Miscarriage in Japan: What to Expect and What It Means

What Is a Miscarriage in Japan?

In Japan, a miscarriage is called 流産 (りゅうざん, ryūzan). It is defined as a pregnancy that ends before 22 completed weeks of gestation. Anything after 22 weeks is classified differently — as a stillbirth (死産, shizan).

The great majority of miscarriages happen in the first trimester, before 12 weeks. JSOG data shows that chromosomal abnormalities are found in around 80% of miscarried tissue — a one-time error in cell division, not something caused by anything the mother did or did not do. Many people spend a painful amount of time wondering what they could have done differently. In most cases, the answer is nothing.

If you are experiencing bleeding or abdominal pain during pregnancy, go to your 産婦人科 (sanfujinka — obstetrics and gynaecology clinic) as soon as you can. If the clinic is closed, go to the nearest hospital with an obstetric department.

How Common Is It?

According to JSOG, around 15% of pregnancies end in miscarriage. Across the population, roughly 38% of women who have ever been pregnant have experienced at least one. The rate rises with age — after 40, more than 40% of pregnancies end in miscarriage.

These numbers are not meant to minimise what has happened — but they matter. Miscarriage is not a rare event. Many people around you have been through something similar, even if they have never talked about it.

The 4 Types of Miscarriage

Japanese obstetrics classifies miscarriage into 4 types, each reflecting a different stage of the process. Your doctor will use these terms, so knowing them in advance can help you follow what is being said.

切迫流産 (seppaku ryūzan) — Threatened Miscarriage

In Japanese obstetrics, a diagnosis of 切迫流産 is made whenever a pregnant woman presents with bleeding or cramping in the first half of pregnancy — even if the pregnancy looks entirely healthy on ultrasound. Many women who are told 切迫流産 go on to have completely normal pregnancies.

If your doctor said 切迫流産 and you are unsure what is happening, ask directly: 赤ちゃんは元気ですか (Akachan wa genki desu ka — "Is the baby alright?"). The answer will tell you everything about where things currently stand. If the answer involves stopping work for a while, employer health insurance can cover part of your salary during that time — see our guide to the sickness allowance.

How It Is Diagnosed

Diagnosis is by ultrasound scan (超音波検査 — chōonpa kensa) at your 産婦人科. The doctor looks for the gestational sac, fetal growth, and whether a heartbeat is detectable at the appropriate stage.

A 稽留流産 can come as a complete surprise at what feels like a routine check-up. There may have been no warning signs at all. If findings are uncertain — for example, if the pregnancy is very early and a heartbeat has not yet been visible — most doctors will ask you to come back in one to two weeks before making a definitive diagnosis. This waiting period is difficult, but it is standard practice: the scan needs to show clear evidence before a diagnosis is confirmed.

If you are experiencing significant bleeding or strong cramps, go to the hospital directly rather than waiting for a scheduled appointment.

Treatment: 子宮内容除去術

When the pregnancy has not passed completely on its own, surgery is usually recommended. The procedure is called 子宮内容除去術 (しきゅうないようじょきょじゅつ, shikyū naiyō jokyojutsu) — which translates roughly as "surgical evacuation of the uterine contents."

Two techniques are used in Japan:

The procedure is typically done under general or local anaesthesia and takes around 10 to 20 minutes. Most hospitals in Japan perform it as a day procedure — you come in, have the surgery, rest for a few hours, and go home the same day. The hospital will give you instructions about eating and drinking beforehand, and what to expect during recovery.

It is entirely reasonable to ask your doctor which technique they use and why.

Recurrent Miscarriage

Two consecutive miscarriages is called 反復流産 (hanpuku ryūzan). Three or more in a row is 習慣流産 (shūkan ryūzan). These terms carry specific clinical meaning in Japan — once you reach either threshold, your obstetrician will typically recommend investigations to look for an underlying cause.

JSOG is clear on this: a successful pregnancy in the future is still very much possible.

Causes that investigations might identify include blood clotting disorders, uterine structural issues, chromosomal factors in either partner, and immune system conditions. Some cases remain unexplained even after thorough testing — which is frustrating, but not unusual.

Recovery and the Road Ahead

Physical recovery from a first-trimester miscarriage usually takes a couple of weeks. Bleeding tends to settle within one to two weeks. A follow-up scan confirms that the uterus has returned to normal.

Most obstetricians in Japan suggest waiting for one to two full menstrual cycles before trying to conceive again — partly to allow the uterine lining to recover, and partly to make it easier to date a new pregnancy accurately. If you had surgery, your doctor will give you more specific guidance.

Emotionally, there is no correct timeline. Grief after miscarriage varies enormously between people — and between individual losses for the same person. Some people feel ready to move forward quickly. Others find the impact lingers for months. Both are normal. The fact that miscarriage is rarely spoken about openly in Japan does not mean you are expected to feel fine quickly.

Getting Support in Japan

Miscarriage is still a largely private matter in Japan — it is not commonly discussed, and there is little formal community support. That can make it feel lonely, particularly as a foreigner who may already be navigating life here without the people you would normally turn to.

A few things that can help:

• Your midwife or obstetrician. The midwife (助産師, josan-shi) at your hospital can be a good first point of contact. Many hospitals have a midwife you can talk to separately from your doctor.
• Postpartum care centres (産後ケア施設). Some postpartum care facilities also support women who have experienced pregnancy loss. Your hospital can advise you.
• English-speaking communities in Japan. Expat parent groups — particularly in Tokyo and Osaka — often have members who have been through the same thing and are willing to talk.
• Telling the clinic team. If you are struggling emotionally, it is worth letting your 産婦人科 team know. Mental health support is available in Japan, and they can make a referral.

Useful Phrases at the Clinic

Tap 🔊 Play to hear the phrase spoken aloud in Japanese.

Japanese Vocabulary