HEALTH TIME
ONE WOMANS EXPERIENCE ON BIRTH IN CH
Like
many aspects of pregnancy and child rearing, we know, empirically and
intuitively that an accurately charted birth experience is elusive. Predicting
the course of events during a birth is an approximate endeavor. Thus,
this article is meant to merely add a one data point in a less than linear
experiment, to maybe add a layer of comfort for those brave or stupid
enough to engage in the highly speculative game of parenting. When people
become parents, it seems that most of their energy is poured into planning
and ensuring (and insuring) in the hopes that our children will be ok,
if not perfect.
This article also comes with the caveat that I have never had a child
anywhere but in Switzerland, so my experience is lopsided, as my comparison
to having a child anywhere else will be based on other people’s
stories.
My husband and I visited three hospitals in the Zurich area while I was
pregnant to determine which would be best for us. Health insurance in
Switzerland works along a three-tier system; one can either have public,
semi-private or private insurance. I’ll leave the reader to deduce
which one is cheapest. With private insurance, a woman gets a private
room in a private clinic, with her doctor at delivery. With semi-private
insurance, a woman gets the same as above but without a private room.
With public insurance, a woman gets a shared room in a public hospital,
where, generally, she will have another doctor perform the delivery.
A woman cannot upgrade from public to private insurance if she gets pregnant
within a certain timeframe, generally a year from the time her contract
starts; thus, if a pregnant woman with public insurance wants private
level care, she will need to pay out of pocket.
My husband and I have public insurance and this was not much cause for
concern. My personal doctor did not deliver at the public hospitals but
given the Swiss medical care’s reputation, we figured any doctor
would be pretty good. In our research, we found that the midwives here
play a more hands-on role during labor and delivery than the doctor and
thus, in our visits to hospitals and clinics, it was they that we sized
up rather than other things.
We visited the following three hospitals in the Zurich area: Universitaetspital
Zurich (public), Hirslanden clinic (private) and Stadtspital
Triemli (public).
Up until my sixth month of pregnancy, I had planned to give birth at
Universitaetspital Zurich, as it was the closest to our house. It is
also the best equipped of the three for any potential complications.
Finally, my husband and I, having spent the past decade on university
campuses for one reason or another, were naturally, if irrationally inclined
to have a baby on one. There are tours given at the Frauen Clinic, the
University’s maternity ward, for expectant parents but they are
conducted in German so we opted to schedule an appointment with a midwife,
an “absprache”. We as expatriates often hear that everyone
in Switzerland speaks English but that’s just not true. The Frauen
Clinic sits atop a hill, and after huffing and puffing my way to the
reception for my appointment, I was met with a stern man at the lobby.
I mumbled something like “geburtplatz?” He narrowed his eyes
and responded “stock D”. At “stock D”, I found
a nice lady behind a counter who also didn’t speak English but
understood French. She took all my information, smiled and disappeared
to the back. For twenty minutes. I periodically called out to see if
there was a problem. The lady kept turning back to me, smiling, indicating
that all was okay. I sat in the waiting area, sweating. The only other
person waiting was what could have only been a transgendered woman. My
thoughts, generally hemmed in by political correctness, went wild. The
person in front of me smiling vaguely, rattled me. What was she doing
here? My suspicion was unfair of course but herein lies an aspect to
Swiss hospitals that is alien to Americans; a distinct lack of security.
It seems any old person can walk in anywhere else. My husband showed
up just as a midwife did. After asking me my name, she quipped, “You’re
late” and walked off. The lady at the counter, still smiling, assured
us she’d be back. Just relax. Be cool. What was wrong with these
people? Couldn’t they see I was pregnant and everything mattered?
Can anyone be cool when they’re expecting a child?
She did eventually return. She smelled pissed off and annoyed. I still
didn’t want to give up on this place so I duly followed her to
a room and went through the list of questions I brought. I asked her
if I could count on an English speaking midwife being present at the
birth; she shrugged and said no. I told her I wanted a natural waterbirth,
if possible and she just barely stifled an eye roll. I told her I wanted
to breastfeed my child, would they help me to get started? She smirked
and answered: “If the baby wants.” The cruelest cut came
when I was done with my questions. My husband, hesitant in participating,
ventured to ask what would be expected of him. The midwife gleefully
slammed her notebook shut and said: “Time’s up! You’ll
have to schedule another appointment.”
We were spooked. Had this experience occurred in any other context than
birth planning, I would have brushed it off as a possible fluke. Too
much was at stake however, so we crossed Universitaetspital off our list.
They didn’t cross us off theirs though. A month later, we received
a bill of 100 CHF for our abridged “Absprache”.
We then visited Hirslanden clinic, the Dom Perignon of maternity clinics
in Zurich. We weren’t seriously considering shelling out 5 digits
worth of cash for an experience at Hirslanden but we had scheduled an
English language pre-natal class there so we got a chance to check out…where
we would have had our child had we been rich!
The weekend course was one big ooh, aah. What impressed us most (to the
point where, for about 15 seconds, along with another public-insurance
couple, we actually did consider sinking our life savings to give birth
at Hirslanden) were essentially bells and whistles. The rooms are huge
and outfitted like boutique hotels. We marveled at the wood paneling
on the walls that discreetly hid outlets for our laptops. We wistfully
admired the designer diaper bag you get when you give birth in Hirslanden.
The mid-wife conducting the course seemed to be very warm and experienced
but not enough to warrant the price tag of a delivery at the clinic.
In fact, the course in itself was one I would not sign up for again:
all the information we received, we could have gotten online.
The last hospital we visited was Triemli. The hospital is at a considerable
distance from our house given that we don’t have a car. The complex
itself is horrendously ugly, a series of over-sized cinder blocks, grey,
foreboding. It sits, predictably, in a beautiful part of Zurich, at the
foot of the Uetliberg. The hideous, man-made and functional thrust upon
the charming, pretty and organic is a leitmotif I see time and again
in this wonderful country and I am still not sure what it is due to.
In any case, the maternity ward here is in a separate building from the
rest of the hospital, a nice nod, I like to think, to the non-pathological
nature of birth.
When I visited, the ward was undergoing renovations but the mid-wife
I “absprached” with (for free!) assured me it would be over
by the time I was due. The mid-wife, who, I swear said her name was Mrs.
Pretzel, spoke no English. I hobbled along the conversation in my poor
German and as I did, I grew more and more relieved, certain. In spite
of the language barrier, she conveyed to me what I needed: warmth, respect,
assurance, experience and holiest of holies, optimism. My decision was
made then and there: Triemli would be the place for us. And it was.
My birth experience ended up being the antithesis to my birth plan. In
the face of my one year old son, the series of events that brought him
here have become laughably irrelevant. If I learned anything about my
preparatory visits to hospitals in Zurich, it is the following: they
are all equipped for different births. Birthing tubs, balls and ropes,
mid-wives knowledgeable in homeopathy and naturopathy, are available
in all the hospitals I visited as are epidurals and c-sections. Rooming-in
with baby is the norm. Footprints and baby hospital bracelets are not.
Contrary to rumors I heard oft and again before having my child here,
the obstetrics in this country do not seem to be militantly “natural” leaning;
they merely make natural choices readily available.
If I were to have another child here, I would opt to upgrade to a private
insurance policy. My horrendous experience with my insurance company’s
reimbursement process is one factor but the critical one is that I would
want my own personal doctor with me during labor and delivery. So, all
in all, I would say that choosing a clinic to give birth in, financial
and health constraints not withstanding, boils down to one’s affinity
to the staff.
MARIANNE
EFSKIND Occupation: intern in public health and family medicine in Vik. |
 |
mamizeits Dr. Marianne
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