The ultimate guide to pregnancy in Switzerland

First of all: Congratulations! Not only for being pregnant, but also for being pregnant in one of the safest and most developed countries in the world.

I remember that I was excited yet scared at the same time while taking my two pregnancy tests. And I cannot imagine what it must feel like for a foreigner who has no clue how the Swiss health system works - and most likely does not have family or close friends around for emotional support.

So, I hope that I can give you some valuable insights into the Swiss pregnancy jungle. I hope that my tone is conversational as if a good girlfriend was talking to you...

Some words on Swiss maternity insurance.

Basic health insurance is your best friend during your pregnancy as it covers pretty much everything. It covers the cost of check-ups, giving birth, post-natal care and even breast-feeding advice. There are no out of pocket contributions or hospital fees.

By law, basic health insurance covers seven medical check-ups and two ultrasounds. One ultrasound will be covered between 10 and 13 weeks, and the second one between 19 and 22 weeks of pregnancy. And for high-risk pregnancies, as many ultrasounds as necessary are covered under a basic Swiss health insurance plan.

What is considered to be a high-risk pregnancy?

Several factors determine what could be considered a high-risk pregnancy in Switzerland. For one, it could be the mother’s age (say, above 35 years), any complications, multiples, chronic diseases, breech presentations, or in the past, C-sections.

As you can see, there are many reasons these days that a pregnancy might be categorized as "high-risk". Depending on your health insurance company and your current and past health situation, they will pay you as many ultrasounds as needed. As for me, I have chosen the SWICA health insurance some years ago (no commercial here!). They would cover an ultrasound approximately every six weeks for the duration of the entire pregnancy (and more often in the third trimester).

I want to stress that this is your own choice whether this is really necessary. For comparison, I talked to women from Norway and because their health system is national, they get paid only one ultrasound during the entire duration of the pregnancy. This was also a normal procedure in Switzerland when my mom was pregnant with my brother and myself (in the 1980’s). It also used to be common to not know what gender the baby is, which I think is kind of cool!

My advice: Please double check that the gynecologist or hospital marks Mutterschaft (maternity) on the invoice that is sent to your health insurer - and not Krankheit (illness). This misunderstanding happened to me during my second pregnancy and caused a lot of trouble and confusion. Needless to say, it took some effort to sort it out with the health insurer.

Finally, give your health insurance company a call or send them an email as soon as you know that you are pregnant. It makes the whole process smoother afterwards. (Guess who forgot to add this step to her to-do list...)

Your baby needs insurance, too!

It might seem way too early at this stage to think about health insurance for your unborn baby. But the sooner you look into it, the better! The reason is that you will have so much more to organize and think about once the pregnancy progresses. There is no rush, but as you talk to your health insurance company anyway, why not ask them to send you a vorgeburtliche Offerte (prenatal offer)?

Once the baby is born, you will fill in the missing information such as the full name, date of birth and so on. The advantage of doing this before the baby is born is that your baby will already have insurance coverage and maybe even supplementary insurance at the time of birth (Zusatzversicherung).

Let’s talk about the worst case where your baby has a physical restriction and you would like to see a therapist. Your health insurer is not obligated to include your baby in supplementary insurance. (Note: Basic insurance is always possible and is compulsory in Switzerland!) I do not want to sow any anxiety here, just keep this in mind while going through the entire process of selecting Swiss insurance.

Even in Switzerland, maternity is big business.

Marketing is not something you would link with pregnancy – but do not be surprised that nowadays, there is a huge marketing force behind maternity in Switzerland. Expecting parents are able to request 3D and 4D ultrasounds (the latter are videos) costing anywhere from 150 francs to 350 francs. You can upgrade your insurance status to „half-private“ or even "private" in order to get the best possible treatment that is out there.

My opinion is that basic Swiss insurance is already much better than in most countries around the globe, so I stuck to it. When I was at the hospital with both my first and second child, I was lucky twice to be assigned a room for myself - even though I do not have "private" insurance. Finally, there is quite a rat-race among the different Swiss hospitals, but more on that in part 2 of the my Swiss baby series.

And now for a sensitive topic.

I apologize for covering a sensitive topic and I wish that you will never be affected. But as we all know, miscarriages are happening a lot at the beginning of a pregnancy and during the first trimester.

You need to know that up to week 12, your pregnancy really is viewed as an "illness" from the standpoint of your health insurer. It only turns into "maternity" after the 12 week mark.

This sounds weird, I know. But for you, it means that if you lose your baby before the 12th week, the health insurer will most likely not pay for the costs like curettage. I personally think this is not right and it can be a kick in the teeth during a time when you are grieving and unstable because of the loss.

Realistically, this means that if you have an insurance policy with a 2500 franc out-of-pocket "franchise", you will be paying costs up to this amount yourself, and only the excess amount will be paid by the health insurer. If you have a franchise of 300 francs, however, this is all you will have to pay.

Those who are dealing with a loss might find comfort here: Stärnechind (German and English), engelskinder.ch (German only), My Star Child (German and English), kindsverlust.ch (German only).

"Psst! Let me disclose a secret..."

When is the right time to tell your boss, your friends and your family that you are a proud mommy-to-be? Custom here in Switzerland is that most women wait until they are three months pregnant. But of course, this is up to you!

Personally, I find three months way too long to keep a big secret like this, so I always told my loved ones earlier. (I even broke the news to my boss before the 12 week mark.) She was glad about the information as it allowed her to find my replacement during maternity leave. And I was glad that I did not have to make a big secret out of why I felt so sick all day and why I stopped drinking coffee. (No coffee?! I still cannot believe how hormones are able to mix up your system…)

There is no law about when to tell your employer. From the moment you do tell them, you will have a dismissal protection for the whole length of your pregnancy, plus for 14 weeks after giving birth. Many employers will grant 16 weeks, however.

More on legal protection of working mothers (PDF in English)

Daddy cool

If you are married, this is going to be easy. Your husband will automatically be viewed as the father of your child and you do not have to take any action. If you are single or living in concubinage, the father of the child will have to fill in some paperwork – the acknowledgement of paternity (Vaterschaftsanerkennung). This document will also regulate the right of succession and the right of the father to associate with the child.

I guess this is easiest to do before the baby is born because there will be so much else going on once the little one is here – and you surely want to rather cuddle that little bundle of joy than hanging out at the registrar’s office (Zivilstandesamt) to sign a stack of papers.

You will also have to choose a family name for the child, and this decision will automatically affect all the children that might follow in the future. Be aware that this is not changeable. Best is to call your local authority (Gemeinde/Stadt) to make an appointment and to ask them what documents they will need from you. Of course, this is not for free, so be prepared to bring your wallet along.

Take a (baby) shower!

Phew, after talking about all the serious stuff, let’s have some fun! Did you know that baby showers are becoming popular in Switzerland as we speak? (We better not mention gender reveal parties as they will probably only make it to Switzerland in another ten years. We are always a bit behind, you know?)

In your home country, baby showers are probably a must-do during pregnancy. Only two weeks before the baby was born, I hosted one myself. Looking back, it is one of the most treasured memories of my pregnancy. If you are looking for a theme or some inspiration for the party, check out Pinterest.

And if you want to order some decorations, have a look at Pinkfisch. It is a Swiss company owned by two moms with seven kids among them. From invitation cards to napkins, straws, ribbons, pompons, lanterns, balloons… This will be the start of your shopping frenzy! Great material not only for your baby shower but also for the first birthday of your baby or for any other fun party ahead.

Let’s party, baby!

And here is a to do list for your pregnancy in Switzerland:

• Pick a gynecologist or a hospital for your check-ups and ultrasounds
• Inform your health insurer that you are pregnant
• Ask your health insurer for a prenatal offer
• Inform your employer about your pregnancy
• Make an appointment with your registrar’s office for the acknowledgement of paternity (if you are not married)
• Organize a baby-shower or even better – let a good friend organize one for you!