It’s been on my mind to share with you all about what it’s been like being pregnant in Switzerland. I’ve waited till now - the start of my 39th week to write it so I had a good idea of the whole journey. I will write about the birth experience (including the final week/s of pregnancy and how that was managed) separately so the post isn’t too long. Due to many friends and family giving birth in Australia, i know a little bit about what is normal there and being able to compare the experience with Switzerland, although it is important to note that my experience here may not be (and most likely isn’t) typical of all pregnancies here in Switzerland either. Anyone’s care here is largely dependent on the gynaecologist you choose to see. So let me jump in to the biggest things i learned, loved and hated about being pregnant in Switzerland.
How much you pay/How much is covered
In Switzerland, it is compulsory to have basic health insurance cover and its not very cheap! I’m not going to go into all the details of how health insurance works here, but here’s a small overview: We pay roughly CHF 800 a month as a couple for basic health insurance. For that, you receive care thats a little better than Australia’s free public health service. In addition to our monthly fee, we still have to pay our franchise (like an excess) - so we pay the first CHF2500 per year of all medical bills. After that, we only pay 10%.
For the first 13 weeks of pregnancy you are considered ‘ill’ which means all the bills are treated as such and dealt with normally through the insurance. From 13 weeks to birth you are considered pregnant and pretty much everything pregnancy related is 100% covered and you don’t have to pay the excess either. We were pleasantly surprised by this and its been a huge financial relief as there are so many appointments you need to go to plus all the unexpected appointments that pop up too, and I don’t know whether you’ve heard but Switzerland is expensive! haha. Its kind of been fun seeing all the expensive medical bills come in and zeroed out - Thank goodness!!
Thankfully we didn’t have any complications or anything go wrong in the first 13 weeks, but I feel for women who miscarry and perhaps need a D&C and then also have to pay for their surgery on top of it all because as per the health system you’re ill not pregnant! I really believe if it is pregnancy related - it should be covered regardless of how many weeks you are.
Routine Scans and Appointments
Here in Switzerland, your pregnancy is managed by your own ob/gyn of your choosing which you go back and see throughout the whole pregnancy. I could be wrong, but this seems to be opposed to being managed largely by your General Practitioner in Australia and only occasionally seeing an obstetrician at milestone dates. I chose an ob/gyn based on some recommendations on facebook, however I wish I would have settled with a gynaecologist before hand and got to know the style of my doctor as I have never really felt 100% happy with my choice (more on that later), but felt like it would be too much trouble to change part way through.
I saw my obstetrician, every 3-4 weeks and at each appointment I had blood drawn, urine sample, weight check, blood pressure check and a growth scan by ultrasound. This is in addition to a short chat with the ob/gyn about any concerns either one of us had. I loved that everything was done in one building and directly before my appointment. Unlike Australia where your blood samples and ultrasounds are usually done somewhere other than your appointment and not likely on the same day either!
I know in Australia, they only do around 3 ultrasound growth scans over the entire pregnancy and initially, i thought the Swiss way of an ultrasound every 3-4 weeks was good. Why wouldn’t i want to see my baby on the screen each month and make sure everything is on track? Well… my baby has always measured on the smaller side pretty much the whole way through the pregnancy. I know that ultrasounds can be slightly inaccurate too. However all these scans just caused a whole bunch of stress that really wasn’t necessary. My doctor became concerned at my baby’s size, and also at her head circumference so we were referred a couple of times to a specialist for more ultrasounds (on slightly more accurate equipment) which showed she was small, yes, but everything was completely fine. This period felt like a rollercoaster of worry and relief and it really made me question what the point of all these ‘extra’ ultrasounds were - does micro monitoring these babies really benefit the health of the pregnancy, or just cause undue worry? Do they pick up more abnormalities in Switzerland than Australia?
You and your baby’s stats are printed on a ‘Mutterpass’ which you continually get updated at each appointment and take home with you and take to the hospital or to any health care provider that needed to see it. I actually loved this sheet of paper. I felt like it was a great overview of how it was all tracking, the information was transparent and I could refer back to it anytime i wanted rather than it all kept for the doctors only.
Overall, the care in Switzerland is at a very high standard - Doctors are well educated and knowledgeable - all the tests were completed quickly and easily and I was updated on results very quickly too. I do believe however that bedside manner and how patients are listened to and spoken to was not so great. Now, I know this is not everyone’s experience here. My ob/gyn came highly recommended by many and I felt she was professional and met my needs medically 90% of the time. Perhaps this was a cultural thing (most likely i think) but i really clashed with my doctor. She is definitely more serious and blunt and maybe its because i’m Australian, but i prefer things a little friendlier. One thing i had to get used to was when she greeted me into the room and asked ‘How are you?’, the answer was carefully written down in my notes and not mentioned again. The stock standard answer for ‘How are you?’ is always ‘good’! I didn’t know I had to pour out my soul to her as I entered the room!
I also got very little information on my first appointment with her back when i was 7 weeks pregnant - she briefly touched on some foods to avoid - raw fish/meat, unpasteurised cheese - and gave me a booklet that was in German which was sort of like a handbook about pregnancy. Needless to say, i didn’t read the book and was left with a lot of questions, not only general questions on pregnancy, but also the process in Switzerland. What could I expect from her, how many appointments will I have, who do I call if I have problems during the pregnancy? I felt like a lot was missed out and i learnt more from support groups online, and through books than I did through my own doctor. I realised they are not in the habit of telling you anymore than you need to know. Results sent through to my doctor weren’t really elaborated on apart from a ‘yes its okay’ - instead, if a copy was sent to me, i would be googling translations to really understand what was tested and what my results meant. For anyone going through the same experience - i 100% recommend purchasing Emily Oster’s book ‘Expecting Better’. She compiles all the information women need to know about what to eat, the risks of various foods and tests, what tests are necessary and all the facts and statistics directly from the research studies with no spin! It really gave me peace of mind and confident in the decisions I was making for myself.
It’s a sad thing to say, but I often left my appointments feeling dumb, depressed or worried. My questions were often met with replies that made me feel silly for asking, I was unnecessarily worried about potential risks that hadn’t even happened or been confirmed yet, and any concerns of pain I had wasn’t really questioned and just brushed off as ‘normal’ which may have been true but i felt like they weren’t investigated adequately. Immediately after failing my gestational diabetes glucose test, I was told I would most likely have to be on insulin at some point in the pregnancy and ‘have’ to go to the main hospital for birth (which was not the hospital I preferred) - Both of these facts turned out not to be true as my blood sugar levels have been in the right ranges since and my choice in hospital is available and safe for me to be at. In hindsight, i wish I changed doctor from the beginning, however i continually doubted my own feelings and that maybe i just ‘took it the wrong way’. I had a much better experience with the specialist doctor I saw at regular intervals - i guess being a specialist and having to give a range of good and bad news, her bedside manner is a little more developed and crucial for the wellbeing of her patients.
All in all…
I sit here now, at the tail-end of my pregnancy pretty happy with my journey and experience. Despite jumping through all the hoops they threw at me, my pregnancy had no complications, my baby is healthy according to all their measurements and tests and I feel really good heading into this birth. I have learnt so much through this journey though- most importantly to trust myself and my body. I have learnt that no one cares as much about your own body and health than you and you need to advocate for yourself, realise that while doctors are incredibly knowledgeable, you also need to understand what is happening and it needs to feel right for you. There is so much information out there and I encourage you to speak to a wide variety of people, read books, hear other peoples experience and educate yourself - knowledge really is power and it gives you the confidence to ask more questions and take ownership over your health and care.
I also learnt to relinquish a little control in some aspects (which is big for me!) and have worked hard to get my head in a good, happy place. Naturally, i haven’t felt like this all the time, and i’m sure i’ll still have doubts in the final week or so - but i feel like i’ve grown as a person. Perhaps I needed to go through this - to become a better human, woman and mother.
After the birth i’ll discuss all the ways i prepared for the delivery - antenatal classes, books i read, podcasts i listened to, my experience in hiring and doula, and hypnobirthing!