Have you heard of the term prenatal diagnosis? Prenatal diagnosis is a test you can take to find out certain information about your baby early on in your pregnancy. If you are living in Japan you may not have heard about it, maybe your doctor hasn’t mentioned it and that is because it isn’t as common in Japan yet as it is overseas. Read on if you would like to know more about this test and where it is available in Japan.
New life – new responsibilities
If you are reading this article, there is a huge chance that you, or someone you love, is expecting a baby. Congratulations! This is a time where you may feel a whirlwind of emotions. Among those must be excitement about this next step you are taking towards a new life; you may feel insecure about parenthood, and even sad that your days as being only a daughter or son are now coming to an end. After all, there are great responsibilities when raising a human being.
It is okay to have all sorts of feelings when you find out you are expecting. Also, if you are the mother-to-be, remember that hormonal changes during early pregnancy widely affect your humor – and you may be crying and laughing at the same time after watching some insurance commercial on the TV. That is completely normal.
When you go to the doctor around the 6th week of pregnancy, the ultrasound exam may be able to check your baby’s heartbeats. For some babies that may be later in pregnancy, so don’t be alarmed yet – trust your doctor. If something is wrong, they will tell you.
You will officially be considered pregnant after the doctor checks the babies’ heartbeat. With this confirmation you will need to visit your city’s city hall and register your pregnancy there. At this time, you will receive a copy of the “Maternal and Child Health and Handbook”. Many cities have them available in English, Spanish, Chinese, Indonesian, Korean, Portuguese, and other languages depending on the location. Check with your city hall if they have it in your language, if necessary.
At this time, you will also receive A LOT of handbook, booklets, pamphlets, and all sorts of guidebooks to help you through your pregnancy. It can be a lot to receive at once, and things start to feel real at this point.
If you are not going back home for prenatal and birth, you may start to realize that you will be giving birth on a foreign land. As much as you may love Japan, and have adopted it as your new home, and even if you are fluent in Japanese, this is not the same as having a baby in your home country. You may feel insecure. Hopefully, you will find a good hospital or birth clinic that is foreigner-friendly. You will get lots of opinions from family and friends back home and the internet. When it comes to pregnancy, Japan can feel more foreign than ever, as rules, customs, beliefs, and fees are much different from back home. You may have people asking about the sex of the baby already. How would you know? Your Japanese doctor said you will only be able to check this around the 20th week!
Prenatal Diagnosis: Common overseas, not so common in Japan.
The reason why many mothers-to-be overseas get to know their babies’ sex in a very early stage is genetic testing, or screening. These tests have become more and more common, affordable and easy to get in recent years.
With genetic testing, it is possible to check not only the baby’s sex, but also if there are any genetic disorders with him/her.
Until some years ago, the only tests available were quite invasive, meaning they needed samples from the baby’s environment. In this case, there is a small chance of abortion, and that is why they were not usually recommended unless there was a reason for doing so.
In Japan, having a genetic test will depend on your doctor’s opinion about the matter, your age, and whether you and your partner want to take it or not.
The doctor’s opinion about genetic testing can affect you taking a genetic test or not because some doctors do not believe it is necessary to have a DNA screening if your baby seems fine during the ultrasound. Also, your age can affect the doctor’s opinion because you only enter the “risk zone” if you are 35 and over. Some places will not even offer genetic testing for pregnant women under 35 years old, even if they want to be tested.
At some hospitals, you will need to participate in one or two counseling appointments with a specialized doctor before being able to get tested. During the counseling, they will explain to you and your partner how the genetic testing and screening works, the risks, and what can be done in case the results show any disorders.
You can see there is a huge difference in how genetic testing is dealt with in Japan and most countries overseas. If these tests have risks, why are they popular?
Well, the reason is that currently there is a noninvasive way of doing genetic testing. The non-invasive prenatal test (NIPT) has been developed and is now widely available. This test uses only a sample of the mother’s blood, and has very low risk. In Japan, however, this testing is still rare.
The test most mothers-to-be are taking overseas is the NIPT.
Prenatal Diagnosis: Non-invasive prenatal test
NIPT only needs a small sample (10ml) of blood from the mother. It is just like having blood drawn for some routine testing. Some of the baby’s DNA can be found in the mother’s blood, and that’s how you get to know if the baby is a boy or a girl (if they find a Y chromosome, that would be a boy, as the mother can’t have Y chromosomes herself).
Of course, NIPT is not only for knowing the baby’s sex. This test also screens for the risk of the most common chromosomal disorders: Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome), Trisomy 13 (Patau syndrome), as well as checks the baby’s Rh blood type.
The NIPT can be taken from the 10th week of pregnancy. This is the earliest it can be when it comes to genetic testing. Having a NIPT before 10 weeks can lead to false results, so it is not recommended.
Taking the test in Japan
While NIPT is still rare in Japan, it is not impossible!
There are a few clinics that offer it, one of them being International Health Care Clinic. They focus their services to foreign nationals living in Japan.
Located in Shimbashi, one of the largest business towns in Tokyo, the International Health Care Clinic is easily accessible and is close to Ginza – a nice walk for you to get some (decaf) coffee after having the testing done!
Full support in English
The International Health Care Clinic will give you full support in English.
First, it is easy to make a reservation through their website. If you have already been to a clinic in Japan, you may know they can be crowded at times. It’s better to make a reservation for a day and time that you can take some time for your visit, as you never know if you may need to wait or not.
The doctors and staff at the International Health Care are fluent in English. They are also used to taking care of expats, so here you will find a warmer service than what you might get at most Japanese hospitals and clinics.
If you have been to a typical Japanese clinic for your prenatal exams already, you may have felt that the doctor is not as cheerful as he or she would be back home. That’s quite common here; especially if you are visiting a busy hospital. It does not mean that the doctor is a bad one, and there is no need to change the hospital just because of that (but we do understand if you feel like doing so…). It is nice to feel that the doctor understands your feelings when you are talking to them, isn’t it?
Also, the International Health Care Clinic also gives you support after the results are delivered. We will talk more about this in the following sections.
Results delivered by email
Most hospitals will not inform you of the results of your exams until your next visit, which can be 2 weeks to 1 month later from your previous appointment. That may sound very old-fashioned to some. At the International Health Care Clinic, your NIPT results will be delivered by email within 12 days from the test appointment.
That means you do not need to take more time to visit the clinic again just to get the results, which a very helpful feature for the mother-to-be, who may be not able to pay another visit due to work or morning sickness.
Support in case the results are positive
If you get a positive result for a genetic disorder, doctors will recommend taking further genetic screening. That is because as accurate as the NIPT can be, with over 99% accuracy for Down syndrome for example, it is not only the baby’s DNA that is found in the mother’s blood sample.
Further testing means that you will be recommended to take an invasive genetic testing. That will be done at a hospital. The International Health Care Clinic will introduce you to a partner hospital, and will cover your exams fee there (only for amniotic fluid test, which costs around 200,000 yen).
Dealing with insecurity
Getting a positive result can be a big deal for some. You may want to get further genetic screenings done, or you may not. Remember, that’s a particular choice that must be discussed between you and your partner first.
If you have a web of support from home, it can be a good idea to talk to them about it and get an opinion from your family doctor. Be careful as the outcomes can be way different from what you were expecting. Try to keep your mind open, but also be careful to filter anything toxic.
Sharing a positive result on social media will bring to you all types of comments, opinions, and suddenly everyone is “specialized” in the topic. Think twice before sharing the news, double check with your partner if you are ready to receive lots of information that is not always helpful.
If you decide to have an amniotic fluid test, and get a positive result again, it is up to you and your partner what to do next. Anything further than that will vary from family to family – and the overall opinion can be extremely different if you are from Iceland or El Salvador.
Whatever your decision mat be, you can find support groups of people online that share the same ideas as you. It does not matter how your pregnancy goes, there will always be someone out there that is willing to share these experiences with you. Helping yourself accept the support is also important. Even if you are busy, taking some time of your week to enjoy some (once again, decaf) coffee (on or offline) with other ladies that are sympathetic to your situation is one of the best things you can do to yourself during this time of your life – whether you got a positive or negative result, or during any decisions you make.
Enjoy your pregnancy
If you feel you want to try some of the prenatal care you would have home without leaving Japan, the International Health Care Clinic can help you with taking a NIPT. Feel free to contact them for more details, they will be glad to help.
Once again, congratulations on your pregnancy!
As overwhelming as it can be sometimes, try to relax. Cool your mind before making any decisions, visit as many hospitals as you wish, join pregnancy groups on social media, etc. If you are already having morning sickness, believe that it is coming to an end soon – it will!
After the baby is born life will change and you may not be able to take as much time for yourself as you can do now. That is very much true for moms that will stay alone at home most of the day after the baby is born.
Pregnancy is a time in life when you deserve to be (more) pampered. Enjoy it!