Japan to Introduce Free Childbirth Policy Starting in 2026

Japan, a country facing one of the world’s lowest birth rates and a rapidly aging population, is confronting major social and economic challenges in the coming decades. For years, the Japanese government has implemented various policies to encourage higher birth rates, but their effectiveness has remained limited. In this context, the Ministry of Health, Labour and Welfare (厚生労働省) has officially proposed a groundbreaking new policy: full coverage of childbirth costs starting from the fiscal year 2026.

This policy marks a significant step forward in reducing the financial burden on families while promoting childbirth as an essential part of ensuring Japan’s sustainable social development. In this article, HSB JAPAN will provide a comprehensive and detailed look at the policy, the reasons behind its implementation, its specific components, as well as the challenges and public responses surrounding this initiative.

1. Background and Objectives of the Policy

1.1 Declining Birth Rate – A Major Challenge for Japan

Japan is currently facing a rapid aging population and a record-low birth rate. The country’s average fertility rate stands at only around 1.3 children per woman—far below the replacement level of 2.1. Projections indicate that Japan’s population will shrink from approximately 125 million in 2020 to about 88 million by 2065. This demographic decline poses serious consequences for the labor force, social security systems, and long-term economic development.

1.2 Childbirth Costs – A Significant Barrier for Young Families

One of the main reasons couples hesitate to have children is the high cost associated with childbirth and newborn care. According to surveys, the average cost of a normal delivery in Japan has risen to around ¥518,000 (approximately 90 million VND) over the past decade. A large portion of these costs is not covered by national health insurance. Additionally, optional services such as private rooms, painless delivery, and added amenities further increase the total expense, making childbirth a financial burden for many young families.

1.3 Main Objectives of the Policy

The Japanese government hopes that offering free childbirth will:

• Significantly reduce the financial pressure on young families

• Encourage more couples to feel confident about having children

• Ensure the quality of obstetric and maternal healthcare is maintained and improved

• Help balance social and economic development in the face of population decline

2. Detailed Content of the Free Childbirth Policy Starting in 2026

2.1 Free Coverage for Natural Childbirth

According to the draft announced by Japan’s Ministry of Health, Labour and Welfare, starting from the 2026 fiscal year, the cost of natural childbirth will be fully covered by public health insurance. Currently, only cesarean (surgical) deliveries are covered under the national insurance scheme, while natural births are not. This marks a significant improvement that will relieve families of the heavy financial burden typically associated with giving birth.

2.2 Increased Lump-Sum Childbirth Allowance (出産育児一時金)

In addition to insurance coverage for delivery costs, the government plans to increase the lump-sum childbirth allowance to provide extra support for families. Since April 2023, this allowance has already been raised from ¥420,000 to ¥500,000. However, with childbirth expenses continuing to rise, this amount still falls short of covering actual costs, leaving many families under financial strain. By increasing the allowance and combining it with full insurance coverage for childbirth, the government aims to significantly improve the support available for new parents.

2.3 Ensuring the Quality of Medical Services

The Japanese government emphasizes that cost reduction will not come at the expense of healthcare quality. The free childbirth policy will be implemented alongside measures to ensure that medical facilities have sufficient resources, staff, and equipment to provide the best care for mothers and newborns. This includes maintaining and expanding a skilled workforce of obstetricians, midwives, and specialized healthcare professionals. The goal is to deliver safe, high-quality maternity care nationwide while alleviating financial burdens.

3. Challenges in Implementing the Policy

3.1 Regional Disparities in Childbirth Costs

Childbirth costs in Japan vary significantly between regions. For example, the average cost of a natural delivery in Tokyo exceeds ¥620,000, while in Kumamoto Prefecture it is only around ¥388,000. This disparity poses a major challenge in establishing a standardized insurance reimbursement rate nationwide. To address this, the Ministry of Health, Labour and Welfare has proposed a flexible pricing mechanism that adjusts based on regional conditions rather than enforcing a rigid, uniform rate across the country.

3.2 Concerns from Medical Facilities and Doctors

Some healthcare providers have expressed concern that a standardized insurance reimbursement rate may not cover actual operational costs—especially in urban areas where expenses are higher. According to a survey conducted by the Japan Society of Obstetrics and Gynecology, about 7.6% of medical institutions indicated they might stop accepting natural births if insurance caps were imposed.

Additionally, fixed pricing could limit the ability of hospitals to offer optional services, such as epidural anesthesia (painless delivery) or private birthing rooms. This could lead to dissatisfaction among patients and reduce service diversity in maternity care.

3.3 Issues Related to Painless Birth and Optional Services

Painless birth (epidural anesthesia during labor) is increasingly popular among expectant mothers, but it is currently not covered by public health insurance. Some local governments, like Tokyo, have started offering subsidies of up to ¥100,000 for this service starting in October 2024. However, expanding insurance coverage to include such specialized services remains a contentious issue, as it requires dedicated medical personnel and specialized equipment. Balancing quality, accessibility, and cost-efficiency continues to be a challenge in policy implementation.

4. Opinions and Feedback about new policies

4.1 Positive Feedback from Families and Social Experts

Many families and social experts support the free childbirth policy, viewing it as a necessary and timely solution to address the low birth rate issue. Reducing childbirth costs will provide a financial incentive for couples to feel secure about having children, especially in the context of rising living expenses.

4.2 Concerns from the Healthcare Sector and Obstetricians

As mentioned earlier, many doctors and medical institutions oppose the full insurance coverage of natural childbirth costs unless there is careful calculation of pricing and compensation mechanisms. They warn that without proper support, some hospitals may stop accepting expectant mothers, which could negatively impact future medical care.

4.3 Financial Issues and the Burden on Social Insurance

The funding for the free childbirth policy will come from the social health insurance fund, contributed by workers and businesses. However, insurance premiums are steadily increasing and have reached a record high (9.34% in 2025 for health insurance organizations of large enterprises). This poses a challenge in balancing citizens’ benefits with the financial burden on the current working generation.

5. Prospects and Supplementary Measures

5.1 Flexible Regional Support

The Japanese government is considering implementing a flexible mechanism that adjusts costs according to each region, based on local healthcare infrastructure and expenses. This aims to prevent imbalances and help medical facilities maintain efficient operations.

5.2 Enhanced Communication and Cost Transparency

One key proposal from experts is to increase transparency regarding childbirth costs and services. This would help families make informed choices while fostering healthy competition among medical institutions.

5.3 Investment in Healthcare Workforce Development

To ensure quality services, Japan needs to continue investing in training obstetricians, midwives, and healthcare workers, especially in underserved areas. Attracting young medical professionals and improving working conditions will help reduce pressure on the healthcare system.

6. Conclusion

Japan’s move to provide free childbirth from 2026 is a groundbreaking policy demonstrating a strong commitment to addressing the declining birth rate and aging population. This comprehensive solution aims to reduce the financial burden on families and create favorable conditions for couples to have children confidently.

However, the policy also faces significant challenges—from balancing costs and ensuring service quality to managing healthcare sector reactions and social insurance finances. Success will require close coordination among government agencies, healthcare providers, the public, and other stakeholders.

If implemented effectively, the free childbirth policy will play a crucial role in sustaining Japan’s social development and could serve as a valuable model for other countries facing similar demographic issues.

---

Detailed information will be announced by Japan’s Ministry of Health in the near future. HSB JAPAN will provide full updates once official decisions are made so that everyone can prepare well for the upcoming changes.

Contact us now for consultation on maternity benefits!