Arielle Busetto 
A nursery program in rural Japan. (©JAPAN Forward)
Moe Kawakita, a young mother in Tokyo, is waiting to see if her 11-month-old will be accepted by public childcare in April. "If he doesn't get it, I have no choice but to extend my maternity leave."
Kawakita isn't alone in her struggle. She is one of many facing the pressures of raising children in the capital. Jasmine Ortlieb, a mother from the United States, has a one-year-old in daycare in Shibuya Ward, but the application phase is key. "When you apply, you need to say that being able to get into daycare is essential. If not, it's a complete gamble whether you get a spot."
Public daycare is so sought after that there are even websites that rank which ward has the longer waiting list for daycare.
A Priority of the Japanese Government
Japan has faced the challenge of increasing the number of births for a long time. The fear is that falling births could lead to a population drop, a decrease in the productive workforce, and an increasing financial burden from an aging population.
The total fertility rate — defined as the average number of children per woman — varies across the country. Okinawa has the highest at 1.60, while Tokyo has the lowest, hitting less than one for the first time in 2024. A fertility rate of 2.0, known as the "replacement rate," is often touted as necessary to maintain a stable population.
In 2023, Prime Minister Fumio Kishida said it was the "last chance" to tackle declining births. He aimed to create a "Children First" society.
Home to almost a third of the Japanese population, local governments of the greater Tokyo area have increased their efforts. They offer benefits such as lump sum payments to support childbirth and financial assistance for each child.
JAPAN Forward spoke with experts and mothers living in Tokyo to gain insights into the challenges and potential solutions to boost the number of children in Japan.
Red Tape and Hidden Costs
"The cost of raising a child in Tokyo is hard to sustain," says Kawakita, who lives in Minato Ward, one of the city's most expensive neighborhoods.
Childbirth costs alone are significant. They normally include a week-long stay in the hospital and the associated medical care. Kawakita says her child's birth cost about ¥500,000 ($3,330) at a university hospital, even with the national and local governments support. This amount can rise with additional services, such as epidurals."The government said it would cover the costs, but the financial support I managed to apply for didn't cover all of it," she explains.
Navigating the bureaucracy to receive these benefits can also be frustrating. "The government does provide a lump sum for each child, which helps. But it's hard to keep track of all the paperwork," Ortlieb notes.
Yan Fan, who grew up in Seattle, also found the bureaucracy challenging, especially with the language barrier. "I had to ask a Japanese friend to help. Also, I had to send documents more than once, it's not an easy process."
Childcare and Housing a Bottleneck
Beyond financial assistance, daily childcare can be another obstacle. Minato Ward offers a temporary daycare system (一時保育), which charges ¥500 per hour. Even so, finding trustworthy childcare is still a significant challenge.
Itomi Sato, who runs her own company in Roppongi, uses 一時保育 but notes the lack of available babysitters. One woman, who chose to stay anonymous, says she uses a babysitter company introduced by the Tokyo government. However, there are months-long waiting lists.
Similarly, Fan says she gave up trying to find a babysitter through third-party websites as it was a time-consuming process. There are private agencies that take care of the organizational aspects, but they can have higher price tags.
Adding to the financial strain is the rising cost of housing. In Minato, where Kawakita lives, housing is a major concern. She works at an insurance company, and her husband is a medical professional. They worry about the burden of renting property should their family grow. "When you have a child, you need more bedrooms, which inevitably drives up the rent, even for smaller flats."
Pressure of Returning to Work
When it comes to returning to work after childbirth, the experience often depends on the mother's profession and type of employment contract.
Kawakita's company allows for one year of maternity leave. Meanwhile, Fan is an entrepreneur and has flexible arrangements.
However, for self-employed individuals like Sato, the pressure to return to work is different. Sato is the president of her own company, and she returned to work just one month after childbirth. "If you work for yourself, the moment you stop working, you stop earning income. There's a real pressure to get back to work," she explains.
In general, many of the mothers interviewed emphasized the societal expectation that women be flexible in balancing child-rearing and work. Ortlieb, who works in an NPO, says that while she is grateful to have flexible working hours, it's often expected that the responsibility of childcare falls on the mother.
"Daycare calls the mother if the child is sick. The pediatrician expects the mother to be the point of contact, and so on." "In that sense, changing attitudes is difficult," says Ortlieb.
Many of the mothers also discussed the hidden challenges in balancing work, housework, and childcare. "I have so much help, and I barely feel like I am holding it together," says Fan. "There is so much hidden work that goes with parenthood, and more people need to be aware of that."
Challenges of Paternity Leave
The husbands' work schedule also has an impact on the burden of childcare.
Kawakita's husband is a doctor, a field where leave is often taken at the bare minimum. "In the medical field, it's hard to take leave," she says.
Fan's husband works for a foreign company, and she notes that "The higher one goes in a company, the harder it is to take paternity leave." She adds, "I think there needs to be more of a discussion of how much fathers are important in raising children."
Another View
One story that stood out to me was that of Izumi Funasaki. She became a mother on the cusp of turning 40. In many ways, she says, she benefited from being able to prioritize her career in her early 30s.
Now, however, she says she is grateful to the local government for offering to cover the cost of childcare. "I was amazed, I felt that it was much less expensive than what I predicted."
It wasn't always easy. Funasaki is a writer, and like many freelancers, she felt the pressures of having to return to work as soon as possible. To this day, she says, "I feel that my work has decreased by 20% the second that people know that I am a mother."
Yet, for many things, Funasaki feels like she got help with her circumstances. For one thing, the cost of birth, in Funasaki's case, was covered by a mix of insurance and government benefits. Her household also qualified for public housing with capped rent and financial benefits for families. This significantly alleviated the financial burden, she says.
Finally, her husband is also lucky to be able to take one year of paternity leave.
"There are things to worry about. But honestly, I have come to think I might be able to have a second child!" says Funasaki.
Winds of Change
Funasaki's example suggests that some companies are beginning to change their approach to paternity leave. Ai Kawaguchi, editor-in-chief of NewsPicks for WE, a media focused on women and leadership, says that she has seen a shift in workplace attitudes.
"Over the past two years, there’s been a drastic change, especially regarding fathers. Progressive companies are creating environments where taking paternity leave is not just encouraged but expected," she explains. "This, in turn, has created success stories that inspire other people to do the same." She quotes virtuous examples like Mercari or Recruit, which has recently changed its definition of managers to accommodate a family life — with less overtime and other burdens.
BIOTECHWORKS-H2 Chief Operating Officer Miki Nitani is an example of a leader who is trying to change corporate culture. She explains how she has created an environment where women can quickly increase their salary in a merit-based way. "In Japan, we are often attached to the idea that one needs to work x number of years or x number of hours. Instead, we need to reward based on results. That way, we can also be more flexible when it comes to maternity leave or paternity leave."
The shift in attitudes may also be influenced by workers themselves. A Ministry of Health survey found that in 2024 the majority of people in their 30s and 40s say they don't want to work in a company that doesn't promote leave for parents.
A Broader Debate on Fertility
Tokyo has particular conditions that differ from the rest of the country. Even within the capital, conditions can vary greatly depending on the ward.
Still, decreasing fertility is not unique to Japan. Countries like Sweden, that have generous policies for families, or India, with a significant young population, are grappling with similar problems. Even France, once touted as an example of high fertility, has recently seen its rate drop to about 1.6.
In Japan, the Tokyo government has announced measures like an epidural subsidy or free daycare for the first child starting from September 2025. The news is already being greeted favorably. "That will be incredibly helpful. I am very grateful to the local and central government because I feel that the conditions for child rearing have really improved," said Sato.
However, experts caution that just throwing money at the problem is unlikely to solve the falling births.
Earl Kinmonth, Professor Emeritus at Taisho University, who has closely looked at the issue of fertility, argues that even efforts to encourage more participation in child-rearing will not be enough. "Nothing in the government proposals is likely to have substantial or lasting impact," he notes via email. This is because driving factors are difficult to address, such as higher education levels for men and women or fewer expectations to have heirs to take over a family business.
Looking to the Future
Despite the burdens of childbearing and the many unanswered questions, not all mothers are discouraged. Ortlieb says she plans to have three children.
Sato explains that once she wasn't very good with children, as she found them "loud and labor-intensive." She says her opinion has since changed.
"Every day, I'm happy. I know women who regret not having children, and I believe everyone should live without regrets. We should do all we can to support families in making that possible."
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Author: Arielle Busetto
