2022 年 12 巻 p. 37-48
The Indian migrants in Japan as of December 2020 comprised a population of 38,558 people, with women making up around 30% of this number. Many Indian women migrate to Japan with their husbands who have accepted job opportunities there, and some arrive as newlywed wives of Indian men already established and working in Japan. These married women are often expected or choose to begin childbearing in the early years of their marriages or of their migration to Japan. Their reproductive health care journey can be an enormous challenge as they deal with social and cultural differences in a new country. Through qualitative interviews with Indian women who have lived in Japan for five or more years, this article explores the reproductive health care experiences of Indian women migrants during pregnancy and at the time of birth and reflects on the challenges these women face.
The population of Indians living in Japan has gradually increased over the years, particularly with an influx of Indian professionals to Japan in the 21st century, mostly to Tokyo. Many Indian men move with their wives, but some migrate as bachelors and later marry women from India (Wadhwa 2021). For most Indian women, the reason behind migration differs: most move to Japan as 'trailing spouses' (Yeoh and Khoo 1998; also cited in Wadhwa 2021), with the women arriving as dependents of their husbands. Women who take advantage of professional opportunities in Japan are also followed by their husbands, but these are rare cases.1
Many immigrants expect to have more health and medical service options in Japan than in their country of origin (Tanaka 2020), and Indians are no different. Before moving to Japan, most of these Indian women do not have any information about the medical facilities in Japan, and what’s more, many Indian women have minimal knowledge about their own reproductive health. This article will highlight the overall experiences of getting pregnant and giving birth in Japan. Some women who give birth in Japan, despite challenges, shared positive experiences, whereas others reflected on the challenges that forced them to temporarily return to India to give birth. Through the narratives of these women, this paper reflects on their journey to becoming mothers as new migrants, on the obstacles they face and the kind of support they receive to overcome those challenges. Bharadwaj (2016) investigates the relationship of patients with clinicians in India and presents an account of how wider ‘cultural issues’ are sometimes addressed in these clinical settings.2 This paper further looks into reproductive health care experiences of these Indian migrant women in a socio-cultural context by reflecting on their relationship with the clinicians in their home country and their host country, and how it shapes their overall migrant life in Japan.
Of the total Indian population in Japan, Indian female migrants make up only 30 percent.3 A total of 17 (see Table 1 for details) respondents married to Indian men were interviewed for this research paper. The respondents had been living in Japan for 5-15 years. They came from different parts of India, but all of them were from metropolitan cities in their respective states. As per the Indian standard, they belonged to the middle or upper-middle classes, and if/when they were in India, they accessed well-equipped hospitals and other quality medical facilities. In particular, I contacted women who moved to Japan soon after marriage or in the early years of their marriages and those who gave birth in Japan. Some women intended to give birth in Japan, but they returned to India for one to two years because of challenges they met in Japan. Also, giving birth in Japan is becoming popular amongst members of the Indian community, although in the past, and even at the time of this research most women preferred returning to India for childbirth. Some women choose to give birth in Japan to avoid temporary separation from their husbands.
The minimum education of all the respondents was a Bachelor’s degree from India. A few, particularly those in the teaching profession, held additional Bachelor's degrees in education. Some had earned a Master’s degree. Married Indian women migrants in Tokyo work in various job categories (Wadhwa 2021:170). The most common category of Indian women workers is homemakers looking after their children and attending to household chores. The second category is teachers. Some worked at Indian schools and others at English conversational schools, popularly known as eikaiwa in Japan, or as Assistant Language Teachers (ALT) in public schools. Some of these women earned additional Bachelor's degrees in education to get a teaching position in Japan. The popularity among Indian women of the teaching profession in Indian schools or as English teachers derives from various reasons – for example, lack of opportunities in the corporate world due to limited Japanese language skills and the long working hours customary in Japanese professional life. Depending on their personal choices and circumstances4, some women choose to work in the corporate world or do full time-jobs. Some also work part-time in factories (packaging industries), as tutors, or in family businesses to help their husbands. Indian women may also work in small-scale businesses from the convenience of their homes, such as catering services offering homemade Indian food, Indian sweets, and eggless cakes, or in beauty salons providing services such as hair removal with wax, threading, facials, spas, and hair care.
| Serial Number | Names | Age | Region in India | Number of years in Japan | Profession (in Japan) |
Number of children (Place of birth) |
| 1 | Asha | 35-40 | Punjab | 15-20 years | Teacher | 1 (Japan) |
| 2 | Babita | 30-35 | Jaipur | 10-15 years | Homemaker | 1 (India) |
| 3 | Chaavi | 35-40 | Punjab | 15-20 years | Teacher | 2 (Japan) |
| 4 | Dipa | 30-35 | Delhi | 10-15 years | Homemaker | 2 (Japan) |
| 5 | Esha | 40-45 | Punjab | 10-15 years | Part-time | 2 (Japan) |
| 6 | Falguni | 30-35 | Bihar | 5-10 years | Homemaker | 2 (Japan) |
| 7 | Garima | 40-45 | Punjab | 5-10 years | Professional | 2 (India) |
| 8 | Hema | 30-35 | Delhi | 10-15 years | Homemaker | 2 (Japan) |
| 9 | Ishita | 40-45 | Punjab | 5-10 years | Homemaker | 1 (India) |
| 10 | Jaanvi | 35-40 | Punjab | 5-10 years | Homemaker | 2 (Japan) |
| 11 | Kajol | 40-45 | Jaipur | 15-20 years | Homemaker | 2 (India) |
| 12 | Lalita | 35-40 | Pune | 15-20 years | Homemaker | 2 (India) |
| 13 | Maira | 35-40 | Mumbai | 10-15 years | Self-employed | 2 (India) |
| 14 | Nisha | 25-30 | Jharkhand | 5-10 years | Homemaker | 1 (India) |
| 15 | Omisha | 30-35 | Punjab | 10-15 years | Part-time | 3 (Japan) |
| 16 | Palak | 35-40 | Tamil Naidu | 5-10 years | Professional | 1 (Japan) |
| 17 | Quincy | 30-35 | Kerela | 5-10 years | Professional | 1 (Japan) |
Notes: The data was collected in the years 2019-2020. Also, it is important to note that even though the place of birth for the majority of the children is Japan (Greater Tokyo Area), even now, it is still popular for women to give birth in India (Wadhwa 2021). Since the paper focuses on experiences within Japan, it was a conscious choice to interview those who gave birth in Japan or wanted to give birth in Japan but due to circumstances had to go to India. Greater Tokyo area includes Tokyo metropolis, and the prefectures of Chiba, Gunma, Ibaraki, Kanagawa, Saitama, and Tochigi, as well as the prefecture of Yamanashi in the neighboring Chubu region. The majority of the respondents were from Tokyo, but three lived in Tokyo during their initial years and then moved to different regions. One of them at the time of interview was in Gunma, the other two in Ibaraki.
The women interviewed all belonged to one of the aforementioned professional categories. These women, unlike their counterparts living in India, did not have support from full-time or part-time helpers. Some did hire cleaning or cooking services after having their children5. A lucky few had their mothers-in-law, mothers or both visit them in turns for three months near the time of delivery or after, whereas some had to manage everything on their own as their parents could not come to Japan because of their health, visa restrictions, or other personal issues. Most of the women at the time of the interview had gained basic Japanese language skills picked up over the years living in the country. Moreover, a few opted for formal training and achieved intermediate or native level.
I conducted qualitative interviews with the respondents over a period of 18 months from 2019 to 2021. I met most of these women during five years of extensive fieldwork (2013-2018) for my book on Indian migrants in Tokyo (Wadhwa 2021). Additionally, I made new acquaintances through Indian community events. During our interviews, I briefly introduced the women to my ongoing research project about Indian migrant women’s reproductive healthcare in Japan and had general conversations about their childbirth experiences. Based on these conversations, I whittled down the respondents to those who gave birth in Japan and those who wanted to but could not. The reason to include the latter group was mainly to include reflections on the challenges these women faced that led them to change their minds. I conducted in-person, phone and Zoom interviews (with video), and with some I had follow-up interviews. Most of the initial interviews lasted between one to two hours; follow-up interviews usually lasted thirty minutes to one hour. Some respondents also sent me voice notes or messages on WhatsApp with further information about their experiences that they thought would help my research. These notes at times led to other rounds of follow-up interviews. Two of the interviews were originally audio-recorded, and then for a different project, the same women again talked about their journey of becoming a mother in Japan and were recorded on video for the documentary Finding their niche: Unheard stories of migrant women (Wadhwa 2022). All the names given to the respondents in this paper are pseudonyms.
The women spoke openly about their experiences. Some of them were initially hesitant to talk about their challenges fearing that it would reflect negatively on Japan, which was not how they necessarily felt about their second home. However, by guaranteeing to protect their identities and explaining the importance of their contribution, the women gradually began to speak freely. They referred to their experiences as challenges they faced as migrants and not necessarily something that made them feel negatively about their life in Japan.
“When will you have a baby?”
“Do not delay; your biological clock is ticking.”
“If you delay, you will have trouble having a baby.”
These statements dog Indian women after marriage. They might hope to escape these awkward questions once they move to and begin living in a foreign country, but for my respondents, that was not the case. This type of advice often came up during the phone calls with their in-laws and relatives or during visits back to India. In some instances, even within the Indian migrant community in Japan, they would meet women who would ask these same types of questions.
Another set of statements often came after their first baby was born:
“Won’t you have a second baby?”
“Two babies are important; a child needs a brother or a sister.”
“In a foreign country, a single child will get lonely. The second baby is important.”
Among my respondents were married couples who lived in India and married there, then moved to Japan in the early months or years of their marriage. Some women moved to Japan soon after their marriages to husbands who already resided in Japan. Still other women had to stay back with their in-laws for a few years before they could finally join their husbands in Japan. This could be due to a lack of support from the husband’s company, which may be reluctant to sponsor a visa for their employee’s dependent wife, or due to expectations on the part of the in-laws that the newly wed bride would stay with them to learn the family ways and traditions. Almost all the women interviewed moved to Japan on dependent visas. One of the respondents moved to Japan as a single woman on a scholarship as a student and found a job in Japan and received a working visa. She then met her husband in Japan.
Some of the women interviewed for this paper did not give in to pressure to have children early and decided to wait a couple of years after moving to Japan before planning a family. Some of them succeeded, and things went as per their plans, whereas a few had accidental pregnancies earlier than intended. Some experienced multiple miscarriages that delayed their plans. A few had a change of heart and after feeling settled in Japan, they decided to try for a child after six months or so instead of the original plan of one to two years. This change often occurred because their career in Japan did not go as expected.
As Chaavi narrated:
“My original plan was to wait for two years. My in-laws wanted me to have my first child quickly, as they feared that a delay in planning and taking contraceptive pills for birth control could lead to complications. My friends suggested that I settle in my new environment and with my husband before planning for a kid. I was hoping that after moving to Japan, I would find a suitable job just like the one I had in India. But I could not. And so, I decided to give in, and we started planning for a baby after six months.”
Failure to find a suitable career in Japan often made these women feel that having a child would be a logical choice for them, as was also suggested by the older adults in their families back home. Furthermore, delays naturally happened in some cases due to difficulties in conceiving. Whereas some preferred to use their early time in Japan to explore the country with their husbands as an extended honeymoon period, sooner or later they embarked on their journey towards planning a family.
In some cases, the health of female migrants improves due to integration into better health systems in their host societies, but more often, the health of female migrants is affected negatively (Adanu and Johnson 2009). There are discussions about the ‘healthy migrant effect’ and the ‘exhausted migrant effect’ (Bollini and Siem 1995). The former refers to recently arrived migrants having better health in comparison to non-migrants, and the latter reflects the health situation reversed over the duration of stay (Bollini and Siem 1995; also cited in Czapka and Sagbakken 2016). The deterioration in migrants’ health often results from stress over issues such as communication difficulties, new environments and culture (Weishaar 2008; Czapka and Sagbakken 2016).
The Japanese health and welfare system is often wins praise not only from Japanese citizens but also by foreigners in general, despite the language barriers. However, when it comes to pregnancy, it can be confusing – starting from their first consultation to booking a hospital for delivery – and much gets lost in translation. During the initial years of their migration, which also coincided with the time they planned for childbirth, most of these women didn’t have conversational Japanese language skills. At the same time, the doctors and other staff at the hospitals had limited English language skills. Additionally, a lack of translation services at the institutional level exists in Japan. If the confusion is resolved through the help of a Japanese-speaking friend (often another Indian migrant) or in some cases by their husbands, and if the pregnancy goes smoothly, a woman can have a ‘hotel-like’ experience during childbirth in Japan.
This section draws on the respondents’ narratives to articulate the experience of giving birth in Japan. It focuses on the challenges as well as the support network within their own Indian community that helps mitigate the obstacles.
5.1 Making the decision, seeking supportEsha, 40 years old at the time of the interview, described the early stages of conceiving a child and determining her pregnancy with the help of another migrant family:
“I wanted to experience childbirth abroad and for my child(ren)’s visa it would have been an easier thing to do than processing it in India after birth. In the beginning, I was happy to be with my husband, but a few weeks later, I started feeling alone. I had no prior experience. I only knew one Indian family here, and I visited them almost every week. She had two children at the time. When I missed my periods, I told her, and she took me to the pharmacy and told me about the pregnancy test. I did the test, and I was positive. Then, with her support, I went to see a doctor, and until my baby was born, she accompanied me to the doctor on all my visits because I did not know the language or the whole procedure. She even took me to the city office to do all the formalities after my pregnancy was confirmed.”
Esha comes from Punjab. She had to wait nearly two and half years to join her husband in Japan in 2007. At the time of their marriage, Esha’s husband worked as a plumber for a Japanese employer, and by the time of the interview, he ran his own plumbing business. Esha conceived their first child at the age of 28, a few months after moving to Japan.
When we first had a conversation about her pregnancy, she spoke in a bit of a hesitant tone. Eventually she opened up and confessed that even though she wanted a baby, she had no prior knowledge of the process, neither from a general medical, gynecological perspective, nor in the specific context of medical services and procedures in Japan. If it were not for her Indian friend, she would have had no idea where to go or what to do.
Another woman, Asha, shared her experience:
“I was excited that I was moving to Japan (in 2005) to be with my husband. I was new in Japan and just knew a few people through my husband. I was trying for a baby but was not successful. In 2006, I went to see a doctor many times for checkups. He recommended hormonal injections to me and mentioned there can be side effects. I was scared and then didn’t go back. Then, later in 2007, a friend recommended me a doctor and I went to the clinic for a check-up and was told to get hormonal injections.”
Also from Punjab, Asha, 39 years old at the time of the interview, had her first child around the age of 28. She moved to Japan in 2005 after spending the first two years of marriage with her in-laws in India. Her husband was then the owner of an Indian restaurant in Tokyo.
Esha and Asha went through similar situations. They had to wait in India for a couple of years before finally joining their husbands. While for Esha conceiving happened naturally, for Asha, she had to undergo treatment. In both the cases, as new migrants, support came from the acquaintances they made within the Indian community through their husbands’ contacts. These acquaintances had experience either getting pregnant or giving birth, sometimes both, in Japan. They not only helped these two women understand the medical processes in Japan but also gave them support and guidance that they would ordinarily find in their families back home but couldn’t access in the same way abroad.
Indian women living in India are often surrounded by many older adults such as their mothers, mothers-in-law, aunts and other relatives. In normal circumstances, these elder women make up the most significant source of support at the time of pregnancy. Once women are pregnant, elderly women of the house take charge, and the pregnant women are well taken care of. The involvement of men of the house, including husbands, in the past and even today in prenatal health, is limited. As linguistic and cultural barriers do not pose an issue in India, women can also have open discussions with the doctors.
Whereas in Japan “language and cultural differences can negatively impact immigrant women’s birth experience” (Igarashi, Horiuchi and Porter 2013), the support from within their community was something that often came to their rescue. As Hagan (1998) mentions, “Community with mature networks provide newcomers with emotional and cultural support and various other resources, …”
At the time – that is, in the 2000s – the Indian community in Tokyo was smaller than it was to become in the late 2010s and early 2020s6, support amongst the respondents invariably either came through their husbands’ connections with Indians at work or in the community, or at Indian gatherings, events, religious sites like temples, or even Indian restaurants. These women were able to make friends one way or another who ended up being their sources of support throughout their full term of pregnancy.
For some women, like Falguni, things did not happen as planned. After marriage, she moved with her husband to Japan with high expectations for her career. They lived in the state of Maharashtra and both worked before moving to Japan. A few months after their marriage, Falguni’s husband’s company offered him a transfer to Japan. She quit her job but hoped to find another in Japan. However, due to a lack of native-level language skills, she could not find a position and so decided to start planning a family.
“We moved to Japan a couple of months after marriage. Initially, I planned to wait a couple of years, settle in a new country, and find a suitable job. However, when I could not find a job, I thought I should plan a family and at least get free from that aspect of life, and on the other hand, I could also learn the language and maybe in future I would find a job."
In Falguni’s case she was lucky to find an English-speaking doctor7, and her husband went to all the appointments at the hospital with her. There were two scenarios Indian migrant women encountered in the pursuit of pregnancy. First, like in the case of Esha and Asha as new migrants, they could meet a helpful acquaintance who would become their close friend in the longer term. This person would offer them support and advice and lend their basic language skills to help the women sail through their childbirth journey. In such cases, the husbands (despite in some cases knowing the language) could not offer support because of their busy jobs with less supportive work environments. In the second scenario, like Falguni’s, husbands would make time to accompany their wives to medical appointments. Falguni's husband worked in a multinational company and in an international environment. He was also in a senior position and had a supportive boss above him. The overall work culture in Japan involves long working hours, and whether in a professional Japanese or international setting, or even self-employed, it can be hard for the husband to take time for doctor’s appointments on a regular basis. In such situations, having a friend in the community plays a vital role for these migrant women.
5.2 ChallengesFor Esha, her first pregnancy went very smoothly, but complications arose during her second pregnancy. She had her second child five years after her first, at the age of 33. During both pregnancy terms she had eating issues. However, by the time she was pregnant with her second child, she had made more connections in the Indian community.
“My second child was premature. I was taken to hospital in my 5th month as I had started sudden bleeding. At the time, my husband was in India because his father was in ICU, and he had to leave in an emergency. I was alone with my five-year-old son. Nevertheless, one of my friends came immediately, called the ambulance, and took me to the hospital. Moreover, another friend took my son and looked after him for ten days. Then, my husband was back, and my mother-in-law also joined later and looked after my son.”
Esha had to stay in the hospital for two months. In her seventh month of her term her daughter was born, but she was premature.
“The baby stayed in the hospital and completed nine months. But I was sent home. I was admitted in the hospital that was two hours by train from my house. I was weak and couldn’t go to meet my daughter every day. I had to go to give my breast milk. The doctors were worried about me traveling two hours, so they moved the baby to a hospital closer to my house where I used to go for check-ups before I got admitted, which was only 15 minutes away.”
The mother-in-law could not stay longer than three months due to visa issues. While her presence offered support in looking after Esha’s son and husband while she was in the hospital, when her mother-in-law left, Esha was on her own again. The only support she had was her friends in the community. In terms of her treatment from a medical perspective, she felt satisfied with the doctors, but emotionally she felt lonely.
“At the hospital, they taught me to feed the baby. My second child was kept in intensive care because she was premature, so for two months, they asked me to visit as much as possible so that the baby could recognize my smell and get better sooner. I am not sure if in India they would have offered the medical support of this level but emotionally, I would have done better in India.”
She further added,
“The doctors were supportive, facilities were great, but communication was an issue. Also, the doctors were expecting me to decide to keep the baby or abort. And I was not in a state to decide, and my husband was not here with me. At first, I decided to abort the baby, but then my friends in the community said that I should continue, and that gave me confidence. If it was not for the support I got from my Indian friends, both pregnancies could have been very challenging despite the good medical facilities in Japan.”
Anderson (1985) argued in his paper that health professionals who provide primary contact with the health care system do not always grasp the circumstances of women’s lives and seem unable to bridge the chasm between themselves and women. Women’s childbirth experiences are influenced by their culture (Greene 2007; also cited in Igarashi, Horiguchi and Poter 2013). In the case of these Indian migrants who decided to give birth in Japan, they could not build a level of warmth in their conversations with their respective care providers despite being thankful for the services they received. The lack of Japanese language skills and extremely limited use of English at medical facilities further made communication difficult. In addition, many felt that their relationships with the doctors in Japan were very professional, unlike in India where they felt warmth in conversations with their doctor.
Communication was similarly an issue in the case of Asha. A doctor initially recommended her hormonal injections during her first visit in 2006. She felt scared because she was not able to understand the doctor well, but when her Indian friend recommended a doctor, she agreed to start the treatment again.
“On my first visit when the doctor told me that I would have side effects, I was not able to understand the science behind it because of the language gap. There was so much delay and issues in conceiving, and I was not willing to discuss this with anyone in India. I was desperate to get pregnant and I agreed to get the injection from the doctor my friend recommended. I got pregnant with twins, but one child's heartbeat stopped a few months later. I was worried even though the doctor told me not to worry. My daughter was born safely, and I was satisfied with the overall treatment, but I do think from an emotional perspective it would have been easier for me to have a birth in India with family support.”
Most women who gave birth in Japan were satisfied with the medical facilities and the training they received in how to look after their baby. Everything was very systematic, and despite the communication gap, they seemed to have managed the process of giving birth in Japan. However, – and especially among those whose parents could not visit them soon after childbirth – they felt that giving birth in India would have given them the advantage of having comfortable and heart-to-heart communication with doctors and support from their family. The most common expression amongst my respondents was:
“In India half of the problems are solved just by talking to the doctor. That is not possible here. In India the doctor would tell us what to do. Here the doctor will ask us, give us choices and want us to decide.”
Although the women faced language barriers and a lack of emotional connection to their doctors, they admitted to an advantage of a good medical system and polite doctors and nurses. Even so, the Indian women I spoke to felt at times hesitant with foreign doctors. They felt a stark difference in comparison to their relationship with their doctors in India. In India, doctors commonly dictate the decisions for patients, which is also seen negatively in some situations as a “money-making” tactic. In Japan, doctors lay out all the pros and cons, the different possibilities for a patient and give them a choice to decide for themselves. In these circumstances, Indian women often felt more pressure, especially in situations when they found themselves incapable of making the decision. For some women, considering these factors, giving childbirth in India seemed a better and safer choice.
As also reflected in a paper on Nepalese migrants in Japan (Shakya et al. 2018), the lack of Japanese language skills contributed to poor access to health care among migrants. Women often felt they needed an interpreter during visits to health facilities in Japan. Differences in language between health care professionals and patients act as barriers to health care access (Yeo 2004)8. Miscommunications can lead to inefficient use of health services (Kravitz et al 2000; David and Rhee 1998)9. Bharadwaj (2016: 214-242) gives an in-depth observation of the encounters between patients, clinicians and staff in India. He emphasizes the efforts made by the staff to develop an informal relationship with the patients through friendly talk to act as a bridge between the doctor and the patient. He further reflects on the humorous nature of the doctors with their patients to put them at ease and lighten the atmosphere. This aspect was missed by the Indian women, especially at the time when they also missed family support the most. To overcome miscommunication and for emotional support, some chose India over Japan for childbirth.
5.3 Choosing India“I had two miscarriages in Japan and one failed IVF. At the time, I was not only new in Japan but also young. After my miscarriage, I stayed at a friend’s place because I wanted some support and care and my husband was busy at work and could not take days off. Indian people don’t consider IVF good, but I could not hide it.
I wish the doctor in Japan had given me some instructions on how to look after myself during IVF treatments and miscarriages. I cannot stay at someone’s house after a certain point. Eventually I gave up and went to India for my treatment, but at the cost of staying away from my husband for almost a year. The treatment in India is cheaper than Japan, and the doctors make you feel like they want you to get pregnant as much as you do. They do everything for the patient’s success. I didn’t see that in Japan.”
This is the story of 32-year-old Babita, who moved to Japan after almost two years of marriage to live with her husband, who resided in Japan. Her husband worked as a salesperson under an Indian trader in Japan and later changed jobs to work in an international set-up as a recruiter. Babita was 24 years old when she moved to Japan, and at the age of 28 she had her first miscarriage. The whole experience took a toll on her, both physically and mentally. She had the support of her Indian friend in Japan, but constant failures to conceive led her back to India where she finally got pregnant, had a baby girl, then moved back to Japan to be with her husband. Currently she is considering having her second child and deciding between Japan or India for childbirth.
Another person (cited in Wadhwa 2021:56) mentioned a friend who had a miscarriage due to miscommunication and decided to go back to India permanently with her husband. A few others found the whole system of getting their appointments at the doctor and reserving a bed for their delivery at a hospital so complicated that they decided to give birth in India for the convenience of familiarity, family support, and comfort. As also mentioned in ‘Indian Migrants in Tokyo’ (Wadhwa 2021), the women usually went back after her fifth month and before her seventh month of pregnancy. Husbands accompany them to India and come back to Japan, then later return to India at the time of the delivery.
This paper discusses scenarios in which Indian migrant women move to Japan and make the decision to start planning a family, hoping to experience childbirth in Japan. Their major struggle revolves around communication, and even though a cliché, language discrepancies created a gap and at times an emotional disconnect between them and their healthcare providers. As Waitzkin (1991) mentions [also cited in Bharadwaj 2016], in approaching a physician for help, a patient brings not only a physical problem but also a social context. Unlike in their home country, these women didn’t see the healthcare professionals as someone they could look to for emotional solutions. These perceptions result from the different experiences they have had in their home countries. In the beginning, they feel a social isolation as a new migrant and their healthcare experiences further contribute to that perception. That in turn leads them to look to women in their community for support. The husbands offered support but at times had limitations due to their work pressure. In a foreign context, too, the role of women, like in their home country, becomes an important factor for a pregnant woman both during pregnancy and after birth.
Several Indian women appreciate the support and training for new parents they get from the hospitals and often refer to it as “hotel-like treatment” during delivery, but there are also irritants, namely the communication and cultural differences, because of which many still go back to India to give birth, resulting in a temporary separation from their husbands. There was hope, especially amongst new migrants, that their host country would come up with support to bridge this language and cultural gap.
This research is a part of the KAKENHI (18KK0030) research project - Migrant women and SDGs: Access to sexual/ reproductive health in Japan. The author was a co-investigator and her research focused on ‘Reproductive health of Indian migrant women in Japan’.
1 In recent years, single women have also moved to Japan, but most of these single women eventually leave unless they can find a potential partner within Japan or someone who would move to Japan for them.
2 Bharadwaj (2016) in his book chapter (pp. 214 -242) “focuses on the paradoxical nature of clinic/ patient interaction that both reinforces high expectations and deepens the ambivalent feelings treatment seekers have about their past and present medical encounters”
3 As per the Official Statistics of Japan Website, the total number of Indians in Japan as of 2020 was 38,558. The number of men is 26,434 and women was 12,124. As per the data, the number of women in the age group 26-30 years was 2,245; for 31-35 years, 2,259; for 36-40, 1,434.
4 Personal choices refer to situations where some opt to work in the corporate sector or full-time jobs, even though they may or may not be able to find jobs in their field of expertise. And the circumstances mainly refer to the options available for taking care of their child in their absence.
5 Recently, there are women in the Indian, Nepalese or Filipino communities who offer cooking and cleaning services. They are informally hired through word of mouth or by contacting them through references or via community or social media groups that are especially made for such purposes. For food, they mainly get help from women in the Indian or Nepalese communities. For cleaning, it could be any of the three. But the cost of these services at the time of the research was around 1,500 yen per hour, which is much higher than one would pay in India. Also, these services, if used, are affordable only for a few hours a week, not on an everyday basis in most cases. There are also companies through which one can formally hire these services (mainly cleaning), but the cost in such cases can be 2 to 4 times more.
6 The population of Indians in Tokyo as per the Official Statistics of Japan website in Japan in 2007 was 20,589, and that in 2020 was 38,558.
7 This is usually not the case. In most cases the respondents had Japanese-speaking doctors. Even if they do find an English doctor then they are not necessarily near to their place of residence.
8 Also cited in Shakya, Tanaka, Shibanuma and Jimba 2018.
9 Also cited in Shakya, Tanaka, Shibanuma and Jimba 2018.
