TOKYO REPORT: Tokyo’s Pain-Relief Childbirth Subsidies Draw Strong Demand

Tokyo, July 27 (Jiji Press)–The Tokyo metropolitan government launched an epidural subsidy program for childbirth last October, becoming the first prefecture-level government in Japan to help cover the cost of pain-relief deliveries. In the six months through March, the metropolitan government received 12,059 applications, well above its projection of about 9,500. “We see this as reflecting strong interest among many people,” a metropolitan government official said. Under the program, Tokyo residents who give birth under epidural anesthesia at medical institutions designated by the metropolitan government are eligible for subsidies of up to 100,000 yen to cover related costs. In Japan, pain-relief childbirth commonly involves epidural anesthesia, in which medication is injected through the back into an area near the spinal cord to ease labor pain. Safe and effective use of the procedure requires obstetricians and anesthesiologists with expertise. 60 Pct Express Interest In a 2024 survey conducted by the metropolitan government among Tokyo residents who had given birth, more than 60 pct of about 11,300 respondents said they had wanted an epidural during childbirth. Still, only 35.8 pct of all respondents said they actually had an epidural delivery, while 28.1 pct said they had wanted one but gave up on the option. Asked why they had decided against an epidural, with multiple answers permitted, the largest number of respondents, 1,377, cited circumstances that prevented their preferred delivery method, such as the need to undergo a cesarean section. This was followed by high costs, cited by 1,050 respondents. Epidural childbirth is a medical service not covered by public insurance and often costs about 100,000 to 200,000 yen, on top of regular childbirth expenses. After reviewing the survey results, the metropolitan government began subsidizing the cost of epidural childbirth to “support people who hesitate for financial reasons,” an official said. Incomplete Documentation Challenges have emerged six months after the launch of the subsidy program. The Tokyo government had expected applicants to receive subsidies about four months after filing for them. Even so, documentation problems were found in around 60 pct of applications, causing significant delays in many payments. In numerous cases, itemized statements and receipts issued by medical institutions listed childbirth-related costs only as lump sums, making it difficult to confirm whether an epidural delivery had actually been performed, according to officials. In response, the metropolitan government has alerted medical institutions to the problem and added to the application form more detailed explanations of the required documents. An official said that “documentation deficiencies have been gradually decreasing,” adding that the metropolitan government will continue working to raise awareness of the system. According to a 2025 survey by the Japan Association of Obstetricians and Gynecologists, epidural births accounted for 16.2 pct of all deliveries at member facilities nationwide in 2024, more than triple the 5.2 pct recorded in 2017. As demand for pain-relief childbirth continues to grow, a Tokyo metropolitan government official expressed hope that financial concerns will not prevent women from choosing the option. “We hope to create an environment in which anyone who wishes to have it (an epidural delivery) can do so without having to give it up for economic reasons,” the official said. According to the association, Tokyo had the highest share of epidural births among all prefectures in 2024. By contrast, no such pain-relief births were reported in Iwate or Kochi prefectures, reflecting the limited number of medical institutions in rural areas that offer the procedure. Establishing a robust medical framework remains a key challenge to expanding access to epidural childbirth. END [Copyright The Jiji Press, Ltd.]