Cultural Differences: No Sex Please, We're Pregnant

Women all over the world are faced with lists of things to avoid while pregnant, so I wasn't surprised to learn that Japan has a very long list of its own. What did surprise was just how different some of the prohibited items and activities are, with women here banned from doing things that pregnant women back home take for granted. So here is a list of some of the odder restrictions I've come across so far:

Sex

I'm pretty sure that these days no medical practitioner or pregnancy guide in Japan actually prohibits sex during a healthy pregnancy, but the general public apparently doesn't know that. Compared to English language pregnancy websites and books (which will usually have several pages or even a whole chapter dedicated to pregnant sex, perhaps with helpful illustrations of recommended positions), Japanese pregnancy resources have little to say about sex. Basically, the Japanese advice is: yes, it's safe, but be careful. And wear a condom. Seriously, a few posts back I mentioned seeing the condom suggestion in one of my Japanese pregnancy magazines, and since then it's popped up in several other resources. Apparently a naked penis is too filthy to be allowed anywhere near a fetus, and experts (including one doctor) here require it to be sheathed in latex. Which really takes all the fun out of pregnancy sex, as when else can you indulge in unprotected, spontaneous sex? (To be fair, I was able to find a few English websites recommending condoms during pregnancy, but that was only in a few very specific situations, like when having sex with a new partner. Which has to be the funniest English-language pregnancy advice I'd heard yet).

With or without a condom, however, I don't think a lot of sex is being had among expecting Japanese couples. According to my own research, which is admittedly unscientific and completely anecdotal (talking to Japanese friends and acquaintances, skimming through Japanese message boards and Question and Answer type websites, and reading about the experiences of foreigners married to Japanese on English language blogs and message boards) plenty of Japanese couples completely abstain from sex during pregnancy. There seem to  be two main reasons for this: a strong belief that sex can harm the fetus, and embarrassment by Japanese women (who are famously weight-conscious) about their weight gain and big bellies. Of course, given the popularity of the sexless marriage here (an estimated 30% of Japanese married couples don't have sex at all), pregnancy could just be a sensible time to start practicing abstinence.

Work

As with sex, there is no official rule against working while pregnant, but it's still the norm for women to quit their jobs by the second trimester. Most Japanese people are quite shocked to hear that North American women often work throughout their entire pregnancies, and while some women here express envy that women abroad can choose when to quit, most people seem to think women should stay at home while pregnant. I've actually never met a Japanese woman who worked during her pregnancy, but I've heard foreign women in Japan complain of difficulties while working during pregnancy: of not being able to find maternity business wear, of Japanese mothers-in-law nagging them to stop working as it's "dangerous to the baby", and of being scolded by strangers for riding trains during rush hour.

My own job ended this spring (nothing to do with my pregnancy, my contract ended) so unfortunately I don't have much first-hand experience with attitudes towards pregnancy in the workplace. But I do have a few private classes and they ended sooner than I would have liked. My students (all older ladies) decided at the end of my second trimester that teaching them must be too much of a burden for me and thus ended their classes. This after months of them constantly asking if I was really OK to keep teaching and warning me to be careful on the stairs, be careful on the bus, be careful in this heat, be careful at night, etc. These women definitely represent an older generation, but I think their attitude is still fairly typical. Last year I had a private student who quit both her job and our classes due to pregnancy- when she was just six weeks along! To be fair she may have had a good reason that she didn't feel like discussing (like severe morning sickness or a high-risk pregnancy) but the reason she gave for quitting was that she wanted to concentrate on her pregnancy. She may be an extreme example, but it's so rare to see a pregnant working woman in Japan that it's clear that working during pregnancy is still frowned upon.

Bicycles

I'd heard about this one ages ago, but had kind of assumed it was an old-fashioned or rural thing and wouldn't be enforced here in Tokyo in this day and age. But no: cycling while pregnant is officially banned in Japan. Pregnancy resources say no bicycling. My midwife says no bicycling. The old lady behind the counter of a local sushi take-out scolded me for bicycling. The only reason my doctor hasn't warned me of the dangers of bicycling is because he doesn't say anything at all.

As far as I can tell the supposed danger lies in a combination the risk of harming the fetus in case of a fall, and the overly intense physical strain involved in operating a bike. Of course, once the baby is outside that dangerous womb bicycling is just fine: stick a baby seat on a bike and you're good to go. Everyone who has lived in Japan has a story about an outrageous baby-on-a-bike sighting. My personal best was a bike with two baby seats, with baby in the front, a toddler in the back and neither wearing helmets. There were plastic bags full of groceries dangling from both handles of bike, and the mom was riding one-handed while holding an umbrella over herself and the baby (the toddler had a little umbrella of his own). Yes, it was raining, and she was riding on the road (not her fault really as sidewalks are not plentiful here). I'm the only person who even turned my head at the spectacle, but had she been pregnant she would have been in trouble.

Sports

In North America there are a few sports that a pregnant woman absolutely can't do: scuba diving, contact martial arts, skiing and the like. Beyond that, it's left up to the judgment and good sense of the expecting woman and her medical practitioners. In Japan the list of prohibited sports is much longer and has no room for the common sense of the pregnant woman in question. The list may be so restrictive that it includes everything that doesn't involve an official maternity class. There seems to be a lingering belief that physical exertion of any kind is potentially dangerous, and pregnant women are discouraged or even banned from participating in anything more strenuous than walking. Even walking seems to be frowned upon by the older generation: my middle-aged students were very surprised to learn that my midwife ordered me to go for daily walks and told me that in their day they were encouraged to stay home and let their mothers-in-law do the shopping and errands.

These days walking is acceptable and even encouraged, but other light forms of exercise can be hard to do as many gyms, pools and classes ban pregnant women outright. (Luckily the city-run pools in my area allow pregnant women, but judging from the reaction we got when we called to ask about the rules, and from the stares I get from the other swimmers when I go to the pool, I am the first pregnant swimmer anyone has ever seen.) Women who want to keep fit during pregnancy are advised to join a maternity exercise class, most often maternity swimming or maternity yoga (there are also maternity aerobics and maternity pilates classes, but they're pretty rare). I would actually have loved to have tried either, but it seems that the "maternity" prefix allows gyms and studios to charge double, and I couldn't afford it.

My midwife is rather enlightened when it comes to exercise (as long as it doesn't involve two wheels) and now that I'm at the end of my pregnancy she has instructed me to walk for at least two hours a day. She also wants me going up and down stairs as much as possible (which horrifies my older students, who believe there's no bigger danger to a fetus than a flight of stairs) and recommends climbing one of the smaller mountains in the Tokyo area like Takao-san (I did hike Takao-san in my first trimester and it was so tough that I can't even imagine trying it at this point). Yet I am only grudgingly allowed to go swimming, because of the risk of chilling my uterus. Which brings me to the most frustratingly weird restriction of all:

Getting Cold

This category of things to avoid is a huge one, but held together by two uniquely Asian theories: that certain substances and activities can cool the body, and that a cool body is dangerous for a fetus. I was familiar with the Japanese obsession with body temperature before my pregnancy, and knew that there was a strong belief that keeping the midsection covered and warm was of utmost importance. I'd even bought into it a little, wearing a haramaki (stomach wrap) to bed in the winter (I swear nothing cures my cold feet like a haramaki, as odd as that sounds). But this fear of the cold is brought to new heights of ridiculousness during pregnancy.

The thinking goes that a developing fetus needs to keep warm, which seems sensible enough. Unfortunately, the Japanese believe that a woman's body is incapable of regulating its own temperature and keeping a baby safe, so an expecting women must take all sorts of precautions against chilling her womb. Never mind that the baby is protected from the cold by several layers: skin, fat, muscle, uterine wall and amniotic fluid. Never mind that the human body is designed to direct heat to the internal organs, and that a woman's body is especially good at keeping the uterus warm. Never mind that it's summer (never mind even that this summer is the hottest on record and hundreds of people are dying of heatstroke). Never mind that women all over the world, in all kinds of climates, are capable of safely bearing children without special precautions other than dressing sensibly. Nope, pregnant women in Japan need all the help they can get keeping their unborn babies warm.

The first like of defense is to wear a sarashi, haraobi, haramaki, girdle, or other warm cover over the midsection. The next, for women who believe such things (and admittedly not all Japanese women do), is to keep the temperature-related tsubo (meridian points) warm. These points are at the back of the neck and the ankles, so a high-necked top or scarf and socks or legwarmers must always be worn. Yup, even during a heat wave. Other physically direct ways to stay warm are nightly hot baths (which most Japanese take anyway) and the use of heavy blankets at night. This is all in direct contrast to western wisdom, which says to avoid baths and overly warm clothing and bedding while pregnant as they bring a risk of overheating the fetus.

Actively avoiding getting cold is just as important as keeping warm, so pregnant women are advised to keep the air conditioning set high (or shun it altogether), never drink cold drinks or eat ice cream, and be very careful when getting out of that nightly bath to avoid cooling down too fast- you have to dry off quickly, put on warm pajamas (don't forget the haraobi and socks!) and always, always, always use a hair dryer. Never let your hair dry naturally! Swimming, if it must be done, is allowed only in heated pools (maternity swimming classes are held in pools with a temperature of at least 30C). Never swim in the ocean, unless you're on vacation in Hawaii or Okinawa where the ocean is warm, and definitely stay out of lakes and rivers.

But the strangest way of keeping the baby warm is not through directly physical means, but through food: namely by eating foods that have warming properties and avoiding those that are cooling. This practice seems to have its roots in Chinese medicine and is certainly not followed by all pregnant women in Japan, but most midwives are major believers in the miraculous temperature-changing powers of food and mine is probably the biggest believer of all.

It's not as simple as eating hot food to keep warm (although temperature is or course important): foods are actually divided into categories of those with warming properties and those with cooling properties. Some sources add a neutral category as well, and most agree that foods generally keep their heating or cooling properties no matter how they're prepared. The lists vary quite a bit depending on the source (it's not like there's any scientific research to refer to, after all) and one expert may contradict another, so the following lists might not match what you've heard. But according to my midwife, warming foods are carrots, ginger and most root vegetables; asparagus; kabocha squash; onions and garlic; eggs; and meat, especially liver. Cooling foods include all fruit (most other sources only prohibit certain fruit, usually tropical varieties); milk and all dairy products except hard cheese; eggplants, tomatoes, cucumbers; raw vegetables in general; and spicy food.

Needless to say I think this is all ridiculous, but I also think it's dangerous: an expecting mother needs to nurture her baby and keep herself comfortable, and prohibiting entire categories of food places her health at risk and adds unnecessary burdens. Completely avoiding dairy, for example, depletes a woman's body of calcium just when she needs it the most (the leafy greens and tiny, bone-in fish recommended in Japan for calcium would need to be consumed in such high quantities that there would be little place at the table for any other food). And banning many of the foods that pregnant women seem to crave the most (like fruit and spicy food) just makes an already difficult time even harder, especially if morning sickness is a factor.

In Conclusion

There are many other things I've heard pregnant women can't do in Japan, such as flying, watching sad or scary movies and TV shows, using seatbelts, consuming any amount of caffeine, and taking any kind of medicine. But these are ignored, thank goodness, by enough women here that they're not quite universal rules. Plus I've heard some of the same things back in Canada. In fact, there are probably just as many silly rules back home, and I'm just lucky to be spared hearing about them.

But I get the impression that the things a western woman has to avoid during pregnancy are mostly environmentally based: there seems to be a fear of toxins in the environment invading a woman's body and endangering her baby (this post from Wide Lawns and Narrow Minds offers a nice summary of all the ridiculous things that are said to be dangerous during pregnancy in North America). Whereas here in Japan the fear seems to be of the pregnant woman herself. I detect a subtle mistrust of a woman's body, a belief that the uterus is not fit to nurture a baby by itself and needs outside help. There is no appreciation of the amazing way evolution has designed our reproductive systems to shelter and foster a new life, and rather than being thought of as the protective organ that it is, the womb is thought to be in need of protection. Even worse, women themselves aren't trusted to make their own decisions. She can't choose how to exercise, but must pay to take a maternity class so a professional can tell her what to do. She may crave an ice-cold drink on a hot day, but her midwife knows better. She may need to ride a bike to catch her train, but will pass an old lady along the way who will tell her she shouldn't.

It's this attitude that makes me reject a lot of Japanese pregnancy wisdom. Although I love the position I'm in, observing how two cultures treat pregnancy and being able to pick and choose the practices from each that make the most sense, I definitely lean towards a western view of pregnancy. I think my body is perfectly designed to carry my baby and trust myself to do what's best for both of us.

Comments

[Rona Y]

In my experience working at a private language school in Japan, my Japanese co-workers who became pregnant quit around the time they started to show.

But at schools (both public and private), almost all my co-workers who became pregnant continued working until maybe their 8th? month and then went on mat leave, but all returned to work after their mat leave was up.

I can't remember if you mentioned this before (or if I did), but mat leave is very different in Japan than in Canada. My co-worker told me she could decide when she began her mat leave, but even if she started around her 6th month, she did not have to return to work until 1 year after her child's date of birth. In her case, she took 14 months of mat leave, but another of our co-workers who had really bad morning sickness took about 18 months. BUT, however long you take, your entire mat leave is unpaid!

BTW, the "use a condom if you're going to have sex with a new partner while pregnant" thing is really funny. Yet it's sort of scary. . .

Hope you're doing well, and that the weather has cooled down for you. It's quite chilly in the Canadian prairies right now!

[Lori]

"(To be fair, I was able to find a few English websites recommending condoms during pregnancy, but that was only in a few very specific situations, like when having sex with a new partner. Which has to be the funniest English-language pregnancy advice I'd heard yet)."

Maybe I'm missing something, but it's always recommended to use a condom when you're having sex with someone new. Just because you're pregnant doesn't mean the risks of catching diseases disappear.

[amy]

Hello there! First time commentor and I couldn't resist commenting on this topic! Cultural differences can be fascinating. I think the physical restrictions on pregnant women stems in the historical family culture in Japan. When you think about it, when a woman married into the husband's family, she became the in-law's primary house maid, farmhand, cook, cleaner, etc, and the only opportunity for a young wife to get some "rest" was when she was pregnant with the family's child, whom would grow and eventually carry on the family name. For the husband's family, their pregnant daughter-in-law was now a vessel carrying really precious cargo, and probably wanted to ensure that the child would be born to the world safely. That also kind of explains how there's the "mistrust" of the woman's body - I mean, how could a daughter-in-law's body be trusted? Anyhow, I've heard this in the Korean culture as well where a pregnant woman is treated very fragile throughout her pregnancy and even after birthing, partialy because the new-mother knew that once her body was "normal" she would be put to task to all the physical labor that would be assigned by the MIL. The world's changed since long-long-ago, and many Japanese women are increasingly becoming independant, so I'm sure many of the unscientific physical restrictions will slowly go to the way-side. Good luck in Japan! I'm sure there will be more cultural eye-openers once your baby is born. :)

[astrorainfall]

Love this post!!

I'm Chinese by ethnicity so am familiar with this hot and cold thing in the body. I do believe in the balance of yin and yang by way of food but even the Japanese take it to another level. My students tell me ridiculous things like a warm bath in summer (in this horrible heat!) helps you sweat to cool your body but keeps you warm internally.

I also had a student who quit taking lessons after she found out she was pregnant at 8 weeks. She wasn't working either. The boredom of doing nothing but nesting sounds ludicrous to me...

[suzy]

What a brilliant post... very funny! It seems like there's not much official advice on pregnancy in Japan but lots and lots of anecdotal / superstitious stuff. Here I feel like the pregnancy police frown on you for drinking too much coffee and things like that, but at least it's all stuff with an actual medical basis. Although the sushi thing here is pretty stupid, I wish they would just say "don't eat unhygenic shopping mall food court sushi"... but I guess a lot of people don't know that there is any other kind.

[Alex Case]

Wow, I got through the whole of my wife's pregancy without being aware of most of that. I had the exact same theory about Japanese women being removed from all work to protect them from their mother in laws, though

[Sandy]

I've heard of bicycling and other astride activities such as horseback riding being off-limits to pregnant women. And I second the first poster's comments about "hot" and "cold" foods being present in Korean cultures. My mother, to this day, attributes any positive traits I have to the quality of foods she ate when she was pregnant. Even now, she'll select certain items to "warm" or "cool" my blood...the temperature of the blood apparently being the cause of all illness and/or moods. Oh, and the weather. You don't want to eat hot foods in hot weather because it will make you prone to anger or getting upset. Stuff like that.

[Kathrine]

It's interesting to see that many of the foods you listed as cool foods to be avoided can be problematic for those with/or with the potential for certain health issues...fruit are high glycemic, even those that are supposedly low glycemic do spike the blood sugar, especially for sensitive individuals...dairy is hard on the GI tract and many asian people tend to be lactose intolerant plus pregnancy does put a strain on the GI tract, hard cheeses have the lowest lactose content...tomatoes, eggplants etc. are nightshades and common allergens, many "spicy" spices come from peppers which are also from the nightshade family...for those with allergic tendencies, the cooked forms of vegetables are more likely to be tolerated than the raw forms, plus raw forms are just harder to digest, esp. for a system that is under any stress. It just happens that due to my combination of diabetes(that I manage with diet alone) and food allergies, I have to avoid all the cooling foods you listed and most of what are listed as warm foods are ok and are dietary staples.I didn't come at these dietary changes with any knowledge of the ideas of warm and cool foods so maybe there is some medical basis.

There is growing evidence that our attention should be more on Vitamin D and exercise to prevent osteoporosis so I'm not so sure that we can say with confidence that the things we've told in the west about calcium and not being able to get enough from dietary sources other than dairy and supplements are true.

I'm caucasian but am the on the small end of average for a Japanese woman. I do have to say that those of us who are petite and thin, we do feel temperature differences more easily and have a harder time warming up when cold. That's not to say that I think that is a danger to a fetus.

It's been interesting to read your reports on pregnany in Japan! It's helped me alot to understand some things that I observed with some Japanese friends and acquaintances here in the U.S. during their pregnancies and early motherhood.

Best wishes to you and yours during this special time in your life.

[Helen]

Hi! I am 38 weeks pregnant in Japan. I am totally on your side that here, in Asia, women do not trust their own body being capable of safely carrying the baby. I was even warned by friends not to stretch out my arms to reach upper shelves or by Chinese friends at university about using computer and mobile phone. Not to mention that I had the hardest time finding an extra-large swimming wear that can fit my growing belly.

[Diana]

Hello,

Congratulations on your beautiful baby boy!
I just read 2 of your posts and I find your blog very interesting.
I like cultures and I find Japanese culture very intriguing.
I am myself pregnant 18 weeks so I enjoy even more to read about this subject. I like your witty style of writing.
Related to this post, I have to say I did read in my English websites that riding the bicycle is not advised while pregnant.
Keep on posting and I will be reading you!
Lots of best wishes for you and your family!

[J Williams]

"Maybe I'm missing something, but it's always recommended to use a condom when you're having sex with someone new. Just because you're pregnant doesn't mean the risks of catching diseases disappear."

I know this was posted a couple of months ago, but just in case the person who wrote it checks back: You did miss something Lori- with morning sickness, stretch marks, sore/leaking boobs and a huge belly, the idea of having sex with a new partner while pregnant is kind of laughable. Not something most women have to worry about, I can assure you...