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Calendrier du suivi de grossesse — Japan

Une traduction française est en préparation. Les informations ci-dessous sont affichées en anglais pour le moment.

This is a general overview of the prenatal visits many people in Japan are offered during pregnancy, drawn from public guidance by Japan's Ministry of Health, Labour and Welfare and the WHO. Every pregnancy is different — your own care provider decides which checks and timing are right for you. It's here for reference and orientation, not as medical advice.

Disclaimer: BabyBerry est destinée à l'information générale et au suivi personnel. Ce n'est pas un dispositif médical et elle ne donne ni avis médical, ni diagnostic, ni traitement. Consultez toujours un professionnel de santé qualifié.
  1. Initial Visit — Semaines 5–6
  2. First Blood Panel — Semaines 7–9
  3. Results Review — Semaines 10–12
  4. Switch to Abdominal Ultrasound — Semaines 13–16
  5. Routine Check — Semaines 17–18
  6. Mid-Pregnancy Anatomy Scan — Semaines 19–20
  7. Last Monthly Visit — Semaines 21–23
  8. Glucose Screening + Cervical Length — Semaines 24–26
  9. Late Anatomy Scan — Semaines 27–28
  10. Biweekly Monitoring — Semaines 29–32
  11. Biweekly Monitoring — Semaines 33–34
  12. Late Blood Tests + GBS — Semaines 35–36
  13. Weekly Visits Begin (Full Term) — Semaine 37
  14. Final Weekly Monitoring — Semaines 38–40

Initial Visit

Première visite prénatale · Semaines 5–6

Pregnancy confirmation via transvaginal ultrasound, rule out ectopic pregnancy, urine test, early infection screening

Bon à savoir: Once the fetal heartbeat is confirmed, you should register your pregnancy at your local municipal office (市区町村役所) to receive the Mother and Child Health Handbook (母子手帳). This handbook is essential — it tracks your entire pregnancy and your child's health until age 6, and comes with the 14 prenatal checkup vouchers (受診票) that cover most of your checkup costs.

Examens courants

  • Transvaginal Ultrasound — A transvaginal ultrasound is performed to confirm the gestational sac is inside the uterus, ruling out ectopic pregnancy. If you are far enough along (usually around 6 weeks), the doctor will also look for a fetal heartbeat. This is the most reliable way to confirm a viable early pregnancy.
  • Urine Pregnancy Test — A urine test confirms the presence of hCG (human chorionic gonadotropin), the hormone produced after implantation. While home pregnancy tests are highly accurate, the clinic test serves as an official confirmation and is documented in your medical record.
  • Chlamydia PCR Test — A cervical swab or urine sample is tested for chlamydia using PCR, which is the most sensitive detection method. Untreated chlamydia during pregnancy can cause preterm labor, premature rupture of membranes, and neonatal conjunctivitis or pneumonia. If positive, it is easily treated with antibiotics safe for pregnancy.
  • Vaginal Culture — A vaginal swab is cultured to check for bacterial vaginosis, candidiasis, and other vaginal infections. These infections are common in pregnancy and can increase the risk of preterm labor if left untreated. Early detection allows for safe and effective treatment.

Comment se préparer

  • Write down the first day of your last menstrual period (LMP) — this is essential for calculating your due date.
  • Wear easily removable clothing, as a transvaginal ultrasound will be performed. A skirt is most convenient.
  • Bring your health insurance card and any referral documents if you have them.
  • If you have been tracking basal body temperature, bring the chart to help date the pregnancy.

Conseils

  • If no heartbeat is seen at 5-6 weeks, do not panic — it is often too early. Your doctor will schedule a follow-up in 1-2 weeks to recheck.
  • The initial visit is NOT covered by the 14 vouchers — you will pay out of pocket (typically 5,000-15,000 yen). Coverage begins from the next visit after you receive the 母子手帳.
  • Start taking folic acid supplements (400 mcg daily) as soon as possible if you have not already. This is critical for preventing neural tube defects in the first trimester.
  • Ask your clinic about their delivery policy early — many popular hospitals and birthing centers in Japan require early reservation (分娩予約), sometimes by week 12.

First Blood Panel

Visite 1 · Semaines 7–9 · Un jeûne peut être nécessaire

Comprehensive blood panel including HTLV-1 (Japan-specific), blood type, infections, rubella immunity, thyroid function, fasting glucose

Bon à savoir: This is the most extensive blood draw of your entire pregnancy. Japan's first blood panel is notable for including HTLV-1 screening, which is not routinely done in most other countries. HTLV-1 is endemic in parts of Japan (especially Kyushu and Okinawa), and since it is primarily transmitted through breastfeeding, early detection gives you time to make informed feeding decisions. If your rubella HI titer is 16 or below, this does NOT mean you have rubella — it means your immunity is low and you need to take precautions.

Examens courants

  • Blood Type (ABO + Rh) — Determines your blood type (A, B, AB, or O) and Rh factor (positive or negative). This information is critical for emergency transfusions during delivery and to identify Rh incompatibility. If you are Rh-negative, your doctor will monitor for antibodies throughout pregnancy.
  • Irregular Antibody Screening — This test checks for unexpected antibodies in your blood that could attack the baby's red blood cells. Irregular antibodies can develop from previous pregnancies, blood transfusions, or naturally. If detected, your pregnancy will be closely monitored for signs of fetal anemia.
  • Complete Blood Count (CBC) — Measures red blood cells, white blood cells, hemoglobin, and platelets. This test establishes your baseline and checks for anemia, which is common in pregnancy due to increased blood volume. If hemoglobin is low, iron supplementation will be recommended.
  • Fasting Glucose + HbA1c — Fasting blood glucose and HbA1c are measured to screen for pre-existing diabetes or early gestational diabetes. HbA1c reflects your average blood sugar over the past 2-3 months. Uncontrolled blood sugar in early pregnancy increases the risk of birth defects and miscarriage.
  • Thyroid Function (TSH, FT4) — TSH and free T4 levels evaluate thyroid function. Both hypothyroidism and hyperthyroidism can affect fetal brain development and increase pregnancy complications. Thyroid function changes naturally in pregnancy, so pregnancy-specific reference ranges are used.
  • Syphilis Screening — Blood test for syphilis, which can cross the placenta and cause congenital syphilis with serious complications including bone deformities, anemia, and neurological damage. Early detection allows effective antibiotic treatment. Syphilis cases have been rising in Japan in recent years.
  • Hepatitis B (HBs Antigen) — Screens for active hepatitis B infection, which can be transmitted to the baby during delivery. If positive, the newborn will receive hepatitis B immunoglobulin and vaccine at birth. In Japan, universal hepatitis B vaccination for infants was introduced in 2016.
  • Hepatitis C (HCV Antibody) — Screens for hepatitis C virus infection. Mother-to-child transmission occurs in about 5-10% of HCV-positive pregnancies. There is no vaccine for hepatitis C, but if positive, the baby will be monitored after birth. Delivery method does not significantly affect transmission risk.
  • HIV Screening — HIV screening is a standard part of prenatal blood work in Japan. Early detection allows for antiretroviral treatment during pregnancy, which reduces mother-to-child transmission risk to less than 1%. The test is confidential, and partner notification counseling is provided if positive.
  • HTLV-1 Antibody — HTLV-1 (Human T-cell Lymphotropic Virus Type 1) screening is unique to Japan and has been included in nationwide prenatal screening since 2011. HTLV-1 is mainly transmitted through breast milk. If positive, breastfeeding must be modified — options include exclusive formula feeding, short-term breastfeeding (under 3 months), or frozen/thawed breast milk. Japan has one of the highest HTLV-1 carrier rates among developed countries.
  • Rubella Antibody (HI Titer) — Measures rubella immunity using the HI (hemagglutination inhibition) method. An HI titer of 16 or below indicates insufficient immunity. If your titer is low, you should avoid crowded places during the first trimester, your partner and family members should be vaccinated, and you should receive the rubella vaccine after delivery. Rubella infection in early pregnancy can cause congenital rubella syndrome with heart defects, cataracts, and deafness.
  • Toxoplasmosis IgG — Tests for past exposure to toxoplasmosis, a parasite found in undercooked meat and cat feces. If IgG is negative (no past infection), you must take precautions to avoid first-time infection during pregnancy: cook meat thoroughly, wash vegetables well, wear gloves when gardening, and have someone else clean the cat litter box.
  • Cervical Cancer Screening (Pap Smear) — A Pap smear collects cells from the cervix to screen for cervical cancer and precancerous changes. This is a standard part of the first blood panel visit in Japan. The test is safe during pregnancy and does not affect the baby. If abnormalities are found, your doctor will discuss follow-up options.

Comment se préparer

  • Come fasting — do not eat anything from the night before. Water and plain tea are OK.
  • Bring your Mother and Child Health Handbook (母子手帳) and the prenatal checkup vouchers (受診票).
  • Wear short sleeves or a top with sleeves that roll up easily — multiple blood vials will be drawn.
  • Prepare a list of any medications, supplements, or herbal remedies you are taking.
  • If you have a family history of thyroid disease or diabetes, mention it to your doctor.

Conseils

  • This is the longest blood draw — typically 7-10 vials. Bring a snack and a drink for after the blood draw, especially since you will be fasting.
  • Results typically take 1-2 weeks. Your doctor will review everything at the next visit. If anything requires immediate attention, the clinic will contact you.
  • Ask your partner and family about their rubella vaccination status. In Japan, men born between 1962-1979 were not routinely vaccinated and may be at risk.
  • If you feel lightheaded during the blood draw, let the nurse know. Lying down or having your legs elevated can help prevent fainting.

Results Review

Visite 2 · Semaines 10–12

Review all blood test results, transvaginal ultrasound for CRL and heartbeat, check for uterine fibroids

Bon à savoir: This visit focuses on reviewing your first blood panel results and confirming the pregnancy is progressing well. The miscarriage risk drops to about 2-3% once a heartbeat is confirmed at 10-12 weeks. Note that NT scan and NIPT are NOT routine in Japan — they are available on an opt-in basis at specialized facilities (出生前検査認証施設), usually for women over 35 or with specific risk factors. If you are interested, discuss this with your doctor early.

Examens courants

  • Transvaginal Ultrasound (CRL Measurement) — The crown-rump length (CRL) is measured to confirm gestational age and refine your due date. CRL is the most accurate dating measurement when done between 8-13 weeks. The heartbeat is confirmed again, which is very reassuring — the miscarriage risk drops significantly after a heartbeat is confirmed at this stage.
  • Blood Test Results Review — Your doctor will go through all the results from the first blood panel — blood type, CBC, infections, rubella, HTLV-1, thyroid, glucose, and cervical cancer screening. Any abnormal results will be explained and a management plan discussed. This is an important visit to ask questions about any findings.
  • Uterine Fibroid Check — The ultrasound will also assess whether you have uterine fibroids and their location relative to the pregnancy. Most fibroids do not affect pregnancy, but large ones near the placental site or cervix may require monitoring. Fibroids can grow during pregnancy due to increased estrogen.

Comment se préparer

  • Fasting is not required for this visit.
  • Bring your Mother and Child Health Handbook (母子手帳) — the doctor will record findings.
  • Write down any questions about the blood test results you want to discuss.
  • If you are considering prenatal testing (NIPT/NT), prepare questions about your options.

Conseils

  • If the rubella result shows low immunity (HI ≤ 16), avoid crowded places in the first trimester and encourage your partner to get vaccinated. You can be vaccinated after delivery.
  • Morning sickness may peak around weeks 8-12. If you cannot keep food down, inform your doctor — severe cases (hyperemesis gravidarum) may need treatment.
  • This is a good time to discuss your workplace situation. In Japan, you are entitled to pregnancy-related leave and reduced working hours — ask your doctor for a 母性健康管理指導事項連絡カード if needed.

Switch to Abdominal Ultrasound

Visite 3 · Semaines 13–16

Switch from transvaginal to transabdominal ultrasound, first fetal biometry (BPD, FL, AC, EFW), 4D ultrasound widely offered in Japan

Bon à savoir: From this visit onward, the ultrasound switches to the abdominal approach, which is more comfortable than the transvaginal probe. You are now entering the second trimester — for most women, nausea begins to improve and energy returns. In Japan, 4D ultrasound is uniquely common and many parents enjoy the vivid images of their baby. This is also when many women begin to show and consider telling their workplace about the pregnancy.

Examens courants

  • Transabdominal Ultrasound with Fetal Biometry — Now that the fetus is large enough, the doctor switches to abdominal ultrasound. Key measurements include BPD (head diameter), FL (femur length), AC (abdominal circumference), and EFW (estimated fetal weight). These measurements track growth and help confirm gestational age. The doctor will also assess the placental position.
  • 4D Ultrasound — 4D ultrasound (real-time 3D) is widely offered in Japan and shows your baby's face and movements in real time. While not medically essential, many Japanese clinics include it as part of routine checkups. The best images are obtained between 13-28 weeks when there is enough amniotic fluid around the baby's face.
  • Fundal Height Measurement — Starting from around this visit, your doctor will measure the distance from the pubic bone to the top of the uterus (fundal height). This quick external measurement, combined with ultrasound, helps track fetal growth. A significant discrepancy may prompt additional evaluation.

Comment se préparer

  • Wear a two-piece outfit for easy access to your abdomen during the ultrasound.
  • A moderately full bladder can help with abdominal ultrasound image quality — drink some water before the visit.
  • Bring your Mother and Child Health Handbook and checkup vouchers.

Conseils

  • If your clinic offers 4D ultrasound, ask if they provide printed photos or digital images. Many Japanese clinics give these as keepsakes.
  • You may start feeling movement (quickening) between 16-20 weeks. First-time mothers usually notice it later than experienced mothers.
  • The second trimester is the most comfortable period for many women. Take advantage of this time to prepare your home and research childbirth classes (両親学級).

Routine Check

Visite 4 · Semaines 17–18

Routine checks with ultrasound, fetal biometry, quickening may begin

Bon à savoir: This is a relatively straightforward routine visit. Quickening (first fetal movements) may begin around weeks 16-20 — many women describe it as fluttering, bubbles, or light tapping. First-time mothers typically notice it closer to 18-20 weeks. The second trimester is generally the most comfortable period of pregnancy, with improved energy and reduced nausea.

Examens courants

  • Transabdominal Ultrasound — Routine ultrasound measuring fetal biometry (BPD, FL, AC, EFW) to track growth. The doctor will note the fetal position, placental location, and amniotic fluid level. The baby is now large enough that you may see detailed features like fingers, toes, and facial profile.
  • Blood Pressure, Weight, Urinalysis — Routine vital signs are checked at every visit. Blood pressure monitoring is important for early detection of pregnancy-induced hypertension. Weight gain is tracked to ensure healthy progression. Urinalysis screens for protein (preeclampsia marker) and glucose (gestational diabetes marker).

Comment se préparer

  • Continue wearing two-piece outfits for easy ultrasound access.
  • Bring your Mother and Child Health Handbook and checkup voucher.
  • Note any new symptoms to discuss with your doctor.

Conseils

  • If you have not yet told your workplace, now is a good time. In Japan, the Maternity Health Management Act (男女雇用機会均等法) protects pregnant workers from dismissal and entitles you to time off for checkups.
  • Start researching birthing options in your area. Japan offers hospital births, clinic births, and midwife-led birthing centers (助産院). Each has different philosophies and amenities.
  • This is a good time to sign up for prenatal classes (母親学級/両親学級) offered by your municipality or birth facility.

Mid-Pregnancy Anatomy Scan

Visite 5 · Semaines 19–20

Comprehensive systematic fetal anatomy screening — brain, heart, organs, spine, placenta, amniotic fluid. Japan uniquely performs both mid and late anatomy scans.

Bon à savoir: The mid-pregnancy anatomy scan is the most detailed and important ultrasound of your pregnancy. Japan is unique in performing TWO full anatomy scans — one at mid-pregnancy (19-20 weeks) and another in late pregnancy (27-28 weeks). This dual-scan approach catches anomalies that may not be visible early on. About 1 in 25 babies (4%) has some structural anomaly detected by ultrasound, but the majority are minor and treatable. If something is found, your doctor will explain the significance and next steps.

Examens courants

  • Detailed Fetal Anatomy Screening — A comprehensive systematic ultrasound examining all major fetal structures: brain ventricles and midline, face (checking for cleft lip), heart (four-chamber view and outflow tracts), lungs, stomach, kidneys, bladder, genitalia, all four limbs, spine, umbilical cord (three vessels), placenta position, and amniotic fluid volume. This scan typically takes 30-60 minutes and is performed by a specialist or experienced sonographer. About 1 in 25 babies has a structural anomaly, most of which are minor.
  • Fetal Heart Detailed Assessment — The fetal heart is examined in detail during the anatomy scan. The four-chamber view checks that both atria and ventricles are present and symmetrical. The outflow tracts (aorta and pulmonary artery) are evaluated to ensure they arise from the correct ventricles and are not transposed. Congenital heart defects are the most common structural birth defect, occurring in about 1 in 100 births.
  • Placenta and Amniotic Fluid Assessment — The placenta position is assessed — if it covers or is near the cervix (placenta previa), follow-up is needed as it may affect delivery planning. Amniotic fluid volume is measured; too much or too little warrants further investigation. The umbilical cord is checked for the normal three vessels (two arteries, one vein).

Comment se préparer

  • Eat normally before the scan — an active baby is easier to examine.
  • This scan may take 30-60 minutes — longer than a routine visit. Plan your schedule accordingly.
  • Decide in advance whether you want to know the baby's sex — the anatomy scan often reveals it.
  • Bring your partner if they want to see the detailed images of the baby.

Conseils

  • If the baby is in an awkward position, the sonographer may ask you to walk around and return. This is normal and does not mean something is wrong.
  • If a "soft marker" is found (e.g., bright spot on heart, choroid plexus cyst), do not panic. These are common and usually resolve on their own.
  • Ask for ultrasound photos or a USB recording if available — many Japanese clinics offer this service.
  • Japan's dual anatomy scan approach (mid + late) is more thorough than many countries. The second scan at 27-28 weeks will catch conditions that only become visible later.

Last Monthly Visit

Visite 6 · Semaines 21–23

Routine checks with ultrasound, last visit before biweekly schedule begins at week 24

Bon à savoir: This is the last visit on a monthly schedule. Starting from week 24, checkups increase to every two weeks. This is because the third trimester brings more potential complications that need closer monitoring — gestational diabetes, preeclampsia, preterm labor, and fetal growth issues. Take advantage of the longer interval to prepare questions and address any concerns.

Examens courants

  • Transabdominal Ultrasound — Routine growth ultrasound measuring fetal biometry. The baby is now about the size of a papaya and weighs around 500g. You may see the baby sucking its thumb, yawning, or moving actively during the scan.
  • Blood Pressure, Weight, Urinalysis — Continued routine monitoring. Weight gain in the second trimester should be steady (about 300-500g per week for normal BMI). Any protein in the urine or elevated blood pressure will be noted for follow-up.

Comment se préparer

  • Bring your Mother and Child Health Handbook and checkup voucher.
  • If you have started feeling regular fetal movements, note the pattern to discuss with your doctor.
  • List any questions about the upcoming more frequent visits.

Conseils

  • Starting from 24 weeks, visits become biweekly. Coordinate with your workplace early about the increased frequency.
  • This is a good time to start your birth preparation — tour the delivery facility, pack a basic hospital bag, and discuss your birth preferences with your partner.
  • If you plan to take maternity leave, now is a good time to start the paperwork. In Japan, maternity leave (産前産後休業) begins 6 weeks before the due date.

Glucose Screening + Cervical Length

Visite 7 · Semaines 24–26

50g Glucose Challenge Test (no fasting required), CBC recheck, transvaginal US for cervical length, biweekly visits begin

Bon à savoir: Japan uses a two-step glucose screening process: the 50g GCT does NOT require fasting (a key difference from some countries), making it more convenient. If the GCT is positive (≥140 mg/dL), a 75g OGTT is scheduled — that one does require fasting. The cervical length measurement is important for assessing preterm birth risk. A normal cervix at this stage is 3-4 cm long; less than 25 mm is a red flag. Biweekly visits begin now, reflecting the increased monitoring needed in the third trimester.

Examens courants

  • 50g Glucose Challenge Test (GCT) — Japan uses a two-step glucose screening process. First, you drink a 50g glucose solution (regardless of when you last ate — no fasting required). Your blood sugar is measured 1 hour later. If the result is 140 mg/dL or higher, a follow-up 75g oral glucose tolerance test (OGTT) is scheduled. This approach has fewer false positives than the one-step method used in some countries.
  • Complete Blood Count (CBC) — Anemia Recheck — A repeat CBC is done to check for anemia, which becomes more common as pregnancy progresses due to the expanding blood volume diluting red blood cells (physiological anemia of pregnancy). If hemoglobin is below 11 g/dL, iron supplementation will be started or increased.
  • Cervical Length Measurement (Transvaginal US) — A transvaginal ultrasound measures the length of the cervix. A normal cervical length is 3-4 cm. A short cervix (less than 25 mm) significantly increases the risk of preterm birth. If the cervix is short, your doctor may recommend activity restriction, progesterone supplementation, or in some cases a cervical cerclage.
  • ECG (at some facilities) — Some facilities perform an ECG (electrocardiogram) during mid-pregnancy to check for cardiac arrhythmias or other heart conditions that could complicate pregnancy or delivery. This is a quick, painless test and is not performed at all facilities.

Comment se préparer

  • No fasting required for the 50g GCT — eat normally before your appointment. This is a key advantage of Japan's two-step approach.
  • Expect to wait about 1 hour at the clinic after drinking the glucose solution — bring a book or entertainment.
  • Both abdominal and transvaginal ultrasound will be done at this visit — dress accordingly.
  • Bring your Mother and Child Health Handbook and checkup voucher.

Conseils

  • The glucose drink may taste very sweet and cause mild nausea. Sip slowly if needed, but finish it within the required time. Avoid walking around excessively during the 1-hour wait.
  • If your GCT comes back positive, do not panic — about 15-25% of women have a positive GCT, but only a fraction are diagnosed with gestational diabetes after the follow-up OGTT.
  • A cervical length of 25 mm or less warrants close monitoring but is manageable. Many women with a short cervix carry to full term with proper management.

Late Anatomy Scan

Visite 8 · Semaines 27–28

Second comprehensive fetal anatomy screening (Japan-unique), catches anomalies not visible earlier, heart structures clearer, breech check begins

Bon à savoir: Japan is unique among developed countries in performing two full anatomy scans. This second scan catches conditions that were either too subtle or not yet developed at 20 weeks. For example, ventriculomegaly (enlarged brain ventricles), certain heart defects, and bowel atresia often only become visible in the third trimester. The breech rate at 28 weeks (about 25%) drops naturally to about 3-4% by 37 weeks, so there is no need to worry about breech position at this stage.

Examens courants

  • Second Detailed Fetal Anatomy Screening — This is the same comprehensive scan as the mid-pregnancy screening, re-examining all major structures — brain, heart, organs, limbs, spine, and placenta. Some conditions only become apparent in late pregnancy: certain brain anomalies, bowel obstructions, and kidney problems may not have been visible at 20 weeks. The heart is now larger and structures are clearer, allowing more detailed cardiac assessment.
  • Fetal Position Check — Starting from this visit, the doctor will note whether the baby is head-down (cephalic) or breech. At 28 weeks, about 20-25% of babies are still breech, which is completely normal. Most will turn head-down on their own before 36 weeks. If the baby remains breech, options will be discussed later.

Comment se préparer

  • Eat normally before the scan. An active baby is easier to examine.
  • This scan may take 30-60 minutes — plan accordingly.
  • Bring your Mother and Child Health Handbook and checkup voucher.

Conseils

  • If the baby is breech at 28 weeks, do not worry — there is plenty of time for the baby to turn. Most breech babies turn naturally by 36 weeks.
  • As the baby grows, ultrasound images may show less detail because the baby fills more of the uterus. This is normal.
  • If any new findings emerge from this scan, your doctor will explain the significance and next steps clearly. Most findings are minor and manageable.

Biweekly Monitoring

Visite 9 · Semaines 29–32

Routine biweekly checks, fetal biometry, position check, birth plan discussion

Bon à savoir: As you enter the final stretch of pregnancy, routine monitoring becomes more important. The baby is gaining significant weight now — about 200g per week. Birth plan discussions typically begin around this time. In Japan, epidural (painless) delivery (無痛分娩) is available at some but not all facilities, so if you want it, confirm availability early. Breech babies at 32 weeks still have a good chance of turning on their own.

Examens courants

  • Transabdominal Ultrasound + Biometry — Growth measurements (BPD, FL, AC, EFW) continue to track fetal development. At 30-32 weeks, the estimated weight is typically 1,500-2,000g. The doctor will check amniotic fluid volume and note any growth acceleration or restriction.
  • Fetal Position Confirmation — The baby's position is checked at each visit. By 32 weeks, most babies have settled into the head-down position. If the baby is still breech, the doctor may discuss options such as exercises (逆子体操) or external cephalic version (ECV) closer to term.
  • Birth Plan Discussion — Your doctor will begin discussing your birth plan preferences — delivery method, pain management (epidural availability varies by facility in Japan), who will be in the delivery room, and what to do in various scenarios. In Japan, many facilities have specific protocols, so understanding their approach early is important.

Comment se préparer

  • Think about your birth plan preferences — delivery method, pain management, support person.
  • Bring your Mother and Child Health Handbook and checkup voucher.
  • If you have questions about epidural availability or cesarean section protocols at your facility, prepare them for this visit.

Conseils

  • Start paying attention to fetal movement patterns. While formal kick counting begins later, getting familiar with your baby's active times helps you notice changes.
  • If you plan on breastfeeding, start attending breastfeeding classes offered by your hospital or municipality.
  • Pack your hospital bag (入院バッグ) — delivery can happen unexpectedly. Most Japanese hospitals provide a detailed packing list.

Biweekly Monitoring

Visite 10 · Semaines 33–34

Routine checks, cervical length recheck if concerns, final breech assessment before delivery planning

Bon à savoir: This is the final breech assessment period before delivery planning solidifies. By 34 weeks, about 95% of babies are head-down. If your baby is still breech, your doctor will discuss options at the next visit. External cephalic version (ECV) — manually turning the baby from outside — has about a 50-60% success rate when done at 36-37 weeks. Some women try breech-turning exercises (逆子体操) or moxibustion (お灸) on specific acupuncture points, which are commonly suggested in Japan.

Examens courants

  • Transabdominal Ultrasound + Biometry — Growth monitoring continues. The baby now weighs approximately 2,000-2,500g. The doctor will assess fetal growth trajectory — is the baby growing along the expected curve, or is there acceleration (possibly indicating gestational diabetes) or restriction?
  • Cervical Length Recheck (if indicated) — If cervical length was short or borderline at the previous measurement, a repeat transvaginal ultrasound may be performed. Cervical shortening at this stage is monitored closely as it is a risk factor for preterm birth.
  • Fetal Position Confirmation — The baby's position is checked carefully at this stage. By 34 weeks, most babies are head-down. If the baby is still breech, the doctor will discuss delivery planning — options may include external cephalic version (ECV) at 36-37 weeks or planned cesarean section.

Comment se préparer

  • Bring your Mother and Child Health Handbook and checkup voucher.
  • If your baby is breech, ask about options and what you can do at home.
  • Prepare questions about delivery — what happens if you go into labor early, when to come to the hospital, emergency contacts.

Conseils

  • If your baby is breech, ask about 逆子体操 (breech-turning exercises). These involve specific positions like being on all fours with your chest down, done for 10-15 minutes daily.
  • Make sure your hospital bag is packed and ready. Include your Mother and Child Health Handbook, insurance card, checkup vouchers, and your birth plan.
  • Practice counting fetal movements. After a meal, count how long it takes to feel 10 movements — it should take less than 2 hours. Contact your doctor if movements decrease suddenly.

Late Blood Tests + GBS

Visite 11 · Semaines 35–36

Blood type recheck for transfusion preparedness, irregular antibody rescreening, CBC, GBS vaginal/anal culture

Bon à savoir: This visit combines important late-pregnancy blood work with GBS screening. The blood type recheck is a Japan-specific safety practice for transfusion preparedness during delivery. GBS is found in 15-30% of women as normal flora — being GBS-positive does not mean you are sick or that anything is wrong. It simply means you will receive IV antibiotics during labor (typically penicillin) to prevent the bacteria from passing to your baby during delivery. This simple intervention reduces neonatal GBS infection risk by over 80%.

Examens courants

  • Blood Type Recheck (ABO + Rh) — Your blood type is rechecked in late pregnancy as a safety measure for potential emergency transfusions during delivery. This double-check ensures no clerical errors from the first test and confirms the correct blood products will be available if needed.
  • Irregular Antibody Rescreening — A repeat screening for irregular antibodies that may have developed during pregnancy. New antibodies can sometimes form, especially in Rh-negative women. This test ensures the safety of any blood transfusion needed during delivery.
  • Complete Blood Count (CBC) — Anemia Check — Late-pregnancy anemia check. Hemoglobin levels naturally drop in the third trimester but should remain above 10-11 g/dL. If anemia is detected, iron therapy will be optimized before delivery, as adequate iron stores are important for the blood loss that occurs during birth.
  • GBS Culture (Vaginal + Anal Swab) — A combined vaginal and anal swab is taken to test for Group B Streptococcus (GBS), following JSOG guidelines at 35-37 weeks. GBS is a normal bacterium found in 15-30% of healthy women and usually causes no symptoms. However, it can be transmitted to the baby during delivery, potentially causing serious neonatal infections. If positive, you will receive IV antibiotics during labor to protect the baby.

Comment se préparer

  • Fasting is not required for this visit.
  • The GBS swab is a quick vaginal and anal swab — it takes only a few seconds and is usually painless.
  • Bring your Mother and Child Health Handbook and checkup voucher.
  • Have your hospital bag ready — from this point on, delivery could happen at any time.

Conseils

  • If you test GBS-positive, you do not need to worry about your daily life. The only implication is receiving IV antibiotics during labor, which is a routine and very effective intervention.
  • Confirm your hospital's check-in procedures — when to call, what entrance to use at night, and what to bring.
  • Review the signs of labor with your doctor: regular contractions (陣痛), water breaking (破水), and bloody show (おしるし).

Weekly Visits Begin (Full Term)

Visite 12 · Semaine 37

Full term begins at week 37, NST (Non-Stress Test) starts, internal cervical examination with Bishop Score, weekly monitoring

Bon à savoir: Congratulations — you have reached full term (正期産) at week 37! From now on, the baby can be safely born at any time. Weekly visits with NST monitoring begin, providing regular reassurance that the baby is doing well. The internal cervical exam may feel uncomfortable, but it provides valuable information about how ready your body is for labor. A Bishop Score of 6 or higher suggests labor could begin naturally soon. If you are past 40 weeks, induction may be discussed.

Examens courants

  • Non-Stress Test (NST) — The Non-Stress Test monitors the fetal heart rate pattern over 20-40 minutes using a belt monitor on your abdomen. A "reactive" (normal) NST shows at least 2 heart rate accelerations (15+ beats above baseline for 15+ seconds) within 20 minutes, indicating a healthy, well-oxygenated baby. The test also detects any uterine contractions.
  • Internal Cervical Examination (Bishop Score) — The doctor performs an internal examination to assess cervical readiness for labor using the Bishop Score, which evaluates five factors: dilation (how open), effacement (how thin), station (baby's position relative to the pelvis), consistency (soft vs firm), and position (anterior vs posterior). A Bishop Score of 6 or higher indicates a cervix that is favorable for labor.
  • Ultrasound (Position, Fluid, Weight) — An ultrasound confirms the baby's position (should be head-down), measures amniotic fluid volume (AFI or deepest pocket), and estimates fetal weight. At 37 weeks, the average weight is about 2,800-3,000g. The doctor will also check the placental grading and ensure everything is on track for delivery.

Comment se préparer

  • Have your hospital bag packed and ready to go at all times.
  • NST takes 20-40 minutes — bring something to read or listen to while you wait.
  • Eat a snack before the NST — a slightly active baby gives better readings.
  • Bring your Mother and Child Health Handbook and checkup voucher.

Conseils

  • If the NST is "non-reactive" (no accelerations), it does not necessarily mean there is a problem — the baby may just be sleeping. Your doctor will likely have you drink cold water or gently stimulate the baby and repeat the test.
  • Know the signs that mean you should go to the hospital immediately: regular contractions 5-10 minutes apart, water breaking (clear or pinkish fluid gushing or trickling), heavy bleeding, or sudden decrease in fetal movements.
  • The internal exam is brief but may cause slight spotting afterward — this is normal and not a sign of labor.

Final Weekly Monitoring

Visite 13 · Semaines 38–40

Weekly NST, internal exam (Bishop Score), ultrasound (weight, AFI, placental grading), labor signs discussion, induction discussion if past 40 weeks

Bon à savoir: You are in the final stretch! The average pregnancy in Japan lasts 39 weeks 5 days. If you pass 40 weeks without going into labor naturally, your doctor will discuss induction options. In Japan, most doctors prefer to induce by 41-42 weeks to avoid the increased risks of post-term pregnancy (decreased amniotic fluid, placental aging, larger baby). Remember: your due date is an estimate — only about 5% of babies arrive exactly on their due date. The range of 37-42 weeks is considered normal.

Examens courants

  • Non-Stress Test (NST) — Weekly NST continues to monitor the baby's well-being. As you get closer to your due date, the doctor will pay close attention to the heart rate patterns and any signs of fetal distress. A consistently reactive NST is very reassuring.
  • Internal Exam (Bishop Score) — The cervical exam is repeated weekly to track progress. As labor approaches, the cervix gradually dilates, effaces (thins), softens, and moves to an anterior position. Progress can be slow or sudden — some women walk around 2-3 cm dilated for weeks before labor, while others go from closed to active labor rapidly.
  • Ultrasound (Weight, AFI, Placental Grading) — The ultrasound checks estimated fetal weight (typically 3,000-3,500g at 39-40 weeks), amniotic fluid index (AFI), and placental maturity grading. Decreasing amniotic fluid or an aging placenta (grade III) may be reasons to discuss induction. The average Japanese newborn weighs about 3,000g.
  • Labor Signs Review — Your doctor will review the signs of labor: bloody show (おしるし) — pinkish or brownish mucus discharge; water breaking (破水) — a gush or trickle of clear fluid; and regular contractions (陣痛) — tightening that comes and goes at regular intervals and gets progressively stronger and closer together.

Comment se préparer

  • Keep your hospital bag, Mother and Child Health Handbook, insurance card, and birth plan ready at all times.
  • Know your hospital's contact number by heart and save it on your phone.
  • Have a plan for getting to the hospital — whether by car, taxi, or ambulance. Know the nighttime entrance.
  • If you have older children, finalize childcare arrangements for when you go into labor.

Conseils

  • Walking, gentle exercise, and staying active can help encourage labor. Many Japanese doctors recommend walks and stair climbing in the final weeks.
  • Bloody show (おしるし) means labor is approaching but may still be hours or days away. Water breaking (破水) means go to the hospital — call your doctor first.
  • If contractions are regular (every 5-10 minutes for first-time mothers, every 10-15 minutes for experienced mothers) and getting stronger, it is time to head to the hospital.
  • Remember: the baby will come when they are ready. Try to rest, eat well, and stay calm in these final days. You have prepared well!

Sources

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