The authors developed advance consent in Japanese for epidural anesthesia for pregnant Japanese-speaking women. Their explanatory, sequential mixed methods design involved a survey (QUAN) and telephone interviews with Japanese women (QUAL). An e-mail survey of health professionals (quan/ qual) was conducted concurrently to the QUAL arm. Japanese women and health professionals found advance consent as helpful, though minor problems were identified. Advance consent helped lower communication barriers, and the women wanted more information about pain control. This mixed methods study of Japanese women suggests that bilingual advance consent offers an innovative tool to help overcome the language barrier for non-English-proficient women who predictably needed interventions (e.g., epidurals) under unpredictable circumstances.