Giving birth in Japan as a foreigner: costs and steps

Giving birth in Japan as a foreign resident works much the same as it does for Japanese families: the same city hall notification, the same health handbook, the same cash payment from your health insurance. What is different is the extra paperwork at the end, because a baby with two foreign parents needs a status of residence and a passport of their own. This guide takes you through it in order, from the first visit to city hall to the baby's residence card.

Everything below was checked against Ministry of Health, Labour and Welfare (MHLW), Children and Families Agency (CFA), Immigration Services Agency (ISA), Japan Pension Service and municipal pages on 31 October 2026. We use Shinjuku City as the municipal example; other cities run the same national system with their own forms and extras.

Pregnant in Japan: tell your city first

Once a clinic has confirmed the pregnancy, you file a pregnancy notification (妊娠届, ninshin todoke) at your city or ward office or health centre. In return you get the Maternal and Child Health Handbook (母子健康手帳, boshi kenkō techō), which records your check-ups, the birth and your child's vaccinations until school age.

Shinjuku asks you to notify early, ideally by week 11, and to bring your My Number and an ID such as your residence card. Two details matter for foreign residents:

The handbook comes in other languages. The CFA publishes it in 10 languages, including English, Chinese, Korean, Vietnamese, Portuguese, Nepali, Tagalog, Indonesian, Spanish and Thai. Shinjuku gives a foreign-language copy, as a reference alongside the Japanese one, to foreign mothers who do not understand Japanese.
Notify before paying for check-ups. With the handbook you get vouchers for subsidised pregnancy check-ups. Shinjuku states that check-ups you paid for yourself before receiving the handbook are not reimbursed.

The CFA's recommended schedule is about 14 check-ups: every 4 weeks until week 23, every 2 weeks from week 24 to 35, then weekly until the birth. Your municipality subsidises them, but the amount covered depends on where you live, so you may still pay something at some visits.

The pregnancy support payment

Since April 2025, a national "support payment for pregnant women" (妊婦のための支援給付) has been paid by municipalities together with interviews with a nurse or midwife. In Shinjuku it is worth ¥50,000 after the pregnancy is confirmed and another ¥50,000 per baby after the birth, as cash or an electronic gift card. Your city will explain its own process when you file the notification.

The cost of giving birth in Japan

A normal delivery is not treated as insurance-covered medical treatment in Japan, so the hospital bills it in full. Medical care such as a caesarean section is covered by health insurance in the normal way, with the usual monthly cap on what you pay. MHLW's Birth Navi site (出産なび) lets you compare the services and prices of individual birth facilities before you choose one.

The childbirth lump sum (shussan ikuji ichijikin)

To cover the bill, anyone in Japan's public health insurance (employee insurance or National Health Insurance, including dependants) receives the childbirth and childcare lump-sum allowance (出産育児一時金, shussan ikuji ichijikin):

¥500,000 per baby since April 2023, for births after 22 weeks at facilities in the obstetric compensation scheme. It is ¥488,000 at facilities outside the scheme or before 22 weeks.
You must be insured on the day of the birth, and the birth must be after at least 4 months (85 days) of pregnancy.
Twins mean two payments.

Most hospitals use the direct payment system (直接支払制度): you sign an agreement, your insurer pays the hospital, and you only pay the amount above the lump sum when you leave. If the birth costs less than the lump sum, you can claim the difference from your insurer. If your hospital does not use the system, you pay first and claim afterwards; the deadline is 2 years from the day after the birth. Kyoukai Kenpo (the Japan Health Insurance Association) also lends up to 80% of the lump sum interest-free if you have to pay before it arrives.

Free childbirth is coming, but not yet. A health insurance law promulgated on 5 June 2026 changes how standard childbirth costs are paid, so that mothers do not pay for a standard birth, with a separate fixed cash payment on top. It must take effect within 2 years, and as of October 2026 MHLW's council was still setting the amounts. Until it starts, the ¥500,000 lump sum applies, and birth facilities can choose to stay on it for a while after.

Maternity leave in Japan and the money while you are off

Under the Labour Standards Act, you can take maternity leave from 6 weeks before your due date (14 weeks for twins or more) if you ask for it. After the birth, your employer cannot let you work for 8 weeks, although after 6 weeks you may return if you ask and a doctor agrees.

Childbirth allowance (出産手当金, shussan teate kin): if you are in employee health insurance and are not paid during leave, Kyoukai Kenpo pays about two thirds of your daily pay (based on your average standard monthly remuneration) from 42 days before the birth (98 for multiple births) to 56 days after. If you are on National Health Insurance, ask your city what it offers.
Childcare leave benefit (育児休業給付金): paid by employment insurance at 67% of your pay before leave for the first 180 days, then 50%. It normally runs until the day before your child turns 1, and can be extended to 1 year and 6 months or 2 years if you applied for licensed daycare and could not get a place. Our daycare guide explains that application.
Birth after support benefit (出生後休業支援給付金): since April 2025, if both parents take at least 14 days of childcare leave soon after the birth (or one parent qualifies alone, for example because the other is not employed), each can get an extra 13% for up to 28 days. Added to the 67%, that is 80% of pay, which MHLW says is about the same as normal take-home pay once tax-free status and premium exemptions are counted.

Premiums you may not have to pay

Employees: health insurance and employee pension premiums are waived during maternity leave and childcare leave (for a child under 3) when your employer applies to the Japan Pension Service, and the months still count as paid for your pension.
National Pension (self-employed, freelancers, students): premiums are waived for 4 months from the month before your due month (6 months for multiple births), and the months still count as paid. You can file from 6 months before the due date. From October 2026, a new exemption also covers the following 9 months for mothers, and up to 12 months for fathers, with no income test. Our pension exemption guide covers the other exemptions.
National Health Insurance: the premium for the same 4 months (6 for multiple births) is reduced. In Shinjuku you do not need to file if the ward paid your lump sum.

After the birth: the deadlines

The first month is when the deadlines stack up. In order:

1. Birth registration within 14 days

Every birth in Japan must be registered with a birth notification (出生届, shusshō todoke) within 14 days, counting the day of birth. You file it at the office of the city where the baby was born or where you live. Registering where you live avoids delays, because Shinjuku warns that filing elsewhere can hold up the baby's residence record and the allowances that depend on it.

Bring the form, with the birth certificate section filled in by the doctor or midwife, and your Maternal and Child Health Handbook.
If both parents are foreign, the baby's name is written in katakana. Parents whose nationality uses Chinese characters, such as Chinese or Korean nationals, can use correct Japanese kanji.
There is no fee to file.

Birth certificate in Japan: which document your embassy wants

Japan's family register (戸籍, koseki) only records Japanese nationals, so a baby with two foreign parents has no register entry to copy. Proof of the birth comes from the notification itself, and the office that accepted it can issue two certificates:

Certificate of acceptance of birth notification (出生届受理証明書, shusshō todoke juri shōmeisho): proves the notification was accepted. In Shinjuku it costs ¥350 (¥1,400 on high-quality paper), can only be requested by the person who filed it (or with their letter of authorisation), and is only issued by the office where it was filed.
Certificate of the notification's contents (出生届記載事項証明書): a copy of what the form says. Shinjuku charges ¥350, but it is not public: it is only issued to people with a direct interest who can show a special reason for needing it.

Ask your embassy which one it needs, and whether it needs a translation, before you go to city hall.

2. Embassy registration and passport

If both parents are foreign, ISA points out that the baby does not get Japanese nationality by being born in Japan. Report the birth to your own country's embassy or consulate and apply for the baby's passport there.

3. The baby's status of residence within 30 days

A baby born in Japan without Japanese nationality may stay for 60 days without a status of residence. To stay longer, you must file an application for permission to acquire status of residence (在留資格取得許可申請) at your regional immigration office within 30 days of the birth.

There is no fee, and a parent can apply for a child under 16.
ISA's standard processing period is within 60 days of the birth, and it can be same-day. The application can also be filed online.
Which status you apply for depends on your own status, and ISA lists the documents for each one on the same page. If it is Dependent, our dependent visa guide covers what that status allows.

4. Health insurance

Add the baby to your insurance. With employee insurance, your employer adds the baby as a dependant. With National Health Insurance, register the baby at city hall within 14 days. If one parent has employee insurance, Shinjuku asks you to first check whether that insurer will cover the baby as a dependant. If it will not, bring its written refusal when you join National Health Insurance. Our health insurance guide covers how coverage works at the clinic.

5. Child allowance within 15 days

Apply for the child allowance (児童手当, jidō teate) at your city office within 15 days of the day after the birth. It is ¥15,000 a month until age 3, and late applications lose the missed months. Our daycare and child allowance guide has the details.

Having a baby in Japan means four or five deadlines in the same few weeks, at three different offices. Daruma tracks the ones that apply to you, from the 14-day birth registration to the 30-day immigration application, scans the Japanese letters from your insurer and city office into plain English, tells you which counter to go to and what to bring, and answers questions about your situation, such as which status of residence your baby will get.

Useful Japanese

母子健康手帳 (boshi kenkō techō): Maternal and Child Health Handbook
出産育児一時金 (shussan ikuji ichijikin): childbirth lump-sum allowance
出生届 (shusshō todoke): birth notification
出生届受理証明書 (shusshō todoke juri shōmeisho): certificate of acceptance of birth notification
在留資格取得許可申請 (zairyū shikaku shutoku kyoka shinsei): application to acquire status of residence

Where to confirm this

Guides are dated rather than undated: last reviewed 31 October 2026. This is an organisational aid, not legal or immigration advice — always confirm anything consequential with your ward office, the Immigration Services Agency, or a qualified professional.