The Maternity Handbook (Boshi Techo) & Prenatal Checkups in Japan

May 25, 2026 Maternity Prep Navigator Editorial ~11 min read

If there's one document that defines maternity care in Japan, it's the Maternity Handbook — the 母子健康手帳 (Boshi Kenkou Techou, usually shortened to 母子手帳 / Boshi Techo). This little booklet ties together your prenatal checkups, your baby's growth records, and the subsidies that make care affordable. Here's what it is, how to get it (including foreign-language versions), and what to expect at your checkups. Details and amounts vary by municipality and change over time — always confirm with your city or ward office.

1. What the handbook is & why it matters

The Maternity Handbook is a single booklet that records the health of both mother and child — from pregnancy through your child's early years. It's a long-standing part of Japan's maternal and child health system, and you'll use it constantly.

What's inside

• Your pregnancy record: due date, checkup results, weight, blood pressure and notes.
• The birth record and your baby's measurements at birth.
• Growth charts, developmental milestones, infant checkup results.
• The vaccination record — a key document for daycare, school and travel later.
• General guidance on pregnancy, feeding and child health.

Because the same booklet follows you from pregnancy into your child's school years, it becomes a genuinely useful keepsake as well as a medical document. Years later, the vaccination pages may be requested when you enroll your child in daycare or school, or when you travel abroad and need to prove their immunization history. Many parents also treasure the handwritten birth measurements and first growth entries. In short, it's worth treating the handbook as one of your most important documents in Japan — alongside your residence card and passport.

2. How & where to get it

You receive the handbook when you submit your pregnancy notification (妊娠届 / ninshin todoke) at your local city or ward office (市役所・区役所), or sometimes a local public health center (保健センター). This happens after a doctor confirms your pregnancy.

What to bring

• Your pregnancy certificate or note from the clinic (and the due date).
• Identification — residence card and/or My Number card.
• Any forms your municipality asks for (often available at the counter).

The handbook is issued free of charge. Along with it you'll receive your prenatal checkup subsidy tickets and information on local maternity classes and benefits. Many offices include a short interview with a public health nurse — a good chance to ask questions and get connected to local support.

When to go

There's no need to rush to the office the day you get a positive home test. It's best to wait until your doctor has confirmed the pregnancy and given you an estimated due date, since the office will record that date. After that, register reasonably promptly — registering early means you start receiving subsidy tickets sooner, so you don't pay full price for checkups in the meantime. If you're unsure exactly when or how, your clinic can usually tell you what your specific city or ward expects.

3. Foreign-language versions

Good news for non-Japanese speakers: many municipalities offer the handbook in foreign languages, and bilingual versions are widely available. Common languages include English, Chinese, Korean, Portuguese, Spanish, Tagalog, Thai, Vietnamese and Indonesian, though the exact selection depends on your area.

• Some areas hand you a bilingual (Japanese + your language) version, so medical staff can still read the Japanese side.
• Others provide a separate translated companion booklet alongside the Japanese handbook.
• If your office doesn't stock your language, ask — they may be able to order one or point you to a translated PDF.

One practical point: even if you receive a foreign-language handbook, the medical entries your doctor writes will usually still be in Japanese, and a bilingual layout (Japanese and your language side by side) keeps everyone aligned. If your municipality only offers the Japanese version, you can still ask whether a translated companion booklet or a downloadable guide is available, and a translation app can help you read entries at home. The goal isn't a perfect translation of every page — it's making sure you understand the parts that matter for your care and your baby's records.

4. The checkup schedule & subsidy tickets

Prenatal checkups (妊婦健診 / ninpu kenshin) follow a standard rhythm. A typical pregnancy involves around 14 visits:

• Up to ~23 weeks: roughly every 4 weeks
• 24–35 weeks: roughly every 2 weeks
• 36 weeks to birth: roughly every week

Your handbook comes with a set of subsidy tickets (受診票 / jushinhyou) — usually about 14, matching the standard schedule. You hand a ticket to the clinic at each visit, and it reduces or covers much of the standard cost. Some optional or extra tests may still be paid out of pocket, and coverage levels differ by municipality.

It's worth understanding that these tickets are not the same as health insurance. A normal pregnancy isn't treated as an illness in Japan, so routine checkups aren't billed to your insurance card in the usual way. The subsidy ticket system exists precisely to lighten that out-of-pocket burden. Bring the correct ticket to each visit; if you forget it, you may have to pay the full amount and sort out reimbursement afterward, which is more hassle than simply keeping the booklet in your bag. Also note that the tickets are tied to the standard checkup schedule, so additional or optional tests your doctor recommends may fall outside what a ticket covers — ask in advance so the bill doesn't surprise you.

5. What happens at each checkup

Most checkups follow a similar pattern. While the exact tests vary by stage and facility, you can generally expect:

Every visit

• Weight and blood pressure
• Urine test (for protein and sugar)
• Measuring your belly and, later, the baby's position
• Listening to the baby's heartbeat

At certain stages

• Ultrasound scans to check the baby's growth and development
• Blood tests early on and at intervals (e.g., blood type, anemia, infections)
• A gestational diabetes screening around mid-pregnancy
• A group B streptococcus (GBS) test in late pregnancy

Results are recorded in your handbook each time, so you can follow your own progress. If anything needs attention, your doctor or midwife will explain next steps — don't hesitate to ask questions about anything you don't understand.

How a visit usually flows

A typical appointment starts at reception, where you hand over your handbook, insurance card and the subsidy ticket for that visit. You'll often weigh in and give a urine sample yourself before being called. The consultation with the doctor or midwife is frequently brief and focused, especially at busy clinics, so it helps to have your questions ready. Ultrasound days tend to take a little longer. Afterward you settle any remaining payment at the desk and book your next visit. Knowing this rhythm in advance makes the whole thing feel far less intimidating, particularly for your first appointment.

6. Tips for non-Japanese speakers

Checkups are routine, but the language can be a hurdle. A few things that help:

• Use a bilingual handbook so you and the staff are literally on the same page.
• Write down questions in advance and bring a translation app or a phrase list for common terms (weight, blood pressure, urine, ultrasound, heartbeat).
• Ask whether the facility has interpreter support. Some hospitals offer phone or video medical interpreting; some municipalities provide interpreter services for health appointments.
• Bring someone who speaks Japanese for important visits if you can, especially early on when there's a lot of new information.
• Keep your tickets and handbook together in your bag so you never arrive without them.