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Maternity – pregnancy and birth

Maternité, assurance prénatale et naissance

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The most important maternity care is covered by the basic LAMal insurance, but not all medical care is covered. As an expectant mother, there are many decisions to be made in preparation for the birth of your child.

Here are the 5 steps to prepare for the birth :

In a private clinic

Giving birth in a private clinic means benefiting from the exceptional Swiss healthcare. In fact, private clinics combine the best in care, technology, services and comfort. Allowing a choice concerning the medical team and the approach used.

Birth care in private clinics is expensive. In order to have access to it and to be reimbursed, it is therefore necessary to have previously taken out (for at least one year) a supplementary hospitalization insurance in a semi-private or private ward.

At the cantonal hospital

The largest number of new births is delivered in the cantonal hospitals. In fact, it is the most frequently chosen place to give birth. To give birth at the cantonal hospital, supplementary health insurance is not necessary.

At the cantonal hospital, there is access to the standard care provided by the LAMal health insurance. There is no choice concerning the medical team.

If you have a semi-private or private supplementary health insurance, you are accommodated in another part of the hospital. You have a choice of medical team and your room is single (private) or shared (semi-private) with one other mother.

In a birthing centre

If the mother would like to give birth naturally, she will choose the birthing centre. Empathy, a warm environment, and alternative medicine are the priorities. Epidural anaesthesia is not possible.

As with a birth in a cantonal hospital, the basic health insurance (LAMal) covers the costs.

At home

Home birth is practiced with the help of a midwife who provides the necessary medical resources. The midwife prepares for the birth, accompanies the labour and the afterbirth. The costs are covered by the basic health insurance (LAMal).

Details of the possibilities for giving birth can be found after this article in the section Where to give birth?

Notifying your employer

Once your pregnancy has been confirmed, your employer needs to be informed in order to benefit from maternity leave. Maternity leave entitles mothers to maternity allowance according to the rules of their canton and the collective agreement of their company.

The maternity allowance generally corresponds to 80% of your starting salary.

Although there are no regulations setting the date, the employer should be informed before the end of the third month of pregnancy.

Notify your health insurer

Your health insurance company needs to be informed of your pregnancy, because all maternity-related care is reimbursed without deductible or copayment.

In addition, from the thirteenth week of pregnancy until eight weeks after the birth, all medical care – whether pregnancy-related or not – is also reimbursed without deductible or copayment, with the exception of dental care and preventive measures. These services are therefore not exempted from the contribution to the costs to be paid by the insured.

If you forget to inform your insurer, the hospital will take care of this by requesting coverage for hospitalisation.

The insurer will then tell the hospital what comfort services can be claimed:

  • If you have supplementary insurance that allows you to be hospitalised in a semi-private or private ward, you can choose the hospital, the clinic and the doctor who delivers the baby. It is important to check the date of subscription to this supplementary insurance because the waiting period for maternity coverage is one year.

  • If your insurance is limited to the compulsory basic LAMal, hospitalisation will be in a general ward. This means that you will have to be cared for during your pregnancy and give birth in a cantonal hospital. You cannot choose the doctor.

The mother’s insurance covers the costs of pregnancy, childbirth and the birth of the child. It does not cover the care of the child after birth.

LAMal covers the main maternity entitlements. In order to avoid surprises the coverage of the basic insurance LAMal needs to be examined thoroughly to identify what is missing.

Maternity, main LAMal coverage

Preventive examinations: amniocentesis and placenta analysis (in case of high risk)

  • Check-ups during and after pregnancy, prescribed by a doctor and carried out by a doctor or midwife.

  • Delivery at home, in a hospital or in a birthing centre.

  • Contribution to the costs of childbirth preparation classes.

  • Breastfeeding advice.

  • Services provided by midwives before, during and after childbirth.

Midwives, LAMal coverage

Before the birth, midwives can provide the following services, which are reimbursed at 100% by the basic LAMal:

  • Check-up examinations

  • Prescription of an ultrasound examination

  • Prenatal CTG examination using cardiotocography (examination of the baby’s heartbeat)

  • LAMal covers CHF 150 for an individual or group class preparation for childbirth.

  • 3 sessions are covered by LAMal for breastfeeding advice.

  • After the birth, for prenatal follow-up care at home, midwives can make visits during the 56 days after the birth:

  • Prenatal check-up between the sixth and tenth week.

  • In case of premature birth, multiple birth, first child or caesarean section: maximum 16 visits, and maximum five times for a second visit on the same day. Additional home visits require a medical prescription.

  • In other situations, during the 10 days following the birth, in addition to the home visits, a maximum of five second visits on the same day. Additional home visits require a medical prescription.

  • Additional home visits after 56 days after the birth are only possible if prescribed by a doctor.

The limitations of the basic LAMal insurance coverage can be seen when the individual provisions are examined.

If you would like to give birth in a private clinic, have a choice of nursing staff, have access to more examinations than those provided for by the compulsory basic insurance (ultrasound scans, etc.) or if you would like to benefit from comfort services during your delivery, then the benefits provided by the compulsory LAMal insurance are not high enough.

For maternity-related care, supplementary insurance has a waiting period. You are not covered immediately. That is why this insurance should be taken out in advance as soon as maternity is envisaged.

The article supplementary maternity insurance provides an overview of this topic.

Prenatal insurance to protect your baby

The basic LAMal maternity coverage covers care directly related to the birth, any minor complications and the costs of the newborn’s hospital stay. However, if the child is ill, the mother’s own insurance will not cover the costs.

The easiest way to avoid unpleasant surprises is to take out prenatal insurance for the baby. As the name suggests, prenatal insurance should be taken out before he or she is born.

This prenatal insurance consists of a basic LAMal insurance and supplementary insurance of your choice. It will be automatically approved by the insurer (no health questionnaire needed). It is invoiced from the birth of the child.

If you did not sign up your baby for a supplementary insurance before the birth, you will have to answer a postnatal health questionnaire about the baby. Depending on the answers to the health questionnaire, the health insurance company can refuse to insure the baby.

A guaranteed place in a private clinic

In order to give birth in a private clinic with no worries, it is essential to take out prenatal insurance with the option of hospitalisation in a semi-private or private ward.

The “babypackage” offer of the insurers rarely offers this option. You should be careful here it could be problematic. You can have a semi-private insurance policy yourself, but your child may not have the additional semi-private insurance. In this case, if your baby needs to be treated with specific care at birth, the clinic can:

  • Invoice the costs to the parents

  • Or refuse to take care of the baby

  • And request that the child be moved to a cantonal hospital and treated in a general ward.

The article prenatal insurance outlines the advantages of this insurance for the child. It explains when it should be taken out. During pregnancy, prenatal insurance will not cost more and will always be accepted.

 

Now that you have learned about the 5 steps to prepare for the birth, here are the next steps for a calm birth:


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