在日本工作的馬來西亞人在日本懷孕了該怎麽辦? What should a Malaysian（Work visa ）living in Japan do if they find out they're pregnant?

 在日本工作的馬來西亞人在日本懷孕了該怎麽辦？

What should a Malaysian（Work visa ）living in Japan do if they find out they're pregnant?

希望以下的經驗和經歷可以幫到在日本生活的同鄉。畢竟當時我要找資料的時候，只能藉助其他國家人的案例自己摸索。

I hope the following experiences can help Malaysian who are  living in Japan. After all, when I was searching for information at that time, I could only rely on the examples of people from other countries to figure things out myself.

分享個人背景：

1.我和我的老公都是合法擁有在日本工作簽證的馬來西亞人（不是永久居民）

2.我和我的老公都是正社員

Sharing my personal background:

1.My husband and I are both Malaysian citizens with legal work visas in Japan (not permanent residents).

2.Both my husband and I are full-time employees (正社員).

驗孕

發現懷孕的過程不外乎是：大姨媽遲到➡ 驗孕棒兩條綫➡看婦產科醫生確認宮内孕和胚胎

在此和大家科普一下，日本有兩種驗孕棒，

一種是大姨媽遲到7天之後檢驗的驗孕棒 （一般妊娠検査薬）（不需要詢問藥劑師，任何藥妝店直接購買，比較便宜，適合生理期穩定的女生）

一種是大姨媽預定日來就能檢驗的早期驗孕棒(早期妊娠検査薬）（需要在有藥劑師的藥妝或者藥局購買，不需要處方簽，比較貴，適合生理不穩定的女生）

我自己的狀況：因爲那陣子生理比較不穩定，我直接買了早期驗孕棒驗孕。其實當初會想要驗孕一半也是直覺，因爲那天頭特別的暈，和平時不一樣，所以我在午休的時候就到公司附近有藥劑師的藥妝店買驗孕棒。結果早期驗孕棒就直接告訴我懷孕了。

第二天，為了確保自己真的懷孕，我買了一般驗孕棒驗孕，結果也是兩條綫，所以其實一般的驗孕棒也是有可能早期檢驗出是否懷孕。

Pregnancy Test

The process of discovering pregnancy usually involves: 

late menstruation ➡ pregnancy test showing two lines ➡ confirmation of intrauterine pregnancy and embryo by an obstetrician-gynecologist.

Here, I'd like to provide some information to everyone: there are two types of pregnancy test kits in Japan:

One type is the pregnancy test taken after a delay of 7 days from the expected period (general pregnancy test kit) (no need to consult a pharmacist, can be purchased directly at any drugstore, relatively cheaper, suitable for women with stable menstrual cycles).

The other type is the early pregnancy test that can be taken on the expected date of menstruation (early pregnancy test kit) (needs to be purchased at a pharmacy or drugstore with a pharmacist, no prescription required, relatively expensive, suitable for women with unstable menstrual cycles).

My own situation: Because my menstrual cycle was unstable during that period, I directly bought an early pregnancy test kit to check for pregnancy. Actually, the reason I wanted to test for pregnancy at first was also partly intuitive, because I felt particularly dizzy that day, which was different from usual. So, during my lunch break, I went to a drugstore near my office with a pharmacist and bought a pregnancy test kit. The result of the early pregnancy test kit directly told me that I was pregnant.

The next day, to ensure that I was indeed pregnant, I bought a regular pregnancy test kit and tested again. The result also showed two lines, so actually, regular pregnancy test kits can also detect pregnancy early.

產院

檢驗出懷孕后，其實不推薦馬上去看醫生。因爲如果只是剛懷孕4周（上一次大姨媽開始日是算起），去醫院檢查也檢查不出一個所以然，只會浪費看診的錢錢。但是也不可以太晚去找醫生，因爲

1.需要好好確認胚胎，還有是不是子宮内懷孕

2.需要趕緊搶產院（沒錯，在東京地區是用搶的，不然你會預約不到無痛和比較經濟實惠和好評的產院）

推薦大概是懷孕6周到8周之間去找醫生，而且千萬不要到婦人科，一定一定一定要馬上找有產院的產婦人科，這兩者是有明顯的區別哦。東京的產婦人科新規預約是很難馬上有時間的，所以當你用驗孕棒檢測到自己懷孕後，第一件事就是馬上搜尋你想要的產婦人科，然後趕快預約。

（我自己個人慘痛的例子是，我先到自己一直以來有去看的婦人科觀察胚胎，然後醫生確認子宮内孕，然後我才搜尋產科，結果等我找到價格經濟實惠又有無痛又受好評的產院時，生孩子的名額已經被搶光了，所以才會造成我最後決定囘馬來西亞生小孩。）

Maternity Hospital

After confirming pregnancy, it's actually not recommended to see a doctor immediately. Because if it's just 4 weeks into the pregnancy (counting from the first day of your last menstrual period), going to the hospital won't reveal much, and it would just waste money on the consultation. But it's also not advisable to wait too long to see a doctor because:

1.It's important to properly confirm the embryo and whether it's an intrauterine pregnancy.

2.You need to quickly secure a spot at a maternity hospital 

(yes, in the Tokyo area, it's like a race to secure a spot; otherwise, you won't be able to book at a hospital that offers painless delivery, is relatively affordable, and highly praised).

The recommendation is to see a doctor around 6 to 8 weeks into the pregnancy. And absolutely do not go to a gynecologist; you must immediately find an obstetrician-gynecologist . There is a totally different between the two. 

It's very difficult to get a new appointment at a maternity hospital in Tokyo, so when you confirm your pregnancy with a pregnancy test, the first thing you should do is search for the maternity hospital you want and make an appointment as soon as possible.

(My own personal painful experience is that I first went to the gynecologist I had been visiting to observe the embryo, and then the doctor confirmed the intrauterine pregnancy. Afterward, I searched for a maternity hospital, but by the time I found one that was reasonably priced, offered painless delivery, and had good reviews, all the delivery slots were taken. This led me to ultimately decide to return to Malaysia to give birth.)

区役所以及媽媽手冊

8周到11周之間，醫生確認了你宮内孕和胚胎之後，醫生會吩咐你下次就需要正式進行''孕婦健診（產檢）''、在下一次產檢爲止，必須到區役所領取媽媽手冊。那個時候你最好調查清楚你所在的區可以申請媽媽手冊的地方。然後按照資訊，到相關部門遞出懷孕表格。

我的區在我遞出懷孕表格之後，直接給我媽媽手冊，裏面有很多產檢的補助券，接下來的每一次產檢都需要帶去產院，還有就是1萬日元的*恭喜懷孕*現金券，可以用那一萬塊的現金券購買懷孕有關的商品，我最後都把券用在 赤ちゃん本舗的育嬰店。另外，區役所還會給你一大曡關於懷孕，生產，育嬰的資料，那些都需要回家好好閲讀吸收知識，在那一大曡資料裏面還有一個申請孕婦5萬日元的購物積分的表格，準媽媽要記得申請，申請后一個月，日本郵局就會把5萬日元購物積分卡寄到家裏面來。

Ward Office and Maternity Handbook

Between 8 to 11 weeks, after the doctor confirms your intrauterine pregnancy and the embryo, the doctor will instruct you that it's time for the official "maternity check-up (antenatal care)." Until your next check-up, you must go to the ward office to receive your maternity handbook. At that time, it's best to research where you can apply for the maternity handbook in your ward. Then, according to the information, submit the pregnancy form to the relevant department.

In my ward, after I submitted the pregnancy form, they directly gave me the maternity handbook. Inside, there are many vouchers for maternity check up  and for each subsequent check-up, you'll need to bring these to the maternity hospital. Additionally, there's a ¥10,000 "Congratulations on Pregnancy" cash voucher that can be used to purchase pregnancy-related items. I ended up using these vouchers at the "赤ちゃん本舗" baby store. 

Furthermore, the ward office will provide you with a large amount of information about pregnancy, childbirth, and childcare. It's important to take the time to read and absorb the knowledge from these materials. Within that comprehensive information package, there's also a form to apply for a ¥50,000 shopping point card for expectant mothers. Expectant mothers should remember to apply for it. One month after applying, the Japan Post will mail the ¥50,000 shopping point card to your home.

與公司上司聯絡的時間點

基本上產科確認你懷孕并且領取媽媽手冊后，就可以和你的直屬上司先報告你懷孕了。但是如果你的工作是屬于需要久站，或者搬搬擡擡的，我覺得一開始驗完孕就可以先和直屬上司説一下。因爲孕期前三個月真的最不穩定和最累，最困，我雖然沒有嚴重孕吐，但是我無法接受任何氣味，連搭電車都會想吐，所以如果可以最好避免通勤的電車。我覺得整個孕期最困擾自己的就是前面三個月，真的好困好累好沒精神，完全和平時的自己不一樣。

前面三個月通常還不會和同事和其他工作來往的客戶或者關係者說自己懷孕，通常都是過了三或者四個月才會逐一和比較有接觸到的同事或者有工作往來的關係者聯係。

Timing to Inform Your Company Supervisor

Basically, after the obstetrician confirms your pregnancy and you receive the maternity handbook, you can inform your immediate supervisor that you are pregnant. 

However, if your job requires prolonged standing or lifting, I think it's best to inform your supervisor as soon as you confirm the pregnancy. Because the first three months of pregnancy are really the most unstable and exhausting. Even though I didn't have severe morning sickness, I couldn't tolerate any smells, and I even felt nauseous on the train, so it's best to avoid commuting by train if possible. I think the most challenging part of the entire pregnancy is the first three months; I was so tired and lacked energy, completely unlike my usual self.

During the first three months, you usually don't tell your colleagues or clients or other work-related contacts about your pregnancy. Usually, it's after three or four months that you gradually inform colleagues or work-related contacts with whom you have regular interaction.

產檢（妊婦検診）

懷孕第11周或者第12周才會正式開始第一次的產檢（可以用輔助券）。第一次產檢都會比較貴，用了輔助券還需要1-2萬左右。因爲要做很多項目的檢查，時間也比較久。之後的產檢就大約1000日元到2，3千日元不等。雖然大家都説日本少子化，但是東京的產院無時無刻都充滿著很多孕婦，更不用説是那些大型綜合醫院。去產檢，需要有至少在產院或者醫院待幾個小時的準備。另外日本的檢查算是蠻佛系，超音波也是很快的一下子就結束。但是如果要做詳細的檢查，像是寶寶基因檢查，唐氏寶寶檢測，詳細超音波，都是可以自費檢查的。

另外日本抓的比較嚴格的檢查就有每次產檢的體重，血壓，還有一開始的甲狀腺檢查。我就因爲甲狀腺檢查不過關，被醫生介紹到内分泌專門做了一系列檢查，但幸好都沒事。

最後一點就是，日本的產科爲了保護孕婦以及嬰兒，基本上不允許孕婦以外的人進入產院。所以爸爸們是無法一起進去看寶寶長什麽樣子。我老公每次不放心我一個人千里迢迢去產檢，他都會站在產院門口等一兩個小時，然後聽我説寶寶現在的狀況，真的有點可憐。一直到我們回到馬來西亞，老公才能親眼見證超音波裏的寶寶還有聼寶寶的心跳聲。

Prenatal/Maternity Check-ups

The first prenatal /maternity check-up typically begins around the 11th or 12th week of pregnancy and requires the use of vouchers which given by ward office. 

The first check-up tends to be more expensive, even with vouchers, costing around 10,000 to 20,000 yen, because it involves many examinations and takes longer. Subsequent check-ups usually cost around 1,000 to 2,000 or 3,000 yen. Despite the common notion of Japan facing a declining birthrate, maternity hospitals in Tokyo are always filled with many pregnant women, especially in large comprehensive hospitals. When going for a check-up, you need to be prepared to spend several hours at the maternity hospital or clinic. Additionally, prenatal examinations in Japan are quite relaxed, and ultrasound scans are usually completed quickly. However, if you want to undergo detailed examinations such as baby genetic testing, Down syndrome screening, or detailed ultrasound scans, these are available but typically require self-payment.

Furthermore, some of the stricter checks in Japan include monitoring weight, blood pressure, and initial thyroid checks at each  check-up. I had to undergo a series of examinations by an endocrinologist because my thyroid check didn't pass initially, but fortunately, everything turned out fine.

Finally, in Japan, to protect pregnant women and babies, generally only pregnant women are allowed to enter maternity hospitals. So, fathers are unable to accompany their partners to see the baby during examinations. Every time I went for a check-up, my husband, worrying about me being alone, would wait outside the maternity hospital for one or two hours, listening to updates on the baby's condition from me. It was quite pitiful. It wasn't until we returned to Malaysia that my husband could witness the baby in the ultrasound and hear the baby's heartbeat firsthand.

地中海貧血携帶因子的孕婦

最後要説的是一些少數人的煩惱。是關於地中海貧血携帶因子的孕婦。在日本地中海貧血携帶基因是很少見的，這一類携帶基因比較常見的地區通常是中國南部的廣東，香港，台灣，新加坡，馬來西亞，所以這一類的檢測并不普及以外，不是所有產科醫生知道地中海貧血携帶因子的孕婦該如何處置（雖然並不需要特別處置，但地中海貧血携帶因子的大多數孕婦本身的血蛋白會比較低，那個不是補鐵可以不上去的）。由於我本身是擁有地中海貧血携帶因子的，所以在日本想讓老公也檢查看看，但在日本的檢測是非常的昂貴，而且分成兩次檢測，和馬來西亞完全不一樣。

第一次檢測是血蛋白分析，電泳分析。第二次檢測是DNA檢測。通常第一次檢查就可以大概知道到底是或不是，但是日本的血液專科會和你説，需要進行到第二次的DNA檢查才能100%確定，但是如果沒有做第一次檢查，是不能直接進行第二次的DNA檢查的。

由於我老公第一次檢查的成績非常正常，血液科醫生說我老公應該不是携帶者，所以我們就沒有進行最後的DNA檢查，而我自己本人則在第一次檢查中，被95%確證為β的携帶者。（日本醫生不會100%和你確證，除非你進行了DNA檢查）

基於地中海貧血孕婦需不需要特別治療，其實如果生活沒有特別症狀是不需要的。我們只會在驗血的時候發現HB不高，然後被說貧血，然後醫生就會拼命叫你補鉄。但是有時地中海貧血携帶因子的孕婦并沒有缺鐵，沒有缺鉄但一直亂補鐵反而會讓血蛋白下跌。但是懷孕本來就容易缺鐵，連地中海貧血携帶因子的孕婦都一樣，如果缺鐵了當然要補鐵。我自己會先從食補開始，比如多吃菠菜，小松菜，牛肉，羊肉，鴨血，豬血之類的，外加大量擁有維他命C的食物幫助吸收鐵。

懷孕28周以來，我的血蛋白(HB)都在9.8-10.7之間徘徊。標準是11.0以上，但我盡力了。。。

回到馬來西亞后，政府醫院的醫生和護士都開給我補血藥，目前還不知道功效如何，但我之後生完孩子后會把補血之路總結一下再與大家分享。

Pregnant Women who are Thalassemia carrier

Lastly, I want to address the concerns of a few individuals regarding pregnant women who are Thalassemia carrier. In Japan, thalassemia carrier genes are rare. They are more commonly found in regions such as southern China (Guangdong), Hong Kong, Taiwan, Singapore, and Malaysia. Therefore, testing for thalassemia carriers is not widespread in Japan, and not all obstetricians are aware of how to manage pregnant women carrying thalassemia traits (although special treatment is not necessary, most pregnant women carrying thalassemia traits tend to have lower blood hemoglobin levels, which cannot be increased solely by iron supplementation). Since I myself carry thalassemia traits, I wanted my husband to get tested in Japan. However, testing in Japan is very expensive and done in two stages, which is completely different from Malaysia.

The first test is a hemoglobin analysis and electrophoresis analysis. The second test is a DNA test. Usually, the results of the first test can provide a general idea, but Japanese hematologists will tell you that the second DNA test is necessary to confirm 100%. However, if you haven't done the first test, you cannot proceed directly to the second DNA test.

Since my husband's first test results were completely normal, the hematologist said that my husband is unlikely to be a carrier. Therefore, we did not proceed with the final DNA test. However, in my case, the first test confirmed that I am a Beta carrier with 95% certainty. (Japanese doctors will not confirm 100% unless you undergo a DNA test).

As for whether pregnant women with thalassemia traits need special treatment, it's not necessary if there are no specific symptoms. Typically, we only discover low hemoglobin levels during blood tests, and doctors will insist on iron supplementation. However, sometimes pregnant women carrying thalassemia traits do not have iron deficiency. In such cases, indiscriminate iron supplementation can actually lower hemoglobin levels. However, pregnancy itself increases the risk of iron deficiency, even for pregnant women carrying thalassemia traits. If iron deficiency occurs, supplementation is necessary. Personally, I prefer dietary supplementation, such as eating more spinach, komatsuna (Japanese mustard spinach), beef, lamb, duck blood, pig blood, and foods rich in vitamin C to aid iron absorption.

Since the 28th week of pregnancy, my hemoglobin levels have ranged from 9.8 to 10.7. The standard is 11.0 or higher, but I'm doing my best...

Upon returning to Malaysia, doctors and nurses at government hospitals prescribed iron supplements for me. I am yet to see the effectiveness, but I will summarize my experience with iron supplementation after giving birth and share it with everyone.

總結

我本人絕對無法沒有無痛的自然生產，日本醫院又不給剖腹的選項，（剖腹只能在醫生判定你不能自然順產，或者寶寶胎位不正的情況下才會緊急實行），東京的高評價和合理價格無痛產院又被搶光光，所以我最終決定囘馬來西亞生孩子。

加上囘馬來西亞有家人的支持，我和我老公這個新手爸媽才會比較安心，不然只有我們兩個孤零零的在日本，面對新生兒手忙脚亂，然後又無法做月子（日本沒有坐月子的習慣，但是日本孕婦基本上都會囘娘家生孩子， 因爲娘家家人至少可以幫忙煮飯，洗衣之類的），我真的無法想象我們兩個會不會瘋掉。

囘馬來西亞生產其實也是重大決定，

1.因爲必須和公司討論自己什麽時候回馬，也需要得到公司的諒解和支持。幸運的是我的公司及工作提供遠程工作模式，在產假之前，我都可以在馬來西亞遠端工作。

2.安全起見，孕婦最好不要在太靠近預產期的時候搭飛機，我選擇27周從日本飛回馬來西亞。

3.寶寶帶回來日本也需要很多手續，這些就要麻煩先囘日本工作的老公一件一件去實行。

4.囘馬來西亞也要找醫生，找醫院，還要到政府醫院開簿子（登錄懷孕資訊），手續很多，挑戰也很多。

5. 日本的產休得津貼，生孩子的津貼也需要好好和公司人事部研究。（我之後成功拿到津貼后也會寫文章和大家分享）

In conclusion,

I personally cannot undergo natural childbirth without epidural anesthesia, and in Japan, hospitals do not offer the option of cesarean section unless the doctor determines that you cannot deliver naturally or if the baby is in an abnormal position. Moreover, the highly-rated and reasonably priced epidural-friendly maternity hospitals in Tokyo were fully booked, so I ultimately decided to return to Malaysia to give birth.

With the support of family in Malaysia, my husband and I, as new parents, feel more reassured. Otherwise, being alone in Japan, facing the chaos of caring for a newborn without the cultural practice of confinement (postpartum recovery period), I couldn't imagine how we would cope.

Returning to Malaysia for childbirth was a significant decision:

1.It required discussions with my company regarding when to return to Malaysia and obtaining their understanding and support. Luckily, my company offers remote work, so I can work from Malaysia before my maternity leave.

2.For safety reasons, pregnant women are advised not to fly too close to their due date. I chose to fly back to Malaysia from Japan at 27 weeks of pregnancy.

3.Bringing the baby back to Japan also involves many procedures, which my husband, who works in Japan, had to handle step by step.

4.Finding doctors, hospitals, and registering pregnancy information at government hospitals in Malaysia also posed many challenges and procedures.

5.Regarding maternity leave allowances in Japan and childbirth benefits, thorough discussions with the company's HR department are necessary. (I will share my experience of successfully obtaining these benefits later.)

寫道這裏，我已經把自己2023年9月發現自己懷孕到2024年囘馬來西亞的心路歷程給終結了下來。下一篇應該是會和大家分享，我是如何找馬來西亞的產院以及在政府醫院做產檢的故事。

在此感謝你讀完我的文章。

Here, I have concluded my journey from discovering my pregnancy in September 2023 to returning to Malaysia in 2024. The next piece will be sharing how I found a maternity hospital in Malaysia and my experiences with prenatal check-ups at government hospitals.

Thank you for reading my article.