Before access to modern obstetrics became widely available in Japan, people had to resort to folk medicine, as well as to a number of religious and magical practices to alleviate the danger that pregnancy and childbirth brought with them. Collectively, these practices are known as anzan kigan – the prayer for safe delivery. Modernization, urbanization and technological advances since the Meiji Restauration all had a profound effect on these practices. Some have all but disappeared, others have persisted, albeit in modified form. Yet others seemed to be on the decline, only to experience a veritable renaissance in recent years. Based on fieldwork conducted in Gumma and Kagoshima, as well as an analysis of recent maternity journals, this paper takes a look at how and why these practices have changed, as well as at the strategies that shrines and temples that offer anzan kigan services have adopted to stay relevant in modern times. It argues that anzan kigan has changed from a socially significant set of practices with heavy religious connotations to a secularized and commercialized event that is most relevant on the level of individual families. Practices that have always been or could be adapted to be compatible with this change are going strong, while those that are not are in the process of dying out for good.