Photo/Illutration Tokyo Governor Yuriko Koike talks in an interview with The Asahi Shimbun at the Tokyo metropolitan government building on Jan. 6. (Natsuno Otahara)

The Tokyo metropolitan government will subsidize the cost of “painless delivery,” the use of an epidural or other anesthetics during childbirth, for Tokyo residents starting in fiscal 2025.

Tokyo officials said this will be the first program of its kind in any prefecture in the nation.

The subsidy will be provided to pregnant women living in Tokyo who receive anesthetics during childbirth at a medical institution in Tokyo, sources related to the Tokyo metropolitan government said.

Epidurals normally costs 100,000 to 150,000 yen ($633 to $949), so the metropolitan government is adjusting the subsidy to reduce the out-of-pocket expense as much as possible.

According to the Japan Association of Obstetricians and Gynecologists, the use of epidural anesthetics during deliveries has been increasing in Japan. Painless deliveries accounted for just 5.2 percent of all childbirths in 2017 but rose to 11.6 percent in 2022.

According to a health ministry survey, the cost of a normal delivery in Tokyo in fiscal 2023 was 625,372 yen, the highest in Japan, exceeding the central government’s lump-sum childbirth allowance of 500,000 yen. For those who chose to get an epidural, the costs are even higher.

Tokyo Governor Yuriko Koike pledge to introduce a subsidy system for painless delivery as a pillar of her campaign during the gubernatorial election last July.

In an interview with The Asahi Shimbun on Jan. 6, Koike said, “Looking at the situation around the world, painless deliveries are quite common.”

Koike hit upon establishing the subsidy after she talked with a female official of the Tokyo metropolitan government.

The official had said, “If I’ll have to go through that pain, I can’t imagine having a second child.”

However, there have been cases of maternal deaths during painless delivery procedures in the past, so ensuring safety is critical.

The metropolitan government is currently considering the details of the subsidy program.

A senior metropolitan official said one condition for the subsidy would require that the delivery occur at an institution with an anesthesiologist and the medical equipment to properly conduct an epidural or similar procedure.

However, it will be a challenge to train personnel and equip medical institutions to meet such requirements.

Regional disparities between Tokyo and nearby prefectures may also cause difficulties.

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