Learn about the schedule and detailed contents of prenatal checkups. Understand the importance of regular checkups for both mother and baby, and explore additional screening options available.
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Summary of this article
Prenatal checkups are regular checkups for the baby and mother. They check if the baby’s growth and development are on track and if there are no health problems with the mother. In the early stages of pregnancy, the checkup interval is once a month or once every four weeks. In the mid-pregnancy stage, the interval is twice a month or once every two weeks. In the late pregnancy stage, the interval becomes shorter to once a week. Blood pressure measurement, urine test, weight measurement, blood sampling, abdominal circumference and uterine fundal height measurement, and ultrasound examination are performed.
What is Prenatal Checkup
Prenatal checkups are regular examinations for both the baby and the mother. These checkups monitor the baby’s growth and development and ensure there are no health issues with the mother. Severe morning sickness leading to dehydration and malnutrition, anemia, pregnancy-induced hypertension, and gestational diabetes can affect both the mother’s health and the baby’s growth and development.
Moreover, if any illnesses or growth delays in the baby are detected during prenatal checkups, treatments can be administered during pregnancy, and arrangements can be made for delivery at specialized hospitals with NICUs (Neonatal Intensive Care Units).
In addition to examinations, prenatal checkups provide consultations and guidance on lifestyle during pregnancy, childbirth, and childcare. The necessity of prenatal checkups is stipulated in Article 13 of the Maternal and Child Health Law, and both the national and local governments are emphasizing this as part of their efforts to address the declining birthrate.
Get Prenatal Checkups When Pregnant
When you find out you are pregnant, make an early visit to an obstetrician. Once the fetal heartbeat is confirmed during the visit, subsequent checkups will be “prenatal checkups,” and you will attend them regularly. If the first visit occurs around the 8th week of pregnancy, the standard number of prenatal checkups until the expected delivery date is 14.
About Prenatal Checkup Subsidy
Even for a healthy pregnancy, prenatal checkups must be attended 14 times. To reduce the burden on mothers, there is a subsidy system called the “Prenatal Health Checkup Cost Subsidy Ticket.” Let’s explain this in detail.
Are Prenatal Checkups Covered by Insurance? How to Use Coupons
Prenatal checkups are not covered by insurance, and the cost of consultations and examinations is out-of-pocket.
The reason is that “pregnancy is not an illness.” The out-of-pocket cost per checkup can be high, ranging from 5,000 to 10,000 yen. To subsidize the cost of prenatal checkups, there are “subsidy tickets.” These tickets are issued along with the maternal and child health handbook when you submit a pregnancy notification at the municipal office. Therefore, subsidy tickets cannot be used until the pregnancy is confirmed.
Recently, more municipalities have been providing cost assistance through “examination tickets.” Here is a brief introduction to the difference between examination tickets and subsidy tickets.
| Examination Ticket | The ticket indicating the items to be tested each time is brought by the pregnant woman to the medical institution for the checkup. |
|---|---|
| Subsidy Ticket | The ticket indicating the subsidy amount is brought by the pregnant woman to the medical institution for the checkup. The medical institution decides the items to be tested. |
Additionally, as of 2017, there are 24 municipalities nationwide where subsidies are available without any limit on the number of times they can be used.
In rare cases, prenatal checkups may be covered by insurance. This happens when an “abnormality is found” during the checkup. Tests and treatments for abnormalities may be covered by insurance. Moreover, if the mother has an existing gynecological condition and is receiving ongoing treatment, insurance may cover these costs as well. It is advisable to check this during your visit.
Furthermore, if you plan to give birth in your hometown, the amount you have to pay may change, so please inquire with your local municipality.
Tests Covered by Coupons
The examination items listed on the subsidy tickets are covered by public funds. The target items vary depending on the timing and number of checkups. According to the Tokyo Metropolitan Government Bureau of Social Welfare and Public Health website, the examination items eligible for subsidies and the recommended times for these checkups are as follows:
Source: Tokyo Metropolitan Government Bureau of Social Welfare and Public Health – When You Find Out You’re Pregnant
Prenatal Health Checkup Examination Items Recommended Time 1st Time Interview, Weight Measurement, Blood Pressure Measurement, Urine Test (glucose, protein qualitative), Blood Test, Blood Type (ABO type, Rh(D) type), Anemia, Blood Sugar, Irregular Antibodies, HIV Antibody, Syphilis (serological test), Hepatitis B (HBs antigen test), Hepatitis C, Rubella (antibody titer test) 2nd ~ 14th Time Interview, Weight Measurement, Blood Pressure Measurement, Urine Test, Health Guidance Every Time Select one item per visit according to the number of visits Chlamydia Antigen Early Pregnancy to 30 Weeks Transvaginal Ultrasound 20 to 26 Weeks HTLV-1 Antibody By 30 Weeks Anemia 28 to 32 Weeks, After 36 Weeks Blood Sugar 24 to 28 Weeks Group B Streptococcus 33 to 37 Weeks NST (Non-Stress Test) After 36 Weeks Use Together with Prenatal Health Checkup Ticket Cervical Cancer Screening Early Pregnancy
Additionally, the number of times ultrasound examinations can be covered by subsidy tickets varies by municipality, so it is important to check this carefully.
Frequency of Prenatal Checkups
The frequency of prenatal checkups is determined by the Maternal and Child Health Act as follows:
| Early Pregnancy ~ 23 Weeks 6 Days | Once Every 4 Weeks |
|---|---|
| From 24 Weeks (7th Month) Onwards | Once Every 2 Weeks |
| From 36 Weeks (10th Month) Onwards | Once Every Week |
The frequency of checkups is only a guideline and may vary depending on the condition of the mother and baby.
Schedule of Prenatal Checkups
Let’s take a closer look at the schedule for prenatal checkups. Below is a standard checkup schedule. Those who give birth at a midwifery clinic or return to their hometown for childbirth may have an increased number of checkups.
Early Pregnancy ~ 23 Weeks
In the early stages of pregnancy, the recommended interval for checkups is once a month or every 4 weeks.
24 Weeks ~ 35 Weeks
In the mid-pregnancy stage, the interval for checkups becomes shorter, with a recommended frequency of twice a month or every 2 weeks.
36 Weeks ~ Until Birth
In the late pregnancy stage, it is a time when the baby could be born at any moment. To ensure that both the mother and baby are prepared for birth, the interval for checkups is further shortened to once a week.
Contents of Prenatal Checkups
Prenatal checkups involve checking the health of both the mother and the baby. Let’s go through the specific tests that are conducted during these checkups.
Examination Items
The tests that check the mother’s condition during prenatal checkups are as follows:
- Blood Pressure Measurement
- Urine Test
- Weight Measurement
- Blood Test (including the items listed on the prenatal checkup subsidy ticket)
Next, here are the tests that check the baby’s condition during prenatal checkups:
- Abdominal Circumference and Uterine Fundal Height Measurement
- Ultrasound Examination
In addition, the following tests are conducted during the course of pregnancy:
| Early Pregnancy ~ 23 Weeks 6 Days | Blood Tests (Blood Type, Blood Sugar Test, Antibody Test), Cervical Cancer Screening |
|---|---|
| From 24 Weeks (7th Month) Onwards | Glucose Tolerance Test, Group B Streptococcus Test |
| From 36 Weeks (10th Month) Onwards | NST (Non-Stress Test) |
The glucose tolerance test is performed on mothers whose blood test results show high blood sugar levels. It involves drinking glucose and then having blood drawn to check for gestational diabetes.
The NST (Non-Stress Test) is a mandatory test for mothers in the late stages of pregnancy. Sensors are placed on the mother’s abdomen to monitor the baby’s heart rate and the frequency of uterine contractions.
Fetal Screening Tests
We have introduced various items of prenatal checkups, but did you know that there is also a test called “fetal screening”? Let’s take a detailed look at fetal screening, a test chosen by many mothers.
What is Fetal Screening Test
Fetal screening is a test that examines the baby’s condition in more detail than regular prenatal checkups. The screening test can determine whether the possibility of the baby having a disease is “high” or “low.” If the possibility is high, more detailed tests are conducted.
Fetal screening is performed using ultrasound. It takes longer than a regular prenatal checkup and checks for abnormalities in the baby’s internal organs, brain, and entire skeletal structure.
The recommended time for the test is around 20 weeks of pregnancy, and the cost is out-of-pocket.
About NIPT (Non-Invasive Prenatal Testing)
In rare cases, abnormalities in the baby cannot be detected with ultrasound alone. A typical example is “chromosomal abnormalities.” Chromosomal abnormalities include Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome), and Trisomy 13 (Patau syndrome). Whether there is a high possibility of these chromosomal abnormalities can be investigated with a test called NIPT (Non-Invasive Prenatal Testing).
The items and accuracy of NIPT (Non-Invasive Prenatal Testing) vary by clinic. At Hiro Clinic NIPT, not only Down syndrome but also sex chromosome abnormalities and partial deletions and duplications in all regions of all chromosomes can be detected in greater detail and with higher accuracy.
If you want to know more about NIPT (Non-Invasive Prenatal Testing), please refer to the following.
Conclusion
Prenatal checkups are essential for understanding the condition of both the mother and the baby, ensuring a safe pregnancy, childbirth, and childcare. To reduce the out-of-pocket costs of these checkups, there are subsidy tickets and examination tickets available. Please make sure to take advantage of these systems.
For those who want to know more about their baby’s condition beyond regular prenatal checkups, fetal screening is recommended. By combining ultrasound examinations with NIPT (Non-Invasive Prenatal Testing), it becomes possible to identify a higher number of potential health risks. At some branches of Hiro Clinic NIPT (such as the Tokyo Station Branch, Nagoya Station Branch, and Hakata Station Branch), both NIPT and ultrasound examinations (echo tests) can be performed. If you want to comprehensively understand your baby’s condition, please consider visiting us.
【References】
- Ministry of Health, Labour and Welfare – Desirable Standards for Health Checkups for Pregnant Women (March 31, 2015) (MHLW Notification No. 226)
- Ministry of Health, Labour and Welfare – Survey Results on the Status of Public Funding for Prenatal Health Checkups
- Ministry of Health, Labour and Welfare – “Let’s Get Prenatal Checkups (Leaflet)”
Learn about the schedule and detailed contents of prenatal checkups. Understand the importance of regular checkups for both mother and baby, and explore additional screening options available.
Read more about Amniotic Fluid Testing
Article Editorial Supervisor
Dr Hiroshi Oka
NIPT specialist clinic, MD
Graduated from Keio University, School of Medicine
