Prenatal Checkups in Japan: Your 母子手帳 and 14 Subsidized Visits Explained

Information current as of March 2026 based on MHLW guidelines and municipal government websites. For a full pregnancy-to-childcare overview, see our complete guide to having a baby in Japan.

What is the 母子手帳 (Mother and Child Health Handbook)?

The 母子手帳 (boshi techo) is a small booklet issued by your local government that tracks your entire pregnancy and your child's health until around age 6. Every doctor and nurse in Japan knows this book — you bring it to every prenatal checkup, the delivery, and all your child's vaccinations and health checkups afterward.

It's more than a record. It's your proof that you're receiving care, and it comes with 妊婦健診補助券 (ninpu kenshin hojoken) — vouchers that subsidize your prenatal checkup costs.

How to get your 母子手帳

Go to the health and welfare counter at your local ward office (区役所 / 市役所) or public health center (保健センター / 保健所). You need to submit a 妊娠届出書 (ninshin todokede sho — pregnancy notification form).

What to bring:

• Your residence card (在留カード)
• Your My Number card or notification card
• Your health insurance card
• A note from your doctor confirming pregnancy (not always required, but recommended)

When to go: As soon as your pregnancy is confirmed by a doctor — ideally around week 6–10. There is no deadline, but the vouchers are most valuable when used from the beginning.

What to say at the counter: 妊娠届を出したいです (Ninshin todoke o dashitai desu) — I'd like to submit a pregnancy notification.

English version of the 母子手帳

Many municipalities offer the 母子手帳 in English and other languages. When you go to the ward office, ask: 英語の母子手帳はありますか？ (Eigo no boshi techo wa arimasu ka?) — Do you have the Mother and Child Handbook in English?

If your municipality doesn't have one, you can order a multilingual version from the Mother and Child Health Handbook Translation Organization (MCFH). Versions are available in English, Chinese, Korean, Thai, Tagalog, Portuguese, Indonesian, Spanish, Vietnamese, Nepali, and Burmese.

The 14 prenatal checkup vouchers explained

When you receive your 母子手帳, you also receive a set of 妊婦健診補助券 (ninpu kenshin hojoken) — typically 14 vouchers that subsidize your prenatal checkups. The standard schedule recommended by the MHLW is:

Pregnancy period	Checkup frequency	Visits
Weeks 4–23	Once every 4 weeks	~4 visits
Weeks 24–35	Once every 2 weeks	~6 visits
Weeks 36–birth	Once every week	~4 visits
Total		~14 visits

How much do vouchers cover?

The subsidy amount varies significantly by municipality. There is no national standard amount — each city/ward sets its own voucher values.

City	Total subsidy (all 14 vouchers combined)	Notes
Tokyo (23 wards, average)	~¥90,000–¥110,000	Varies by ward. Some wards cover more.
Osaka City	~¥120,000	Includes additional tests for some vouchers.
Yokohama	~¥80,000–¥90,000
National average	~¥105,000	Per MHLW survey

What you still pay out of pocket: A typical prenatal checkup costs ¥5,000–¥15,000 depending on the tests performed. Your voucher might cover ¥5,000–¥10,000 of that. For a standard pregnancy, expect to pay roughly ¥30,000–¥70,000 total out of pocket across all 14 visits, after voucher subsidies.

Special tests — like the NIPT (non-invasive prenatal test) or advanced ultrasounds — are not covered by vouchers and can cost ¥100,000–¥200,000 extra.

Using your vouchers at checkups

Each voucher is pre-printed with the tests covered for that visit. Simply hand the voucher to the clinic reception before your appointment. The clinic bills the municipality directly for the subsidized amount, and you pay only the difference.

Important rules:

• Vouchers are tied to your municipality. If you move to a different city during pregnancy, you need to exchange your old vouchers for new ones at the new city's ward office. The new city may issue vouchers with different values.
• Vouchers expire after delivery. Unused vouchers cannot be carried over.
• Out-of-prefecture hospitals: If your hospital is in a different prefecture from where you live, the voucher may not be accepted directly. In this case, pay the full amount upfront and apply for reimbursement (償還払い / shoukan barai) at your ward office afterward. Keep all receipts.

If navigating the ward office in Japanese to get your 母子手帳 and vouchers feels daunting, that's exactly why I built LO-PAL. Post your question for free and a local Japanese person can walk you through what to bring, or even go with you to the ward office.

What happens at each prenatal checkup

Prenatal checkups in Japan follow a fairly standard pattern:

• Every visit: Weight, blood pressure, urine test, uterine measurement, fetal heartbeat check
• First visit (weeks 6–10): Pregnancy confirmation, blood tests (blood type, anemia, hepatitis B/C, HIV, syphilis, rubella antibody), ultrasound
• Mid-pregnancy: Glucose screening test (around week 24–28), Group B Strep test (around week 35–37)
• Late pregnancy (weekly from week 36): NST (Non-Stress Test) to monitor contractions, cervix check

Ultrasounds: Japan is generous with ultrasounds compared to many Western countries. You'll typically get an ultrasound at nearly every visit — sometimes 2D, sometimes 3D/4D. Many clinics give you printed photos or even USB recordings.

If you don't have health insurance

Prenatal checkups are not covered by health insurance (健康保険) because pregnancy is not classified as an illness. The vouchers are your main cost subsidy. However, if your pregnancy develops complications — gestational diabetes, preeclampsia, threatened premature labor — those treatments ARE covered by insurance.

If you're not enrolled in any health insurance, enroll immediately. All residents in Japan (including foreign nationals with a residence card) must be enrolled in either:

• Shakai Hoken (社会保険) — through your employer, or
• National Health Insurance (国民健康保険 / NHI) — through your ward office

See our guide to joining family health insurance for how to add family members to your coverage.

Related articles

• Having a Baby in Japan? Every Step Foreign Parents Need to Know
• Finding an English-Speaking OB/GYN in Japan Before Your Due Date
• Japan's 2026 Free Childbirth Plan: What's Covered
• How to Cap a Huge Hospital Bill in Japan

Get a Local Helper for Your Ward Office Visit

Applying for the 母子手帳 should be simple, but language barriers and unfamiliar paperwork make it stressful. On LO-PAL, you can post a request for free — a local Japanese helper in your area can prepare documents with you, accompany you to the ward office, and make sure you receive all the vouchers and benefits you're entitled to. You only pay when you accept task help.