This article will explore the choices available regarding where to have your baby in Geneva, the advantages and disadvantages of each place, and the safety aspects of your choice.
Your options about where to have your baby will depend on your needs, pregnancy, and the type of insurance you have.
It is important for you to be able to choose where to have your baby because you need to feel confident and in charge of your birth. You have to feel that you are making choices which are suitable for you that fit with your preferences and wishes about the kind of birth you are going to have.
All women are very different and their pregnancies are different. Some women will be recommended to have a hospital birth, other women will really want to have a hospital birth because that feels the safest for them even though the evidence shows that giving birth at home or in a birthing center is very safe. Therefore no woman is the same and it is very important that you make your own choice.
However, before you make that choice you might want to inform yourself first, as the birthplace of your baby will have a huge impact on the type of delivery you might end up having, on the early days with your baby and the days and years which will follow. No woman forgets the birth of her children, it is a powerful event which will stay with you for the rest of your life and therefore it is extremely important that you feel in control of your birth.
So where can you have your baby if you live in Geneva
Home
Birthing centre (Maison de Naissance)
Public hospital
- the Geneva University Hospital (HUG) - Hopitaux Universitaires de Geneve
Private clinic/hospital (basic health insurance LAMal will not cover the whole stay)
Before we look at the advantages and disadvantages of each place I would like to mention a very important study which was done in England between 2008-2010. The study is called The Birth Place Study which collected data on care in labour, delivery and birth outcomes for the mother and baby for over 64,000 ‘low risk’ births. In simple terms, this study is looking at how safe it is to have a baby at home, at a birthing center and in a hospital.
According to this large study, giving birth is generally very safe.
Interestingly this study revealed that women who planned birth at home or in a birthing center had significantly fewer interventions, including substantially fewer Cesarean sections, and more 'normal births' than women who planned birth in a hospital.
For women who had a baby before, there were no significant differences in adverse perinatal outcomes between planned home births or birthing centers and planned births in hospitals. Furthermore, the odds of having a Cesarean section, instrumental delivery or episiotomy, significantly and substantially reduced.
For women having a first baby, however, a planned home birth increases the risk for the baby slightly
( 9.3 adverse perinatal outcome events per 1000 planned home births compared with 5.3 per 1000 births for births planned in a hospital).
Unfortunately, for women having their first baby, there is a fairly high probability of transferring to a hospital during labour or immediately after birth (transfer in labour rate was 45% for planned home births, and 36% - 40% for planned birth center births).
For women having a second or subsequent baby, the proportion of women transferred to a hospital during labour or immediately after the birth was significantly lower (12% for planned home births, 9%- 13% for planned birth center births).
Let's have a closer look at Home Births
Some women like to have their baby in their home with a midwife they know and who has been looking after them during their pregnancy. Not all midwives do home-births and therefore if you are planning to have your baby at home, make sure that you ask your midwife well in advance if she does home births. If you already have a midwife and she does not attend homebirths, it is not a problem to change your midwife. In fact you can change your midwife anytime during your pregnancy, birth or in the postnatal period. This website provides a list of all the independent midwives in Geneva. If you click on the individual midwife it tells you if she does homebirths (accouchement à domicile), what part of Geneva she covers and what language she speaks. https://sagesfemmesgeneve.ch/rechercher.html
Please note that some midwives stated on the website that they do home births, but check that it is still the case as many of them unfortunately don't attend home births. To save you some time phoning around, here is a list of current midwives who attend home births in Geneva:
Nathalie Donnez (Nathalie speaks English very well) Her number is +41 76 775 53 05
Elisabeth Lathuille-Ferjani (Elisabeth speak only French) Her number is +41 77 454 07 37
Véronique Spinnler (speaks only French) +41 22 329 05 55
Nathalie Luisoni (speaks English very well) Her number is +41 79 744 74 84
Advantages of a home birth:
- Having a midwife in labour whom you know
- Being in a familiar environment where you feel safe and comfortable and therefore more relaxed. The more relaxed you are the easier it is to birth your baby due to the oxytocin flow
- You can take as much time as you and your baby need, there are no hospital protocols to rush you
- Cozy, intimate, dark, your own little nest and all the midwife's attention on you. Hospital midwives often have to worry about their other patients, logging notes into a computer, being interrupted by her other duties, having to follow hospital policies, which are there to manage and run a busy large institution and being constantly interrupted by other colleagues and supervisors
- Your labour does not have to be interrupted by a transfer to a birthing centre or hospital, which can slow labour down
- You will not have to leave your other children if you have an
- Having as many birthing partners as you like
- Fewer interventions
- Higher chance of having a natural birth
- You will not have to be separated from your partner after the birth
- Less risk of catching an infection
- Covid-19 friendly
Disadvantages of a home birth:
- You may need to be transferred to a hospital if there are complications. The Birthplace Study found that 45 out of 100 women having their first baby were transferred to hospital, compared with only 12 out of 100 women having their second or subsequent baby. However, if you decide to have your baby at a birthing centre or hospital you will still need to be transferred soon or later as you will be at home for the early stages of your labour. However, transferring at the beginning of labour will be more comfortable than when you are traveling in established labour.
- For women having their second or subsequent baby, planned home birth is as safe as having your baby in hospital or a birthing centre. However, for women having their first baby, home birth slightly increases the risk of a poor outcome for the baby (from 5 in 1,000 for a hospital birth to 9 in 1,000 – almost 1% increase for a home birth).
- Epidural and gas and air is not available at home.
Birthing Centres
Birth centres are small maternity units that are staffed by midwives. They aim to offer a homely and warm, rather than clinical and cold environment.
Midwives are the experts at normality and know when to refer to an obstetrician and transfer. You are much more likely to have a normal delivery if an obstetrician is not involved in your care as obstetricians are experts in abnormalities and complications and therefore their main focus is to look for an abnormality. You know the saying "if you look hard enough, you will find it." However, if you need a Caesarean Section or instrumental delivery there is always lots of time for transfer to a hospital. There are only very few emergencies where every minute counts and they are rare. An experienced midwife will recognise early warning signs and if an obstetrician is needed she will quickly arrange a transfer to hospital.
Birth centres are especially good at supporting women who want a birth without medical interventions. Most are set up with furniture and facilities designed to help you feel like at home, calm and in control.
The aim of birth centres is to treat labour and birth as a straightforward, normal thing to happen, rather than a risky event.
Advantages of having baby at a birthing centre:
- Run by midwives, the experts at normality
- Most birth centres have a birthing pool
- During labour, you are encouraged to move around and find your own position for birth. You can have people of your choice around you, and some birthing centres allow older siblings to be present too if you wish
- Birthing centres tend to be small, feel and look homely, and midwives really try their best for you to have the birth you want. If you are using hypnobirthing or any alternative method like aromatherapy or reflexology, many midwives at the birthing centres are familiar with alternative methods and support it
- Your partner can stay with you and baby after birth until you are ready to go home. Some birthing centres allow older children to stay too
Disadvantages of having baby at a birthing centre:
- Transfer to the closest hospital if complications arise
- No epidural or gas and air
- If you have some problems during pregnancy or you are 12 days overdue you will not be eligible for a birthing center.
Birthing centres in Geneva
The birth house La Roseraie opened in January 2012. This beautiful house located in a large garden is totally dedicated to natural birth. It is particularly aimed at women who wish to give birth in a physiological and non-medical way. La Roseraie has two birthing rooms with pools available to use for pain relief and for a delivery of your baby.
This small birthing centre is situated 3 km from Noyn Hospital (5 minutes by car).
Your basic LAMal insurance will cover all the costs of having a baby at a birthing centre or at home.
Hospital Births
For women who have a complicated pregnancy the safest place to have their baby is the hospital where all the medical equipment, obstetricians and anaesthetists are available just in case it is needed.
You can either have your baby in a public hospital - HUG - Hopitaux Universitaire de Geneve, or a private hospital/clinic. You will have to check with your insurance if all the care in a private hospital/clinic is covered. LAMal insurance does not cover all the costs of private clinics/hospitals.
HUG has everything under one roof. It is a busy unit with over 4000 deliveries per year.
The Maternity has twelve delivery rooms, two of which are “natural” rooms. All the rooms are equipped with a bed, a private shower, a locked wardrobe and a changing table to provide initial care for your baby.
In addition to the standard bed, the “natural” rooms have a parental bed allowing for natural delivery (without anesthesia) and on which you can move as you wish. It can also be used to rest after the birth. A bath is also available for you to relax during the early stages of labor or the dilation stage, but not for the entire delivery.
One person of your choice (partner, family member, friend or doula) is allowed to attend.
All the methods of pain relief are available and 80% of women decide to have an epidural.
Despite a high proportion of high-risk pregnancies, the Maternity’s caesarean section rate is low compared to the Swiss average. It was 28% in 2015 whereas the national average was 33%.
Your stay will usually be 2 to 3 days following a vaginal delivery and 4 to 5 days after a Caesarean section. It depends on your state of health and that of your child. Following a delivery without complications, you may be able to return home after only 48 hours. Your partner will not be able to stay over night unfortunately after the birth of your baby, but can visit during the day between 10am and 9pm. Visiting hours for relatives and friends are from 12pm and 8pm.
Unfortunately, not all midwives speak English, however, there are always 3 or 4 midwives on duty during the day and 2 or 3 midwives at night so hopefully at least one of them will speak English.
HUG also offers a service not many people know about. This service is called "Accompagnement global". A small group of midwives follows you from the first appointment until you go home, including the birth. You have a main midwife, but you also meet the others. If your midwife is not available during the birth of your baby, somebody from that team of midwives will be there.
For more information go to: https://www.hug-ge.ch/accompagnement-global or call +41 (0)79 553 50 86 to book an appointment
Another useful service HUG offers to pregnant women, where you can book an interview with a midwife (separate from any ante-natal checks) before and after giving birth.
More information can be found on www.hug-ge.ch/obstetrique/devenir-etre-maman or call ++41 (0) 22 372 44.
Private hospital with around 600 births per year.
There are 4 labouring rooms (2 of them have a large bath) and 15 postnatal single rooms where you will stay for 3 - 5 nights. If your partner wants to stay with you postnatally overnight, he is welcomed to do so.
You will be looked after by a midwife in labour and your gynecologist/obstetrician will be called towards the end of your labour, just before your baby is born. Be aware that you might not be able to have your baby in water if your doctor is not confident do deal with water births.
A private hospital with over 900 deliveries per year.
The Clinique des Grangettes relies on decades of experience and can meet the most demanding requirements of comfort and safety. An obstetrician of your choice usually manages your delivery. Unfortunately, the rates of Caesarean Sections can be very high in private clinics/hospitals. Clinique de Grangette would not share its Caesarean Section rates, however, that is something you could ask your gynecologist/obstetrician - what are her/his Caesarean section rates and what is her/his opinion on Caesarean sections.
Most midwives speak English and an anesthetist and a pediatrician are always on call if you need them.
A tour can be arranged by making an appointment: +41 22 305 01 14
Very similar to the Clinique des Grangettes, but smaller with around 200 deliveries per year.
Your obstetrician-gynaecologist will be informed upon your arrival and will remain in constant contact with the midwife who will take care of you. The midwife will be looking after you in labour and call your obstetrician just before baby is born as in the clinic Grangettes. Most midwives speak English.
Finally, the anaesthesiologist will be available 24 hours a day. He/she intervenes when necessary or at your request. Similarly, an on-call paediatrician will be available day and night, or your own paediatrician can be contacted.
You can visit this clinic any Saturday between 9am and 1pm.
For more information, call +41 22 839 57 01.
Advantages of hospital births:
- Safer for women who have complicated pregnancy (e.g. diabetic mums, VBAC, pre-eclampsia, breech baby etc.)
- No need to be transferred in the middle of labour if complications arise as anything you might possibly need is at the hospital
- Access to Epidural
- Easy access to theatre in case you need a Caesarean section
Disadvantages of hospital births:
- Sanitized, clinical and cold environment
- Unknown midwives
- Bright rooms
- Limited access to a birthing pool in HUG
- Continuously monitored with a CTG machine which makes it difficult to mobilise
- Risk of interventions are much higher (instrumental delivery, Caesarean section, episiotomy)
- Private hospitals tend to have very hight rate of Caesarean sections and inductions of labour
- Only one birthing partner can be with you during labour
- At the HUG your partner will not be able to stay with you after the delivery
- Limited visiting hours
More information can be found bellow:
List of Birthing Centers in Switzerland:
Birth Place study:
CS and private hospitals: Every 3rd birth in Switzerland is Caesarean section. That is not acceptable. Two new HRP studies show that when caesarean section rates rise towards 10% across a population, the number of maternal and newborn deaths decreases. When the rate goes above 10%, there is no evidence that mortality rates improve. WHO says that CS should not go above 16%.