Braxton Hicks and Utemerin in Japan

Hi folks. I had my 32 week appointment with the Dr. on Friday and it was a bit hectic this time since I had to bring my toddler Clara with me. I usually try to make an appointment for her at the local daycare for the days I have to go to the Dr, but the daycare facilities here in Nagoya are crowded (there aren't enough of them) and I have to make appointments well in advance. If I forget or can't get a call through to them soon enough I have to take her with me to the hospital. I've only had to take her with me a couple of times, and it usually turns out okay because the staff at my hospital are very kid friendly, but it's nice not to have to bring her each time. The nurses at this hospital are very patient with children, and each time Clara tried to run away while I was consulting with the nurse or getting checked they would gently retrieve her for me and give her a toy or something to look at. I really do like the staff at Kaseki Hospital, and am glad that I chose it.


This appointment was much like my last appointment, complete with ultrasound and a cervix check. This time around the Dr. asked me if I had been feeling any contractions, and I said that I had been feeling Braxton Hicks Contractions. I learned about Braxton Hicks Contractions when I was pregnant with Clara and was told that they are normal in the third trimester. You can tell them apart from real contractions because they are irregular and painless, and my Dr. in America said that if they feel uncomfortable the best thing to do is just drink a glass of water and rest until they stop. I have felt them many times before and never had any problem with them during my other pregnancy. So I told my Japanese Dr. I had started having these Braxton Hicks Contractions and he immediately prescribed a medication for me. I was a bit confused and the appointment ended right then, so I left the consultation room only to realize I had no idea what he had just prescribed and why. I had one more consultation with the nurse before leaving so I decided to ask her about it rather than interrupt the Dr. who is constantly seeing patients. I asked the nurse what the medicine was for and she said it was to stop the contractions. I told her that I had felt them before with Clara and was told they were normal. She agreed that they were normal but said that having too many was not good and advised me to take the medicine if I felt them frequently. I asked her how much was too frequent and she said if I felt two contractions in an hour I should take it. So then I go to the pharmacy located in the hospital, and when I receive the medicine the package says to take 3 a day for 7 days. I spent several minutes trying to clarify with the pharmacist (using my broken Japanese, which seemed even worse then usual while trying to discuss medication :P) how much I was supposed to take since the Dr. said to take it when I felt a contraction, not everyday. I finally was able to get across what the Dr. and nurse had both said and figured out what the Pharmacist was trying to say, and then she changed the label on the medication to say basically take one as needed.

So then I go home. I was feeling very frustrated at this point, not with the Hospital necessarily but with my still inadequate Japanese, and I had been unable to figure out exactly WHAT the drug was or what was in it, and why it was being prescribed. (I am uneasy about taking medicine I don't fully understand). When I got home I did a little research online. I found a helpful website called "Kusuri No Shiori" at www.rad-ar.or.jp/siori/english/index.html that lets you look up Japanese names of drugs and see a brief fact sheet in English. I found out that the drug I was prescribed is called Utemerin in English and it is prescribed to halt preterm labor. It also had a list of possible side effects, one of which (heart palpitations) the nurse had warned me about. I did a little more research on other blogs and found a blog that said that Utemerin is rather common for pregnant women in Japan to take, regardless of risk factors for preterm birth. I asked a Japanese friend about the drug, and she said she had not taken it during her pregnancy, but she knew what it was and what is was for. She also told me that she had not had any Braxton Hicks Contractions while she was pregnant and that may be why her Dr. never prescribed it. But that fact that she knew about it tells me that it must be fairly common. She told me that women with a short cervical canal or who are having C-sections often take it. I am having a C-section so that may have influenced my Dr's decision to prescribe it. I understand the concern (if you're having a C-section the Dr. really doesn't want you to go into labor before the scheduled day) but I am still hesitant to take it unless I feel I really need it. Two Braxton Hicks in an hour just doesn't seem like a lot to me, but maybe I'm just too laid back about them? I don't really know. Anywho, I'm keeping the meds in my cupboard but probably won't take it unless I have several contractions in a row 0_o.

Five more weeks left before the big day. I've started buying nursing bras and nursing pajamas and collecting other little things I'll need for the lengthy hospital stay (In Japan, women typically stay at the hospital for a whole week after birth as opposed to the 1-3 days you stay in the US). Hopefully I won't forget anything! ^_^v

Scheduling my Japanese C-section

Yesterday I went to my 30th week prenatal appointment at Kaseki Hospital. Once I hit 30 weeks it was time for me to schedule my birth. Most Japanese moms schedule their births, even if they are not having a c-section. Japanese people tend to keep to very strict schedules at work, school, etc. and so it's normal for Japanese women to have their births induced on a certain day rather than to wait for labor to start naturally. Since I'm having a C-section the birth was scheduled for a couple weeks before the baby's due date (which was December 6th. The birth was scheduled for Nov. 24th) The hospital knew I would have quite a bit of paperwork to do that day and so they called for the English speaking midwife so that she could go over it with Braden and I. She had given me a brief summary of the paperwork before but she went over it again this time to refresh us on the content. This was a great time saver for us since all the paperwork was in Japanese, and even though my husband can read quite a bit of Japanese it would've taken him a long time to look up all the medical terminology. 

We had to fill out 4 forms. The first was a survey about what I wanted to have happen at the birth. The midwife circled the C-section option, but then she did ask me if that was what I actually wanted, adding that she strongly recommended it. I said that the Dr. had encouraged it as well (which he reiterated when I saw him again later during the same appt). I told her that I would do what the Dr. recommended. I had talked to my sister the other day about VBACS and C-sections, and she had mentioned to me that a friend of hers had recovered much easier after her 2nd birth, which was a planned C-section, than her 1st birth, which was an emergency C-section during labor. I felt a little better about having another C-section when I heard that, because I felt like it took me a long time to recover from my first C-section and that was one reason why I didn't want another one. I'm hoping that since this one is planned I'll recover quicker. 

The 2nd form was an application for the birth and birth room. I chose the cheaper option, which means my room won't have its own bathroom. I'll have to use a shared one (which doesn't really bother me). The 3rd form was an application for financial aid from the government. The Japanese government offers a 420,000 yen benefit to new mothers to help pay for birth costs (since a normal birth is not considered a sickness it is not covered by the national health insurance). The last form was an application for government benefits should the baby be born with Cerebral Palsy. (Our baby is not at high risk for this condition or anything, it was just one of the routine papers we needed to fill out). 

After filling out all the paperwork I went through the rest of the appt as normal. Ultrasound, Dr. consultation (during which we scheduled the day for the C-section), and then this time I also got my cervix checked. After that I scheduled the next appt with the midwife and also asked a couple questions about the C-section itself. She told me that I would receive an epidural as anesthesia, that my husband could be present, and that they would cut in the same place as my last cut (which was horizontal). The midwife also gave me a list of things to bring to the hospital for the birth. It was mostly the expected stuff; clothes, toiletries, etc. But it did include a specific request for a certain type of underwear. I didn't know what it meant so the midwife showed me one. It looked like regular maternity underwear except that it had a little button up flap in the front. She told me that I could buy it at a regular pharmacy. I told the midwife that I had never seen one like it before, mentioning that in America the hospital had given me special, lightweight, mesh underwear when my daughter was born, but that there was no flap. We chuckled a bit at the funny little differences between care here in Japan and back in America, but despite the differences there are a lot of similarities too. 

Lastly I had to pay a deposit for the birth. The midwife had explained to me before that since Kaseki was a private hospital it cost a little bit more than the amount I would receive from the government, and that I would need to pay a deposit in the amount of 150,000 yen. She also said that since I was having a C-section that the Dr. considered medically necessary that the insurance would likely pay all of it back (here's hoping!). Although the deposit was quite a bit of money (at least for us :P), the prenatal experience in Japan thus far has been very affordable. I paid about 4,000 yen for my very first appt, but then after that I had gone to the Public Health Office in our area of the city and was eligible for Prenatal Care Coupons that basically make every prenatal appt free. I occasionally have to pay for medicine or an extra blood test or two, but so far I've never had to pay the hospital more than about 2,000 yen for any visit, and I usually pay nothing.

So far the pregnancy itself is progressing smoothly and I haven't had any complications :). I'm at the point though where I'm tired of being pregnant and I'm just counting down the days to the birth! Here's hoping it all goes well!