If the birth goes smoothly, it’s perfectly normal for mother and baby to go home without staying in the hospital!
In the United Kingdom, it is common for mothers to return home within 6–24 hours after childbirth if the birth goes smoothly and both mother and child are healthy. In 2018, when Princess Catherine of England gave birth to her third child, Prince Louis, she was discharged from the hospital just seven hours later. The United Kingdom has a good medical system, under which all medical expenses, from pregnancy to childbirth, are basically free. When a pregnancy is confirmed, the doctor introduces the mother to a dedicated midwife, who then conducts physical examinations—such as urine tests, blood pressure measurements, and fetal heartbeat tests—and also arranges parenting classes, make appointments for various other tests, and provides advice about the birthing plan. Even after giving birth, the same midwife provides follow-up support, including monitoring the health status of mother and baby (free for up to 10 days after delivery). Midwives are not so strict about the pregnant women’s weight management (as long as it does not exceed 100kg) and advise that newborn babies only need to be bathed once every 5–7 days due to the hardness of tap water.
Scotland’s Baby Box initiative: An equal start in life!
In Scotland, all newborn babies receive a Baby Box free of charge to celebrate their birth. The system was launched in 2017 with the slogan, “An equal start in life!” The midwife handles all process related to the Baby Box, from registration to delivery, in addition to explaining gifts contained inside the box and giving relevant advice. Each Baby Box comes with baby clothes (newborn to six months), digital thermometer (ear type), bath towel, blanket, cloth picture book, and various other things. When you open the box, you are first greeted with a poem written by a famous Scottish poet. The Baby Box also comes lined with a mattress, mattress protector, and a fitted sheet, making it a great place for baby to sleep.
ASEAN, Middle East, Oceania
The working mother’s last ray of hope: The nanny
Pigeon’s Singapore Business Division is responsible for a wide area, encompassing Southeast Asia, the Middle East and Oceania. Throughout this region, nannies provide mothers with indispensable parenting support. The names used vary widely (the term “au pair” is most commonly used in Oceania, for example), but by whatever name the nanny is a professional who carries out parenting duties on behalf of the mother. This occupation originally flourished in the United Kingdom. Unlike a babysitter, who watches over small children only temporarily, the nanny is continuously involved in children’s upbringing, even taking responsibility for their education in some cases. In the major cities of Singapore, Malaysia, Vietnam and others, about 70% of couples are dual-income, while in India, Thailand, Indonesia and some other Asian countries, the practice of employing a housemaid is strongly rooted in the culture. These social features form the background to the growing prevalence of nannies in the region.
Nannies specializing in postnatal care and even “flying nannies”
Worldwide the profession of the nanny is surprisingly diverse. In Singapore, for example, one category of nanny is the “confinement nanny,” who specializes in postnatal care. Many dispatch agents for these nannies are certified by the Singapore government. Confinement nannies’ first priority is the care of newborn babies and recovery of the mother post-partum, but they also live with the parents and handle general housekeeping duties, not only bathing the baby and changing diapers in the middle of the night but also cooking meals based on Chinese medicine, cleaning the home and doing the laundry. In the United Arab Emirates (UAE), “Best Nanny Awards” are given out to nannies who excel in duties such as childcare, education and cooking. This award system contributes to the improvement of the quality of the industry and profession. (A Filipina nanny was the winner of this award in 2018). The UAE is also home to airlines that employ “flying nannies,” who care for babies and play games with children on flights.
In Turkey, it's good manners to go see a baby as soon as it's born.
Turkey is known for its pro-Japanese orientation. In this nation that straddles Asia and Europe, the preparations for childbirth are somewhat busier than those in Japan. For example, maternity-ward stays are shorter. A woman admitted to hospital for childbirth can be expected to be discharged the next day. If the birth is by Caesarean section, she may stay two nights. Moreover, the mother is required to bring everything necessary to care for her newborn from her own home, including diapers, nursing bottle, milk, underwear and clothing. As soon as the baby is born, whether in the hospital or at home, the new mother can expect relatives and friends to crowd into her room to congratulate here. In Turkey, it’s good manners to come and celebrate the birth of a baby as soon as the blessed event occurs. After childbirth, the mother is very busy and everyone rushes to support her, including not only the father but also the mother’s mother and mother-in-law. Entertaining the celebrating guests is the duty of the mother and mother-in-law.
Since the 1990s the number of Caesarean sections has risen sharply in Turkey. By 2012 C-sections had risen to account for about half of all births. The situation became so dire that Turkey became the first country to prohibit Caesarean births without good reason.
At birth celebrations in Turkey, people give gifts called nazar boncuk with gold attached.
In Turkey it is traditional to give gifts of nazar boncuk, with gold jewelry or a gold coin attached, as a celebration of childbirth. Nazar boncuk are talismans whose righteous gaze is thought to repel the “evil eye,” gazes of envy, jealousy or evil intent. Guests who arrive to congratulate the new mother are served kompost of peaches, apples or other fruit simmered in water or dilute sugar-water. This popular drink is said to restore the mother’s vigor and promote lactation.
Turkish children wean later than Japanese children with many continuing to breastfeed past the age of two. When they do wean, however, their baby food tends to be rich in nutritious ingredients such as white cheese, butter, olive oil and pekmez (a thick grape syrup).
Indonesia, land of active women
The rise of the participation of women in society is nowhere more stunning than in Indonesia, which elected a female president not long ago. Few Indonesian women today quit their jobs due to marriage or childbirth; in the latter case, most return to work after three months’ maternity leave. With no national health-insurance plan like Japan’s to rely on, parents pay the costs of childbirth out of pocket; fortunately for these couples, company health-insurance policies and the like pay most of these costs, and many companies pay 100% of salary during maternity leave. In Jakarta, the capital and largest city, families commonly hire a full-time babysitter after a childbirth so that the mother can return to work. Average pay for a babysitter is equivalent to about ￥6,000 to ￥10,000 a month, so even families that are not particularly affluent can afford to hire one or two women as domestic servants, and this culture is well entrenched. Incidentally, the custom of wrapping a newborn baby in a towel so that it does not grow up bowlegged is still prevalent in Indonesia.
The mother-and-child health notebook is an idea from Japan that is widely used in Indonesia.
One item in high demand among women expecting or raising a baby in Indonesia is the mother-and-child health notebook. Devised as a health record to enable continuous care of both mother and child from early pregnancy to infancy, the mother-and-child health notebook is in popular use throughout Indonesia. The roots of the popularity of the mother-and-child health notebook lie in a program of support and cooperation from Japan. In the early 1990s, the state of mother-and-child health in Indonesia was among the poorest in the ASEAN region. At this time one Indonesian doctor visited Japan and observed our use of using mother-and-child health notebooks. Deeply impressed, the doctor returned to Indonesia, determined to establish the practice in that country. By the mid-2000s the use of mother-and-child health notebooks was entrenched in every province of Indonesia. Today some 5 million mother-and-child health notebooks are printed and published every year in Indonesia－about five times the number in Japan. Indonesia’s adoption started a trend: About 40 countries worldwide have followed Indonesia’s lead, distributing their own mother-and-child health notebooks. All told approximately 9 million of these notebooks are issued every year around the world, making the mother-and-child health notebook an especially successful Japanese “export.”
The one-child policy was abolished in 2015.
In October 2015 the Chinese government announced that the one-child policy, which had been in effect since 1979, would be scrapped. The effect of this rescission, and the reactions to it, varied for each generation. In Japan, when we speak of a “generation gap” we think of the “bubble generation,” the “pressure-free generation” and so on. In China, generations are labeled by the decade in which people were born. Thus “’70s generation” (qilinghou), “’80s generation” (balinghou) and “’90s generation” (jiulinghou) refer not to those who grew up in these eras, but to those born in them. The balinghou, as the first generation born under the one-child policy, became known as “little emperors” because they grew up under the doting, unconditional love of their parents and grandparents. These balinghou (especially the bawuhou or “late ‘80s generation”), along with the jiulinghou (“’90s generation”), are now of marriageable age and are forming the next generation of Chinese families.
With the abolition of the one-child policy, the number of births in China is steadily rising. However, the new generation is not the only one with a second child; a fair number of parents of the qilinghou generation have a second child, too. In fact, a majority of qilinghou grew up in a family with at least one brother or sister. These families were no doubt influenced by traditional Chinese thought summed up in the proverb duoziduofu: “The more children, the more wealth.”
In China, working mothers are the rule, not the exception!
In Japan we make a big hue and fuss about “women in the workplace.” For the Chinese, working women are nothing new. It is simply accepted that women work in China, and the vast majority of households are two-earner households. Naturally, the country has a full complement of daycare centers, though some suffer a shortage of daycare workers. In comparison with Japan, where expectant mothers receive maternity leave of six weeks prior to the expected delivery date, maternity leave is short in China at just 15 days. It is not uncommon to see pregnant women holding their distended bellies as they commute to work just days before their babies are born. When new mothers return to work, after leave of three or four months after childbirth, they are entitled to a one-hour breastfeeding break (“shortened work hours”) every day until the child is one year old. In urban areas, however, mothers often switch from breast milk to powdered milk when they return to their jobs.
Grandparent-dependent balinghou, independent jiulinghou?
We have said in this column that in China, it’s a given that every mother is a working mother. Yet because of the perennial shortage of daycare facilities, these working mothers are generally dependent on the support of grandparents. Not surprisingly, a relatively high percentage of balinghou parents find it ideal to live under one roof with their grandparents.
The jiulinghou, meanwhile, are more strongly oriented toward the nuclear family. The 2000s, when the jiulinghou began to assert their personalities, were a time of explosive growth in the uptake of modern conveniences such as PCs, flat-screen TVs and mobile telephones. The internet and social networks are essential to the jiulinghou’s lifestyle. Raised in such an environment, the jiulinghou tend to place more emphasis on modern specialist expertise than on tradition. When confronted with doubts or issues regarding parenting, they are likely to look up solutions online before soliciting the opinions of grandparents.
Babies are called “treasure-treasure.”
Babies are a treasure no matter what country you go to. But in China babies are actually called baobao, an endearing word meaning “treasure-treasure.” At the ceremony to celebrate the birth, it is customary to give the baby a changmingsuo, a “longevity bracelet” made of gold or silver (see illustration), in prayer for a long and healthy life. In China great attention is paid to care of the mother after childbirth. The first month after the child is born is called zuoyuezi, the “babysitting month,” and during this time the mother rarely rises from her bed except to nurse her newborn child. Zuoyuezi Centers, separate from hospitals, are established as places where mothers can recuperate after childbirth, providing care for the baby and daily meals. As in Japan, mothers are encouraged to breastfeed. Nursing mothers supplement their diets with soups and other watery foods to promote lactation.
The two-income families that support Malaysia's multi-ethnic society
Malaysia is a multi-ethnic country, with a population that is roughly 60% Malay, 30% Chinese and 10% Indian. While officially an Islamic country, Malaysia recognizes the freedom of each community to practice its own religion and customs. The educational system respects these ethnic identities as Malay primary-school children are taught in Malay, Chinese children in Chinese and Tamil children in Tamil. Not surprisingly, attitudes and customs regarding childbirth and parenting vary widely by ethnic community.
Malaysia is also a booming country with a 4% annual GDP growth rate. Two-income families are common, and mothers typically return to work immediately after two months of maternity leave. Against this environment, the practice of pumping breast milk is gradually rising. Whereas fewer than 15% of infants 6 months of age were exclusively breast-fed in 2006, by 2014 that figure had risen to 35%. This trend is probably the result of a national effort to encourage breastfeeding.
Distinctive parenting customs of each ethnic group
Although customs differ widely among ethnic groups in Malaysia, eating habits before and after childbirth are broadly similar nationwide. Papaya, coconuts and other tropical fruits are regarded as the enemies of the expectant mother, as they are believed to cool the body. Pregnant women eschew durian due to its high sugar content. After childbirth, mothers recover by avidly consuming meals prepared with ginger and other herbs.
Many families, both Malay and Chinese, hold a “full-moon party” when their child is one month old, inviting family and friends to celebrate their babies’ first month of life. At these parties the baby’s head is shaved, the baby is dressed up in new clothes, and the parents distribute gifts of eggs painted red. In Chinese families it is common for the grandparents to give the child gifts of gold accessories. Among the Malay community, it is customary to wash the placenta carefully, wrap it in white cloth and bury it beneath a tree in the garden.
Small children in large families
With a population of 1.3 billion people, India is the world’s second-largest country by number of people. The country’s annual birth rate of 27 million babies exceeds that of China, the world’s most populous country. Under the economy-first policies of Prime Minister Narendra Modi, the number of middle-income, two-earner families is rising, particularly in cities such as Mumbai, Kolkata, Hyderabad and New Delhi. By 2020 the number of high- and middle-income households is projected to reach 149 million.
Family ties are strong in India, and strongly patrilocal. When a woman marries, she typically lives together with her husband, his parents and his brothers and sisters. She receives a great deal of advice on parenting from the mother-in-law with whom she cohabits and tends to follow that advice to the letter. As a result, Indian mothers are taught many ancient child-rearing nostrums. For example, “To be blessed with a trouble-free childbirth, when the contractions begin, drink water that has been soaked in the thumb of your mother-in-law,” or, “On the 15th day after the child is born, begin massaging the baby with oil.”
Middle-income households are even bigger. In addition to the large family described above, a middle-class household may include an army of servants, including drivers, cooks, housekeepers, sweepers, chowkidar (gatekeepers/doormen), bearers (butlers), dhobi (clothes-washers), gardeners and so on. A strong cultural directive against appropriating others’ livelihoods entrenches sharp distinctions among these various jobs. As a result, the job of baby-sitting is left entirely to the aya, or nanny.
The nanny (aya)
No qualifications are required to be an aya. Anyone who likes children and knows how to care for them can be an aya. Aya range in age from 15 to 50-something. Because they are entrusted with the care of their precious children, the hiring process is rigorous: Typically a one-to-three-month trial period is required, along with submission of a health certificate. By the same token, the going rate for an aya is set higher than the salary of other servants. Specializing in the care of children, the aya’s work includes taking the children for a walk in the park, changing diapers, feeding them milk or baby food, and so on. Families often take their aya with them when they go shopping, so that she can care for the children when they eat at a restaurant. The aya also accompanies the family on long vacations, staying with them and attending to their children’s needs.
Contrary to what you might think, parents do not feed their children curry as soon as they have weaned but wait until they have grown a little. They start them off with soft-boiled porridge, then graduate them to khichuri, a porridge fortified with finely chopped lentils, potatoes, etc.
Thailand, Land of… C-sections??
One distinguishing feature of the state of childbirth in Thailand is the high rate of Caesarean sections. Whereas about 20% of childbirths in Japan are performed by Caesarian section, data indicate that in Thailand a staggering 80% of childbirths employ this technique. The Thai people do not regard the ability to bear the pain of childbirth as a virtue, so expectant mothers themselves choose to deliver by C-section as a means of avoiding the pain of childbirth. Another common reason for the high incidence of Caesarean births is the desire of Thai mothers to select a propitious date and time for their children’s birth. An expectant Thai mother will opt for birth by Caesarean section so that the baby will be born according to a schedule decreed by an astrologer.
The Thai people have many unique customs regarding a woman’s life while she is pregnant. It is widely believed, for example, that it is unlucky to purchase baby clothes, cribs, nursing bottles or other goods to welcome newborn babies before the babies are born. These are purchased only after the baby is delivered. Hammering nails in the home of a pregnant woman is thought to bring bad luck to the baby; similarly, use of safety pins on a pregnant woman’s underwear or other clothing is believed to prevent malign influences from entering the mother’s body.
Pigeon nursing bottles and nipples enjoy high market share.
Thailand is a country with many two-income households. Facilities and services are available to enable mothers to return to work immediately after childbirth. Mothers often entrust parenting to their parents, daycare centers or babysitters (in some cases, a maid may be entrusted with housework as well as childcare). Rather than seeking a balance between parenting and work, Thai mothers tend to isolate the two. Also, the social environment is not well outfitted for breastfeeding, so the breastfeeding rate in Thailand is relatively low.
Thailand is a middle-income country with unusually high income disparity. The market for parenting-related goods is crowded and fiercely competitive, with an increasing number of local companies selling low-priced products. Despite this challenging environment, Pigeon’s nursing bottles and nipples, our core products, enjoy high market share in Thailand. Pigeon’s share of the nursing-bottle nipple market is around 50%.
Childbirth and parenting in Singapore
Two-income households are the overwhelming majority in Singapore, accounting for 80% of households. So how do these families handle childbirth and parenting? Nationwide Singapore has 10 hospitals furnished with maternity wards. Many expectant mothers and fathers prepare for childbirth by booking hospital tours, so they can view maternity wards and other facilities and decide where to have their children. A typical maternity stay is limited to two days and one night. Increasingly, Singaporean mothers retain the services of a doula, a childbirth support worker with specialized knowledge of newborn care, to look after them and provide postpartum care services from pregnancy to about one month after delivery. Although Singapore law provides for a total of 16 months’ leave before and after childbirth, expectant mothers in Singapore typically work as close to their due date as possible and then return to work three to four months later, placing their newborns in the care of a daycare center or their parents. Singapore is a city-state with roughly the same area as the 23 wards of Tokyo, so most couples live nearby both sets of parents; this is one reason why Singapore mothers can take so little maternity leave.
The Singapore government is taking concerted measures to deal with a low birth rate.
Singapore, as a small, ethnically diverse city-state, confronts one problem in common with Japan: A low birth rate. Keenly aware that its people are its only resource, the government of Singapore is committing focused efforts toward incentivizing childbirth and providing childcare support. Examples of such programs include a baby-bonus system, which pays congratulatory bonuses to parents when a child is born; a parenting and educational reserve system, which encourages parents to contribute to an education fund for their children; and a daycare subsidy system, which provides thorough support for preschool education. The government also pays salary equivalents for three of the six days of childcare leave to which mothers are entitled every year, as well as two months’ salary for their 16 weeks of maternity leave. To encourage fathers to take part in their children’s care, the Singapore government recognizes paternity leave, providing working fathers with up to two weeks’ pay (of which one week’s pay is legally mandatory).
Breast pumping plays an essential role in the US in encouraging mothers to continue breastfeeding
In the United States, highly knowledgeable breastfeeding experts known as lactation consultants help, support and encourage new mothers in their breastfeeding journey. The first skill new mothers learn is how to express breast milk. Learning about breast-milk expression is essential for many mothers in the US. When they return to work after 12 weeks of maternity leave, the breast pump helps them to continue breastfeeding their babies. Among the provisions of the Patient Protection and Affordable Care Act of 2010 (“Obamacare”), a reform of medical insurance, were coverage for purchase of breast pumps and a legal requirement for companies to provide time and locations for employees to express their breast milk. As a result of this background, today some 85% of breastfeeding mothers use a breast pump. Breast-milk expression is a challenging commitment, as it requires around 20 minutes per pumping session, several times a day, at home and at work. Mothers in the US prefer to use electric breast pumps which shorten the time required for pumping.
IT meets baby care: The thriving “Baby Tech” market
The United States is one of the first and still a fast-growing market for “Baby Tech” products. “Baby Tech” products include baby monitors, which enable parents to see their babies remotely; health-tracking wearables for babies; “smart” nursing bottles; and wearable “smart” breast pumps. Today “Baby Tech” products are driving fresh expansion in the baby-care market, which is currently valued at around US$23 billion. Since 2016, the most outstanding baby-tech products have been honored in the United States with the Baby Tech Award, and more large and small companies are entering the competition every year. In 2017, Lansinoh was nominated as a finalist with the LansinohR Smartpump Double Electric Breast Pump. This product can connect with the Lansinoh® Baby app for convenient tracking of mothers’ pumping sessions.
“Lactation consultants” provide breastfeeding support.
Like their Japanese counterparts, many pregnant women in the United States prepare for childbirth by attending expectant-mother classes. One of the topics sure to be covered in these courses is breastfeeding. The “lactation consultants” who teach these classes provide general breastfeeding support both before and after birth, conveying the importance of breastfeeding and offering guidance and consultation on the subject. These consultants may be obstetricians, pediatricians, registered nurses or midwives, or they may be women who are not medical staff but can provide expectant mothers with breastfeeding support before and after delivery based on their own experiences of childbirth.
Why are double electric breast pumps used in the United States?
Rarely seen in Japan, double electric breast pumps are the most commonly found type of breast pump in use in the United States. These pumps are regarded as essential breastfeeding equipment in the US and so are in wide use there. The reasons for this difference between Japan and the United States lie in differences of social systems and culture. In the United States, where postpartum (unpaid) maternity leave is a relatively brief 3 months at the most, many women prepare for early separation from their newborns by purchasing a double electric breast pump, either through an insurance provider or by retail purchase. The first three months after delivery are the period of maximum breast-milk secretion; recognizing the importance of breastfeeding, these new mothers prepare so that their babies can continue to receive breast milk even after they return to work. To satisfy these needs in the short time available, new American mothers eschew single electric breast pumps and manual breast pumps in favor of double electric breast pumps, which are more time-efficient. Also widespread in the United States is the use of babysitters, on whom mothers depend not only to return to work but also for the occasional night out without taking the baby along. At such times a babysitter may be asked to feed the baby breast milk. For this reason as well, breast pumps have become an essential item for the modern American woman.