' point of view, is that you get paid anything at all at this point.

In order to collect this 50% pay, however, you have to fill out forms every 2 months. Apparently the first time you apply (since it is a different system from the post-birth 2 month system) the payment takes a while to get to you, but after the start up phase the checks come more regularly. Though that also depends on you applying regularly every 2 months. So getting the money isn't a walk in the park, but at least there's a clear system. I assume it will actually feel more like getting a full paycheck every other month, rather than 50% pay. And it should be a healthy paycheck without insurance and pension taken out.

I also discovered that if you apply for childcare (presumably the city run system of child care?) and they don't have room for your child after his/her first birthday (not uncommon), you can apply for up to 6 months more of the 50% pay system. The only extra hurdle is having to prove every 2 months that you are on a waiting list for child care and there still isn't room. I don't plan on taking advantage of this - at least I hope I won't , but it is interesting.

I am not sure how I will go about paying (or if I need to pay) income tax on all of this. My status at work just recently changed, so for this year only, I had to pay city taxes individually (instead of having them taken out of my paycheck monthly by the university). I assume there must be some sort of national income tax as well, and I'm not sure how that will be paid. I need to check into that.

So that's how maternity leave works in Japan. As I've mentioned before, hospital costs are largely covered (if not completely covered) by a one time gift equalling around $4,000 that the city gives when the baby is born. That amount is in addition to the maternity leave described above.

I had not anticipated all the waiting to get maternity checks, but I'm not complaining. Just very glad we have some savings to fall back on...

Maternity Class #3

As I believe I mentioned before, our hospital offered three maternity classes. I missed the first one, but went to the second class on breastfeeding and today was the third class: labor and hospital tour. 

Partners were invited to this one. 

Since it was Sunday, the hospital was mostly closed down. We accidentally arrived about 30 minutes too early, so we went down to the Tully's coffee shop in the lobby and got drinks while we waited. Nice of them to be open on a Sunday morning!

Once it was time for the class, we marched back upstairs and were led into one of the classrooms. There were about 7 couples this time. I think everyone was different from the last class I took before, which surprised me a bit, since the classes are only offered once a month. 

The class largely focused on the anatomy involved in labor as well as the general process. The dads-to-be got to wear a pregnant suit and try out tying their shoes or picking things up of the ground. One fellow absentmindedly just shifted the belly off to his left to lean over and tie his right shoe. This did not net him any creativity points. 

We also learned when to contact the hospital (unlike what I've been reading for the US, the hospital here advised we call in if the water breaks or once contractions are coming 6 in an hour. We will apparently be advised from there on whether to make the trip in or wait longer at home. We were also advised to have taxis on speed dial and to learn the commute time to the hospital. 

Next, they had a massage lesson for the fathers to be. They were instructed in several different massage techniques and told to keep checking with the mother about what felt good and what didn't. Of course, the mothers were on the receiving end of this lesson. I approved of this part of the class. :)

One interesting thing that came up during the class was the question of a birth plan. I had been reading all about birth plans and what to include in them while reading books from the US, but I hadn't heard a peep about them in Japan. What little I had read of foreigners' experiences in Japan, it didn't seem like you had much say in the birthing process. My ears did perk up today, however, when the midwife reminded us to bring our birth plan with us when we check in to the hospital. They do that here? What are our choices? Is there a special form we are suppose to use? Russell and I went to investigate. 

From what I can tell, birth plans in Japan are a somewhat watered down version of what I've been reading about. We asked what sort of things we should specify and the midwife suggested things like how much the father would be involved, what sort of environment the mother would like (bright lighting vs dim lighting, music or not, etc) whether the mother was very scared of pain or any images she may have of how labor would be. Things like that. No mention of any sort of medical intervention - epidural, episiotomy, etc. Actually, now that I think about it, no mention was made at any point of episiotomies... which surprises me a little. My understanding is that they are still basically automatic in Japan (they used to be in the US as well, but seem to be more in an "as needed" status as of the last 10 years or so). We'll have to ask about that at our next appointment. 

Finally, we gathered our things and got a tour of the facilities on the way out. We got to see the shared and private rooms as well as the birthing rooms. The birthing rooms had all sorts of furniture and props to use during labor, which is nice. The private rooms, for recovering after birth, are downright spacious with furniture for visitors, a private shower, etc. The shared rooms aren't bad either. Each curtained area has a bed with lots of pillows, room for the father and presumably for the baby's cart. Showers may have to be taken down the hall, thought. 

We also got to peek in the nursery, where one baby was completely conked out and the other was screaming his head off. One of the nurses mentioned that they do rooming-in at the hospital, so I think the babies only go to the nursery if the mother requests the chance to sleep. 

So anyway- we've got about a month and a half to go. I am eligible to start maternity leave on August 23rd, but I'm planning to push it back to the start of September. I recently got the good news that I will still be paid 80% of my salary - not 2/3 as I had believed. So that's really nice. I'm not sure yet if its 80% until the baby is born and then 2/3 pay for the first two months, or 80% clear through. I'll get more information when I talk to the finance lady on Monday. I have to say, once again, that maternity leave in Japan is outstanding.

Pregnant in Japan: No cold foods!

Back around the start of my second trimester, I was invited to have a one on one chat with one of the midwives about nutrition. I'm not sure if this was because I had missed the first maternity class (which covered that topic, among other things) or if it was because I had had high blood sugar.

Incidentally, I was much more worried about my blood sugar levels than my doctor, who wasn't too worried at all once she found out I had had a large meal and a glass of mango juice about 30 minutes before the blood test. It was pretty clear why my numbers were so high.

Regardless of the reason, however, I was a candidate for some individual dietary consulting, so I met up with one of the midwives to talk food. Of course, this was the day Russell was sick, and while my doctor speaks English, the midwives generally do not. I got a lot of Japanese practice - and was very proud of how much I was able to understand. I love the midwives at this hospital, by the way, they are very patient and good about communicating.

So what did I learn?

The first part of the consultation covered the same health points that I had been reading about online - get lots of iron (I didn't know the Japanese word for iron, but she wrote "Fe"and we were good to go), eat green leafy vegetables and fish, avoid caffeine and empty calories, etc. I did get a list of specifically Japanese foods that are considered excellent sources of nutrition during pregnancy - thinks like natto (fermented soy beans), chirimen (micro fish that are used more like a seasoning), tofu, etc. I later reported these to Russell and he immediately started incorporating them into the meals he was cooking. <3 p="">
Then she transitioned to a different nutrition topic - don't eat cold foods.

Western interpretation: what, like iced drinks? cold noodles (popular in summer)? ice cream?

No - the list included tomatoes, melon, eggplant - rather a large cross section of the fruits and vegetables that are in season at the moment at the grocery store.

Was this a question of eating these foods raw or cooked?

No - but these foods are "cold" foods and, while they are certainly healthy to eat, they supposedly cause your internal organs to contract, which, since my labor will be in the heat of summer, would make things more difficult for me. Instead, she recommended I try to eat more "hot" foods - foods like broccoli and roots (carrots, potatoes, burdock root, etc) which supposedly would make my labor easier.

At this point I was catching on to what she was talking about. I thanked her politely and we finished up our discussion.

So, what did she mean by "cold foods" and "hot foods"? This comes from Chinese medicine. I don't know much about it, so take what I report with a grain of salt, but I was talking with my boss about it and she said its just something so ingrained in Japan that everyone takes it for granted. A normal healthy person is suppose to eat a balance of hot and cold foods (think Yin and Yang) for an optimal diet. Hot and cold foods are categorized partly in accordance with the season in which they are harvested. Cold foods are generally those foods which are harvested around summertime and are suppose to have a cooling effect on the body that complements the heat of summer. Foods harvested in Fall and Winter are considered hot foods. They often come from underground and are suppose to warm your body in winter. Or something like that. Apparently, if you are due to give birth in summer, shifting the balance towards warm foods is recommended for an easier labor, and that's what the midwife was talking about.

While I am trying to be good about getting a range of healthy foods into my diet, I'm afraid I'm not worrying too much about limiting "cold" foods. If its in season at a good price at the grocery store, its gettin' et.

But I appreciate the thought.

Mug Shot

Today I had another doctor's visit. Everything was healthy and average. The baby's weight is estimated at 1857g (If I am remember correctly) which is just about 4lbs. 

The last few appointments have been kind of anti-climactic for ultrasounds. In the past, the baby was small enough that you could see most of him in the view and it made it easier to tell what you were looking at. The last few visits he has gotten big enough that we can't really tell what we're looking at. The doctor always stops to measure the head and the femur and to verify which direction the baby is positioned, and we may catch a glimpse of the heart or skull, but that's about it. The last two or three visits, the doctor has tried to take a picture of the baby's face, but he hasn't been terribly cooperative. Usually she manages something, but its typically been rather skeletal. Fun to see development, but kind of disconcerting when you think of displaying it on the mantle. 

Today, we went through the same routine, but the baby had turned around and his face was very visible. He actually looked like a proportional baby and I could see his features, not just his skull. It was exciting. Apparently the doctor thought so too, because she immediately turned on her 3D imaging software - which as far as I can tell renders the image to make the skin look opaque so you can make out features better. From what I can tell, the 3D image is purely for the benefit of the parents. Many places market it as an up-sell. Russell and I had decided against getting a 3D image (its kind of creepy sometimes) but it does make it easier to tell what you're looking at. This time around was on the doctor. I think she was just excited to get such a clear angle and wanted it to be as clear as possible. 

I kind of wish I could have had the original ultrasound, too, but the doctor kindly gave me the 3D image as a gift, so I didn't say anything. 

Its a close up of his profile. You can see the side of his face with some random anatomy along the top and bottom of the picture.

And here he is:

Not even born and I'm showing off photos of him... Its only going to get worse, you know. 

Rockin' the convenience store

I've posted before about how awesome convenience stores are in Japan. They're just, well... convenient. You can actually get stuff done there. They have things you didn't think you would need but suddenly do need in the middle of the night - like digital thermometers, lightbulbs and socks. Not to mention a decent array of perfectly edible food and often a limited number of fruits and vegetables.

7-11 does have a presence in Kobe, but Family Mart and Lawson have a stronger presence from what I can tell. Lawson is probably the most prevalent convenience store around. We have two walking distance from our house.

One of the convenient things we knew we could do at the convenience store, but which we had never tried out was paying for Amazon orders. Why would you do that? As I've also mentioned in posts of yore, very few people have or use credit cards in Japan. Its a cash society. Which is difficult if you want to make a purchase online. Many online services rely on either money transfers from the bank, or allow you to print out a receipt at the local convenience store and pay there. Once you have paid, a message is sent to the company and your package is mailed.

Since Russell and I do have a credit card, we tended to just default to what was most comfortable and use that. The problem was that money was coming out of our US account (which has no income at the moment) and not out of our Japan account (which does have income). This didn't seem wise long term. Add to that the fact that I wanted to make a large purchase for the university and be reimbursed, but the US credit card registered everything in dollars - and it was even messier. I finally decided to investigate the convenience store option.

Luckily, Amazon had pretty good directions in English for how to navigate the receipt kiosk in Lawson, so I printed out the directions and my purchase code and gave it a try. Worst case scenario, I would mess something up and the order would end up being cancelled. If I managed to pay, I should be all set.

It ended up working out great. I will totally do this again in the future!

And as long as I'm raving about the convenience of the convenience store - here are some other things I got done during the same trip:

-Bought dinner (bento for Russell, sandwich, shredded cabbage and bean salad for me)
-Got $500 in cash out of the ATM (seriously... its Japan.)
-Paid my monthly bills and the ticket for the books I had ordered (total: $400... at a convenience store... at night)
-scanned the ultrasound print-out from the hospital and saved it to my USB stick.

I was feeling pretty empowered on the way home.

Summer again

I hate summer in Japan, and it is now officially summer. Temperatures are in the 80s and 90s, the sun is hot, the breeze is dwindling and its HUMID. I'm hot indoors under air conditioning and I avoid the outdoors like the plague.

Thankfully, the hot and humid weather held off a surprisingly long time. We had an early Spring so I was nervous, but most of the summer has been lovely. Warm but not humid with a nice breeze. I can do that kind of summer. It couldn't last forever, though.

A few things I DO like about summer in Japan:

- huge hydrangeas everywhere
- lush green landscapes
- cold noodles
- fireworks (though you usually have to sit outside in the humidity before the fireworks start.. bleh)
- shirokuma (polar bear) ice cream (shaved ice with - what? - sweetened condensed milk on it? with frozen fruit and sweet beans mixed in)

Russell also recently remembered that we had these ice pack pillows that we had bought for him mom when she came to visit. Basically its an ice pack but its pillow sized and one side of it has something in it to keep it soft. The darn things stays cold ALL NIGHT. Its amazing. Russell is worried I'm going to give myself frostbite I'm so attached to it. Its making summer way better this year, though.

Pregnant in Japan: Second Trimester

Around the start of the second trimester, my regular women's doctor asked me if I had chosen a hospital where I wanted to give birth. Her small clinic didn't provide that service. I hadn't decided where to go - the only place I knew of was the place by the train station that had just been refurbished and was located right next door to Russell's favorite bar. I told her I hadn't really looked around, but was kind of assuming she would send me there, since it was so close. Instead, she recommended a different place - the large city hospital out on Port Island (near the university where I work). She told me lots of foreigners like it there. I wasn't sure what that meant, but I assumed she was implying either that they speak English or follow practices more in line with Western hospitals. Regardless of her reason, I certainly trust her advice, so we set up an appointment at the central hospital. It turns out that for larger hospitals, you have to get a letter of introduction from a smaller clinic to get an appointment. They also have to check your due date and make sure they can fit you in. This all needs to happen fairly early - 6-7 months before the due date for a popular hospital - or they may be too full to take you. I have heard horror stories of women in labor being turned away from hospitals because they had no reservation and the hospital was full. We managed to get our appointment and have our reservation made.

After reading online, birth in Japan appears to be an all natural affair. Women can give birth in larger hospitals or in a smaller private clinic that specializes in birth. For the most part, it is assumed that you will be having a natural birth with no epidurals or other pain relief. At small clinics no pain relief is available at all, though apparently some large hospitals will provide pain management if the mother insists. While there are doctors on hand, the bulk of the patient contact and birth process seems to fall to midwives, who act as a support system for the mother before and after the birth as well. Hospitals in Japan typically require a minimum of 4-5 days stay at the hospital after a normal, healthy birth and the time increases if there were complications or a c-section. I have also heard rumors that hospitals often have a chef on duty to provide tailor made, high end meals for new mothers during their stay. Apparently French cuisine is currently trendy way to spoil the new mother. I don't know if that is true at all hospitals, but I have heard it from a variety of people who gave birth in different hospitals, so it seems to be fairly widespread.

The city hospital I will be going to is brand new and very modern. It even has a Tully's coffee shop on the first floor! (I'm pretty sure that's not typical). They are a research hospital and the central hospital in case of emergency (earthquakes, etc), so they are very large and well equipped. So far, I know they are strong proponents of breastfeeding and they practice kangaroo care (barring complications, they have you snuggle the baby right after its born, skin to skin) and rooming in (keeping the baby with the mother as much as possible during the hospital stay - not in a nursery. Though there is a nursery if the mother needs rest). I don't know about epidurals, but I like this place so much, I don't really care. I would probably opt for a natural birth anyway.

My first appointment was on a Thursday (my non-teaching day) and the doctor was very nice. He didn't speak much English, but Russell has been diligently going with me to appointments and is quite fluent in Japanese (it shocks me sometimes the extent of his vocabulary in new settings - like when speaking to an obstetrician) so we had no problem communicating with the doctor. He wanted to make sure I could communicate easily as well, though, so he recommended we come on Fridays, since the Friday doctor spoke very good English. We made the switch, and while I actually liked the first doctor quite a bit, the Friday doctor is a woman and I can easily talk with her in English, which is nice. Russell was sick one week, for example, and it was quite nice to be able to go to my appointment without worrying about communication.

The hospital itself is a whole new experience. Its quite high tech, since it was built very recently. When you first enter the building (once you are established with a hospital card and an appointment) you go to a kiosk, insert your card, and get a print out of where you will need to go. You also get a remote-control looking device with a screen that beeps to give you instructions on what to do next. My typical visit goes like this: I go to the first kiosk and get the remote, then I head to the urine/blood station, and insert my card in another kiosk. After confirming who I am, a cup drops out of the kiosk with my name and information pre-printed on it. After the urine test, I go to another room to get my blood drawn (if its a blood test day - I've only had one of those, but the lady who drew my blood was awesome). After tests are finished I can either go sit in the lobby for the obstetrician, or I can wander around wherever I like.

Once the doctor is almost ready to see me (presumably while she is finishing paperwork for the previous patient), the buzzer goes off and a message tells me to head to the obstetrics clinic. This is super nice since the doctors are almost always running late. If I wanted to, I could be wandering around, having a snack downstairs, people watching, or whatever while I wait. Usually, I just go straight to the obstetrics room, though. When the doctor is ready to see me, I get another message sent to the remote and I enter the doctor's office. The doctor checks in with me to make sure everything is going okay, then we all head to the ultrasound room, where the baby gets measured and we get to peek in and see how he's doing (yes, we're expecting a boy). The doctor usually tries to get a good shot of the face to print off for us, but if he isn't cooperative we go away empty handed. This is unlike my previous doctor who would print off a variety of angles and shots for me. I kind of miss that... but being able to at least look so often is fun.

After the ultrasound, I meet the doctor back in her office and she confirms the readings from the ultrasound and whether there are any concerns. She asks again if I have any questions and then I'm done. My remote tells me to go to accounting to pay. Normally I would pay at a kiosk, but since I'm using the coupons from the city, I have to interact with a real person. After accounting, I do go to the payment kiosk, confirm that I have no additional charges and return my remote. Its pretty slick.

During our first appointment, we got a massive quantity of papers. We had forms to fill out, more books on pregnancy and taking care of a new baby, information about the hospital. All sorts of things. We went out to buy a 2" notebook to keep it all in and the notebook was barely big enough for the first day's worth of paper. Thankfully the following appointments haven't been so paper heavy.

The first appointment included one extra stop, too. We had a meeting with the general hospital staff to talk over three big points. The first was general liability paperwork, but the second two points were more interesting to me. Because this is a big city hospital, we had the option of having our $4,000 insurance money routed directly to the hospital. Basically, they wouldn't charge us for anything until we crossed the $4,000 mark and would instead charge the insurance. This is different than normal, where the new parents have to pay out of pocket up front and insurance sends them a reimbursement a week or two later. The upside is that you don't need to pay so much out of pocket - its all handled for you. The downside is that if you are under $4,000, you have to go through extra paperwork to get the difference sent to you. Interesting.

Another decision we had to make was a room reservation. This was the key part for visiting the new hospital so early. We had the choice of a shared room - 4 mothers together and only husbands can visit, or a private room - just one mother and visitors can include the husband and parents. This was a hard call for us. From what we understood, a normal pregnancy should fall just under $4,000, but if you get a private room, you will likely be paying out of pocket. Add to that the fact that there are no parents in the country until right before the due date, and we decided to reserve the shared room. They did tell us that the shared rooms fill up more quickly and we can request a private room later - though its subject to availability. My mother will be arriving a few days before the due date, so provided there are no early surprises, we will ask to change to a private room once she arrives. Fingers crossed that there's one to change to!

I'm now just starting the third trimester and I graduated from once a month appointments to twice a month appointments about a month ago. I like twice a month better since I get to see the ultrasounds. Oh - and it turns out that expectant mothers are suppose to bring in their own towel to wipe the ultrasound goo off their tummy. I always forget to bring a towel (since I'm always coming from work) but Russell has started remembering for me. Good team!

I'll try to post again soon about my maternity class. I missed the first one - on nutrition - but a midwife met with me to fill in the gaps. The second one was on breast feeding and handy items the hospital recommended new parents buy ahead of time. The third one is in August - and I believe that one will include a tour of the facilities and a discussion of the procedure when you are actually giving birth. Russell is invited to that one - he had to sit out of the first two. Should be interesting!

Pregnant in Japan: Pre and First Trimester

After years of keeping our family hanging, Russell and I finally decided it was time to grow our family. Doing so while still in Japan brought some concerns (language barrier, far from family) but also a lot of benefits (awesome maternity leave, awesome healthcare).

 I had always read that if you are in the position to plan ahead for getting pregnant, you should consult a doctor for blood screening, dietary advice, health check, etc. before getting pregnant. I dutifully found a women's doctor in the area and went to see her. Apparently this is not normal in Japan. Because I was seeking a women's doctor before I was pregnant, they assumed I was having problems getting pregnant and immediately had me start tracking my temperature and scheduled me to return in two weeks. After a month with no results they started talking about fertility pills. Terrified of having twins, I persuaded them to wait a little longer, and after 2-3 months, I discovered that I was, indeed, pregnant.

At this point I went to see my doctor again, she immediately did an ultrasound to confirm the pregnancy (none of this blood test stuff) and I got my confirmation. She printed out an estimated schedule for the pregnancy and instructed me that before the next visit (two weeks later) I should go to the city ward office and get a Mother/Child book.

I knew a little about Mother/Child books from working with study abroad students. The book is issued by the city in most cases and provides a central place to keep records for the mother during pregnancy and the baby once he/she is born. This includes my blood pressure and weight, results of blood tests, and eventually the results of well-baby check ups for the baby - oh, and immunization records.

I set off to the ward office to get a book. I found the correct floor of the ward office, and they had me fill out a form with my contact information, the anticipated birth date and then quizzed me to make sure I wasn't smoking or drinking alcohol. Once all of that was taken care of, they gave me a large pink envelope stuffed with all sorts of stuff - handbooks on taking care of a baby (yes, babies do come with manuals in Japan), a pregnancy tag to attach to my purse and alert people on train to give me a seat, a Mother/Child book and a book of coupons.

The coupons, it turns out, are funded through city taxes and can be used for medical check ups at most doctors.  I can't remember the exact number, but it was something like 13 $50 coupons and 18 $10 coupons. It probably won't be enough to 100% cover my doctor's visits, but I'm just starting my 3rd trimester and I still have a handfull of $50 coupons left, so they should take me pretty far.

While I was at the ward office, they also informed me that when the baby comes, I should come back to the ward office with the baby and within the first two weeks. Once the birth is verified, my insurance will issue a check for around $4,000 to cover the birth expenses. We will have to pay for anything above that, though apparently a normal birth with no complications usually comes in just under the $4,000 and I believe normal insurance kicks in to help, as with any other medical problem, if there are complications.

As long as I'm on the topic of maternity benefits in Japan, I also found out around the same time how maternity leave works. While Japan has no paternity leave, they do have a national system for maternity leave - no matter where you work you are entitled to 6 weeks leave before your due date at 2/3 pay (covered by insurance and insurance is mandatory in Japan). If you happen to go past your due date, you continue to get 2/3 pay until the actual birth - this probably evens out with some women delivering early and others late... Once you do give birth, insurance pays 2/3 of your income for 2 months - and here's the really nice part - it continues to pay 1/2 of your income up until the baby's first birthday. After the baby's first year, you are no longer entitled to any pay, but I have heard rumor that you are allowed to extend your maternity leave for up to five years and your job is guaranteed when you return - though that part I'm not as confident that I have correct.

Paired with being one of the safest countries in the world for giving birth - for baby and mother - I'm really happy to be having the baby in Japan.

Armed with my Mother/Child book and coupon book, I returned to my doctor. This was why it was so urgent to talk with the ward office before my next medical visit. The doctor wanted to run all sorts of blood tests and it can be expensive - but with the coupons, I didn't have to pay for any of it. Go Japanese healthcare! All tests came back healthy, I got another ultrasound (they seem to be standard at all doctor visits) and the doctor printed screen shots to put in the little "Hello Baby" photo album they gifted me.

I was officially in the system.

Due date: October 2nd

Time to find a dentist

I really need to post about the whole pregnancy process in Japan - its been fascinating.  However, the most recent adventure has been finding a dentist. When I went to the city office to report that I was pregnant, they made a big deal about going to the dentist and said that the city would cover part if not all of the cost of dental care.

I've always been regular about going to the dentist and take pride in never having had a cavity (can't last forever...). All of the documentation I saw about healthy pregnancies in the Japanese documentation (there was a lot) stressed the importance of visiting a dentist.

I wasn't sure whether this was just for a society that doesn't regularly go to the dentist (quite possible) or because there was some special dental treatment for pregnant women. It wasn't clear. In any case, I was happy to see a dentist, and was about due for a visit anyway.

The problem was finding a good dentist. Dentists are not hard to find in Japan. They seem to be on just about every corner. However, I've heard all kinds of horror stories about the quality of care you get. I have only been to the dentist once before - I thought I might be getting a cavity, so a friend found a place that looked modern and high tech. It was certainly that. After the dentist had determined that I did not in fact have any cavities, he dejectedly had me watch a fancy video on my personal monitor showing how they do root canals. They didn't ever suggest I needed a root canal - but I didn't go back.

Being nervous about the dentists in Japan has kept me returning to the US for dental care every year - even though I no longer have insurance to cover the visits. Unfortunately, this year, I will be too late in my pregnancy to make my annual trip home, so it was time to bite the bullet and find a a local dentist I could trust. Nobody around me seemed to have any recommendations - except for one dentist that was way up on a hill (and I'm too lazy).

I finally decided it was better to experiment when I don't have any pain or problems and find someone who can at least do a nice gentle cleaning. I noticed that the dentist across from my train station was open late, so I went and made an appointment for after work.

The result? The hygienists were pretty nervous about talking with a foreigner, but the dentist was great. She was very attentive and careful to explain things so I could understand. She didn't speak English, but she knew a lot of the dental vocabulary in English, so together we could work things out pretty well. The only problem I had was that there was no cleaning. She did check for cavities, congratulated me on being pregnant and asked if I had any questions, then the hygienist gave me this huge sales job with color graphs and charts about a special treatment they could do to keep my teeth looking like a 20-year-olds even when I'm 80 (they call it the 20/80 treatment), then they put some whitener on my front teeth and sent me on my way.

No cleaning.

I was really confused. Then I started looking at the packet of materials on the 20/80 treatment. From what I can tell, the treatment is just what I would consider a standard cleaning - scraping away tarter and polishing the teeth. I should have (and could have) asked more questions, but I was being passively confused, so now I have to go back again if I want a cleaning. Grrr. I'll probably just hide out for a month or so until I feel less dumb and then go schedule a proper cleaning.

I guess I should be happy that I found a nice dentist who isn't too pushy.

Scammed at Hard-Off

Its been such a long time since I posted anything... sorry about that. I have quite a bit to post these days, but I thought I'd start with a rant.

Russell and I have tried and tried to find decent second hand stores in Japan. It has not been easy. There are a large quantity of small shops that usually have decent large appliances (refrigerators, washing machines, etc) but its harder to find furniture and clothing. Finding it all in one place seems especially rare.

Now, Russell and I are cheap - very cheap. For our daily lives, we don't need much, and after 4+ years in Japan, we pretty much have everything we need - so our reasons for searching out a second hand shop had faded. A few months ago, however, we discovered that we were going to be having a baby. Hooray! This, however, meant we would need a few things we had not previously needed. While we have had family and friends very kindly asking to buy us things, our first inclination was to see what we could dig up for cheap in this neck of the woods.

A friend of ours tipped us off about Hard-Off. While the name strikes me as vaguely indecent, it goes along with Book-Off and Home-Off - a set of large scale second hand shops. Book-Off is everywhere, but it was the first we had heard of the others. Last week, Russell went with his friend and explored. He came back with promising tales of barely used baby supplies - strollers, bouncers, pack-and-plays, clothing... all super cheap. It sounded worth a closer look.

Today we had some free time, so we decided to take our wish list and see if there was anything we could do better buying ourselves. We started off at Home-Off on the second floor. Sure enough, plastic baby baths were a dollar, a wide variety of strollers were all under $100 - some were quite fancy at that - bouncers were $10 (this was something we had basically decided against since we wouldn't be using it long enough to validate the price). We were pretty pleased overall, though we decided to wait on making purchases until closer to the due date.

Then we went upstairs to Hard-Off. I think the name must be short for "Hardware-Off" - there were a lot of computers and electronics. We were browsing the kitchen appliances and we saw submersion (stick) blenders. Russell had just been wishing he had one after spotting a video on making home-made mayonnaise with one. There were three brands - a cheap T-Fal blender, another brand we didn't know for $40 (which turned out to be the new retail price on Amazon) and a Cuisinart submersion blender for $40. We checked the Cuisinart on Amazon, and it seemed like a steal, so we decided to get it.

Now, in the US, we would automatically have asked to plug it in and make sure it worked, but we have clearly become too trusting after so long in Japan. We bought the blender and headed home. Once there, Russell found the video he had seen before, watched it again, made sure we had all the ingredients and then opened the box. I think he said something like, "How is this a used Cuisinart?" I glanced over and thought he was referring to the fact that it looked brand-new. It was still in plastic with the direction book and everything. Then Russell pointed out the brand - "Twinbird". We looked it up. A cheap knock-off brand that sells new for about $20. We had been scammed.

We're going back tomorrow to call them on it and get our money back. To be honest, even if we had looked in the box, we may not have noticed the switch until we got home. Good thing Russell noticed before he opened any of the plastic. Sucks that the shop is so far away - easily an hour trip each way.

Grr. We definitely had better things to do with our Sunday.

Update: I waited until Thursday to take back the mixer. Hard-off didn't give me any trouble about it. They just asked if there was something wrong with it - I showed them that the brand was switched and they immediately gave me my money back. So relieved. Russell thinks the party responsible for the scam was likely the person who brought the mixer in. Anyone who looked inside the box would have thought it was the same mixer - brand new. So maybe Hard-Off is still okay... we'll just pay closer attention to to what we buy in the future.