Insurance Coverage for Childbirth: Financial Burden on Expectant Mothers Must Be Reduced

Editorial

14:29 JST, December 23, 2025

If childbirth costs were uniformly capped regardless of which hospital or clinic is used, mothers could give birth with peace of mind, free from financial worries.

The Health, Labor and Welfare Ministry has announced a policy to abolish the program that provides a lump-sum allowance for childbirth and childcare for expectant mothers and instead introduce a system to cover all childbirth costs through public health insurance. The ministry aims to realize the necessary legal revisions during next year’s ordinary Diet session.

Currently, the costs of normal deliveries are determined at the discretion of medical institutions because normal deliveries are not covered by the public health insurance program. To help cover these expenses, the government began providing a lump-sum allowance to expectant mothers through organizations such as health insurance associations starting in 1994.

The amount of the lump-sum allowance was initially ¥300,000, but it is now ¥500,000. A cycle has persisted in which medical institutions raise delivery fees, prompting the government to increase the lump sum, which then leads medical institutions to raise fees again, followed by another government lump sum increase.

Having the public health insurance program cover childbirth costs aims to put an end to this game of cat and mouse.

According to the ministry’s survey, the national average fee for childbirth in fiscal 2024 was ¥520,000. In Tokyo, the average was ¥650,000. Fees tend to be higher in urban areas. Reducing the burden on expectant mothers as part of measures to counter the declining birth rate is understandable.

However, medical institutions have expressed concern that a uniform official price for childbirth set by the government could worsen their financial situation.

Many medical institutions include the costs of celebratory luxury meals and commemorative photography in childbirth fees. A uniform official price set by the government is seen as one factor behind the concern of medical institutions because setting one would make it difficult to include such services, which are unrelated to medical treatment, within the childbirth fees.

Obstetrics inherently tends to involve various high costs. To maintain a 24-hour readiness for deliveries, sufficient staff must be secured in advance.

Due to the declining birth rate, the number of medical institutions handling deliveries has halved over nearly 30 years. If more institutions cease providing care because they believe insurance coverage for delivery costs eliminates potential revenue, it would be pointless.

When setting an official price, sufficient consideration must be given to the financial conditions of medical institutions. Shouldn’t consideration be given to providing additional medical service fees to medical institutions in rural areas facing a shortage of obstetricians, as well as to clinics to secure robust medical staff?

Furthermore, while women who give birth through cesarean section also receive a lump-sum payment, they must pay out-of-pocket fees to bear a portion of the surgical costs. The government’s policy is to partially subsidize these surgical costs if delivery expenses are set at an official price. A sense of unfairness compared to normal deliveries must be prevented from arising.

(From The Yomiuri Shimbun, Dec. 23, 2025)