Pregnancy and childbirth

Information

Inhalt

Pregnancy

4 Complete care in our practice

6 The midwife: Your contact

8 Recommendations for Prenatal Care

10 Classes

12 What do I need to pack when going into hospital?

13 Equipment for the baby

Childbirth

14 Types of contraction

17 Our delivery rooms

18 A natural birth

22 Labour positions

24 Caesarean section

Postpartum period

26 Those first special hours after giving birth

27 Together after the birth

29 Your stay in hospital

31 After the birth

Dear Parents

Congratulations! As you wait for the arrival of your baby,

enjoy this wonderful and unforgettable part of life. At

the See-Spital we are committed to doing everything we

can to bring your child healthy and safe into the world,

as naturally as possible, and to making this a unique and

beautiful experience for you.

We have compiled this information leaflet to help you

adjust to your pregnancy and best prepare for the

imminent arrival of your child.

Our team of midwives and doctors at See-Spital, as well

as our affiliated doctors, will support you throughout

your pregnancy, during the actual delivery and postpar-

tum period, and that initial time back at home.

Dr. med. Plamen Kostov

Head Physician

Gynaecological Clinic

Sandra Kubisch

Senior Midwife

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Pregnancy

Complete care in our practice

Routine maternity checksDuring pregnancy, it is advisable to have checks at regu-

lar intervals. In uncomplicated pregnancies, it is usually

sufficient to have seven such checks at intervals of four

to six weeks until the expected time of birth. With

straightforward pregnancies, some of these checks can

take place in the framework of our midwifery clinic.

Choice of doctorOur medical team consists of various executive

physicians and interns. You are welcome to have your

say in who from our team will take care of you and

support you throughout your pregnancy.

Ultrasound scansAn ultrasound scan is a means for directly observing the

unborn child in the womb. This is not only a wonderful

experience for you, but it can help us detect problems at

an early stage. You can have all the necessary ultrasound

scans in the hospital with us. In addition, we offer you

the possibility of having a 3-D ultrasound scan.

The screenings are carried out by highly specialised

doctors. They are able to offer you the best possible care

in high-risk cases and, if necessary, they can perform the

We look after you in our gynaecological clinic from the moment when you test positive through to the birth. This way you already have the opportunity to build a relationship of trust with our doc-tors and our midwives before giving birth.

wide range of antenatal diagnostic testing

thanks to their extensive experience and the

high-end ultrasound equipment we have at

our disposal.

Naturally we can also be of service, if you

would like us to provide a second opinion.

High-risk pregnanciesIn the event of pregnancy-related problems

and diseases, we will always be there for you.

The integration of our practice in the See-Spital

and our good working relationship with the

other departments, such as nutrition and

diabetes counselling and paediatricians, means

that you and your child will get direct and

immediate co-treatment or further treatment.

Maternity recordAll expectant mothers in our care are given a

maternity record. All the checks and examination

results, including ultrasound scans, are

documented in this record. The maternity record

includes data on the health of the expectant

mother and the development of the child.

It is not only a beautiful keepsake of that special

time before the birth, but also a useful medical

document that provides additional safety in an

emergency – especially when traveling.

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aspects. During the clinic sessions, you can

calmly discuss your concerns and requests about

the forthcoming birth with the midwife.

Any new risks that are detected or pregnant

women with health problems are checked

solely by the doctor. Additional advice from

the midwife is available in this instance.

The midwife: Your contact

Pregnant women, who are cared for by the

See-Spital’s team at the gynaecological clinic,

can already meet our midwives during the

routine checks.

Midwife consultation sessionsWith a straightforward pregnancy, you may

attend two or three regular checks with the

midwife. All the necessary medical examinations

are also carried out as usual.

The midwife sessions are comprehensive

consul tations that are extended with aspects

that are specific to the midwife’s role. It takes

into account both medical and psychosocial

Our midwives are not only your contacts during the birth, they also play a very important role during your pregnancy: carrying out routine checks, running courses and performing antenatal acupuncture.

Antenatal acupuncture As part of our comprehensive programme to

prepare you for childbirth, we can also offer you

antenatal acupuncture sessions from the 36th

week of your pregnancy, i.e. 4 weeks before

the expected delivery date. Our trained mid-

wives perform acupuncture in four sessions,

which take place once a week. This antenatal

acupuncture dilates and softens the cervix.

Studies show that it can significantly shorten

the labour time (opening period) during the

actual birth.

You can arrange an appointment with the

midwife over the telephone by calling

044 728 17 00.

A session costs CHF 50. Check with your health

insurance company to find out how much of

the cost for antenatal acupuncture they are able

to cover.

Naturopathic supportOur midwives have excellent knowledge of

naturopathic medicine and will support you

on request, both during your pregnancy and

childbirth, as well as the postpartum period,

with teas, acupuncture, homeopathy, aroma-

therapy or wraps.

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Recommendations for Prenatal Care

Perineal massage The perineum (the area between the anus and vagina) is

stretched and put under a lot of strain during childbirth.

As a consequence it may be damaged either because

the tissue tears as the baby’s head penetrates through or

because it has been deliberately enlarged with an episio-

tomy. Quite rightly, expectant mothers are fearful at the

thought of damaging their perineum. But generally any

natural tears or incisions in the perineum usually heal

within a short time without complications and any

further discomfort.

You can also help to minimise the risk of injury. We

recommend that you repeatedly massage the perineum

tissue during the time leading up to the birth. By doing

this you will increase its elasticity. Although massaging

your perineum is no guarantee that it will not be

damaged during the delivery, it has been proven to

reduce the severity of the injury. Regular massaging of

the perineum increases the circulation of the tissue,

which in turn improves its capacity to stretch.

Start massaging 6 weeks before your anticipated due

date. Massage the area regularly. You can buy special

perineum massage oil, but you can also use natural oil

such as wheat germ oil or olive oil. A warm shower or a

warm bath beforehand relaxes the tissue, but this step is

not absolutely necessary. Sit in a relaxed position and

bring your knees up with your legs apart. It is useful to

use a mirror and angle it in such a way that you

can see your anus, vagina and perineum. Warm

up the massage oil with clean hands and gently

massage the area between your rectum and

vagina. Then insert just one thumb followed by

the other about three centimetres into your

vagina and press down toward the rectum and

toward the sides at the same time until you feel

a slight tingling or burning sensation.

If you have herpes, thrush or other vaginal

infections, we advise you against massaging

your perineum.

One of our midwives will gladly advise you and

provide you with more information.

Prenatal Care with EPI-NOIn addition to the perineal massage you can also

use an EPI-NO, to prepare for the birth. This is

a training device that strengthens / builds up the

pelvic floor muscles and stretches the muscles.

This is done using a balloon, which is inserted in

the vagina.

In addition to having a positive attitude and being open- minded about the birth, we would like to give you a few more recommen-dations on how you can try to positively influence the delivery of your child.

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Classes

In our antenatal classes you will receive valuable

information and practical advice from our qualified

midwives on pregnancy, childbirth, the postpartum

period and breastfeeding.

The See-Spital regularly holds evening classes during

the week (a total of five nights), consolidated courses

(one three-hour-class) in German or English, as well as

intensive courses on weekends.

In addition to classes for the birth (preparing for the

birth, getting back into shape) we also offer classes

on pregnancy or for mother and baby after the birth.

The classes offered depend on the demand.

For up-to-date information and the application forms

for all of our classes, visit our maternity clinic website:

http://geburten.see-spital.ch > Classes

Ensuring that you are fully prepared for the birth with the help of a midwife is particularly advisable with your first delivery. This way she can clarify any questions you may have, help reduce your anxiety, and prepare you and your partner for life with the baby.

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Sleeping: Cot (70 x 140 cm), waterproof baby blanket,

fitted cotton sheets, sleeping bags, baby U-pillow (not

conventional pillows)

Clothes: Clothes size 56/62. Cotton bodygros, romper

suits, woollen jacket, slippers (wool in winter, cotton in

summer), covering for the head (silk or cotton in the

summer and a sun hat, wool in the winter), padded

romper suit or all-in-one with hood in the winter, baby

blanket

Care: Changing table or unit with changing mat,

nappies in initial size (up to 5 kg), cotton wool pads or

cleaning tissues as throw-aways, wipes on the go, baby

bath or tub, bath thermometer, digital medical thermo-

meter and Vaseline, soft baby brush, rounded nail scissors.

Toiletries: Generally water is sufficient, no additional

products are necessary. If you want to use something,

use almond oil or natural products (e.g. from Weleda).

Important: no perfumed products

On the go: Pram (the extensive range available provides

advice for the individual needs which is very helpful),

Maxi-Cosi car seat, optional: sling or Ergo Carrier, and a

changing bag for nappies, etc.

Extras: Playing blanket or mat on the floor

Equipment for the baby

For the birth

■■■ Swiss citizens: family record book / Women of other

nationalities: Identity card that complies with the

information leaflet from the Civil Registry Office

(a copy of your passport and birth certi ficate) and

marriage certificate, if you have one.

■■■ See-Spital Maternity Record (if you have one)

■■■ Blood type ID card

■■■ Comfortable clothes

■■■ A camera and favourite music (optional)

For the postpartum period

■■■ Comfortable clothes for the day (please remember

the fact that your tummy does not usually disappear

overnight).

■■■ Pyjamas / nightdress

■■■ Socks and slippers

■■■ Bag with your own toiletries

For the baby (when you go home)

■■■ clothes

■■■ Maxi-Cosi car seat

What do I need to pack when going into hospital?

Consider carefully what you will

need to buy. You may be able to

borrow a moses basket, bassinet,

Dondolo, sarong, etc. Children’s

exchanges can also help save on

costs. It is advisable to only get

what you really need to start with

and then to gradually buy things

as and when you need them.

Available at the Hospital

• Breast pads

• Hospital knickers

• Hair dryer, towels, washcloths

• Sanitary towels

• Clothes and nappies for the

baby

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Types of contraction

Types of contraction

Contractions when pregnant increase the circulation /

blood flow and the growth of the uterus. The cervix is

not opened. These kinds of contractions are short and

regular, and the stomach hardens. Often they are not

even felt. 4-10 times a day is normal.

False labour starts around the 36th week of pregnancy

and helps lower the baby deeper into the pelvis. It sof-

tens and shortens your cervix. These are irregular pains

that pull in the groin and the small of the back, about

once or twice every hour for approximately 30 to 40

seconds.

Braxton Hicks contractions can regularly occur

over a shorter time, but then disappear again. They

occur mostly in the groin and lower back area and can

be confused (especially when the first child) with labour

contractions. A warm bath can be helpful if you feel

The uterus is a muscle that cannot be deliberately moved. When the uterus contracts, these contrac-tions are called labour pains. Contractions move the baby into the correct position and advance the birth process. But having contractions does not necessarily mean you are in labour.

unsure: the warm water calms these contrac-

tions down. If the contractions persist or

become stronger, then it is usually a sign that

you are in labour.

Labour pains are rhythmical and regular

and do not stop in any position. The cervix is

opened and the baby lowers down into the

pelvis. Labour pains are mainly felt in the groin

and lower back area. The frequency of the

contractions increases, up to three contractions

in 10 minutes. One contraction lasts 45-60

seconds.

The uterus continues to contract after the

baby is born and causes the placenta to be

expelled. These are less painful and are suppor-

ted in part by oxytocics.

Uterine contractions after the birth help

the uterus to recover and the blood vessels to

constrict by reducing the wound area in the

womb. They appear in the first two to five days,

and increase while breastfeeding.

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It is important for us to know that you feel safe with us.

That is why our delivery rooms have a unique colour

scheme and convey a warm and soothing atmosphere.

The fact that you can enjoy unobstructed views of Lake

Zurich in our delivery rooms may be of little significance

at the time of the birth. However, when you finally hold

your beautiful little baby in your arms, the wonderful

view will perhaps make this unforgettable moment all

the more memorable.

In our delivery rooms you can decide how you want

to bring your child into the world: on the delivery

bed or the floor mat or with the Maya stool. Or maybe

you would prefer to deliver your baby in the warm

water of a birthing pool. You do not need to decide

already, instead you can freely and spontaneously

choose from the many possibilities we offer depending

on how you feel.

Our delivery rooms

With our three fully equipped delivery rooms, each with its own bath, we ensure that there is always sufficient capacity available.

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A natural birth

Every birth and every delivery is unique. If the delivery is

not showing any signs of complications, you will be

looked after primarily by a midwife. She will inform you

about the progress of the birth and about the different

possible labour positions and pain relief options, she will

be impartial and provide you with the best possible care.

In addition to the midwife, the doctor responsible will

also be present at the time of the birth at the latest.

Signs that it is about to startAlmost every woman giving birth for the first time is afraid

of getting to the hospital too late. How ever, first births

usually take longer. If you are experiencing regular

contractions (approx. every five minutes), your waters

have broken (release of amniotic fluid), you are bleeding

heavily or if you are simply unsure, please call us.

A midwife will deal with your enquiry and admission.

We want to offer you a natural birth just how you want it, with plenty of comfort and also the secu-rity of the hospital for unforeseen complications.

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What is done during the «birth»?When you arrive here, you will be accompanied

to an examination room. A midwife will check

the baby›s heartbeat and record the rate of your

contractions with a CTG (cardiotocography). She

will monitor the blood pressure, urine, weight

and position of the baby. You may also have an

ultrasound scan. The onset or progress of labour

can be determined with a vaginal examination.

Once the birth has definitely begun, you will be

accompanied to the delivery room. Once there

we will take a sample of your blood and a

venous access will be set up for administering

possible medication to relieve the pain. You will

have a vaginal examination approximately every

two hours and your heartbeat and contractions

will be monitored.

Breech positionA vaginal birth is possible from a breech

position. This procedure is performed at the

See-Spital after a detailed consultation along

with the careful assessment of the child’s size in

relation to the mother’s pelvis, and after further

birth risks have been ruled out. We will gladly

advise you about 6 to 8 weeks before the

expected date. Please make an appointment

with our clinic: Tel. 044 728 17 02.

If a vaginal birth is not recommended when

the baby is in the breech position, we can try

to rotate the baby into the head-down position

before proceeding with the final solution of a

caesarean section. We are more than happy to

advise you on which methods are available to you.

Pain reliefPractically no birth is completely free from pain.

But the sensation of pain is very individual.

Many women still give birth without using

any painkillers. Nonetheless it is reassuring for

women in labour to know that these days there

are a whole variety of methods on offer to

relieve pain or even turn it off to a large extent.

Simple methods can often help, such as

breathing properly, movement, changing labour

position or a bath. If this does not give enough

relief, then the range of pain relief on offer

ranges from complementary medical methods

such as homeo pathy, acupuncture, massages

and wraps to conventional medication.

At the See-Spital, we offer a pain therapy that

is controlled by the patient. By pushing a button

that controls a pump, the expectant mother can

determine how much pain relief she actually

gets as and when she needs it. It is not possible

to overdose.

With an epidural, a catheter is inserted in the

lumbar region, close to the spinal cord, to

numb the nerves in the lower body. This relaxes

the abdomen and renders the mother almost

completely free from pain.

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Labour positions

Positions 1 to 3An upright position takes advantage of gravity and the pelvis

can move freely. The position with the rope provides support.

Lunging forward in the standing position helps increase the

opening of the pelvis and the pelvic floor.

On all fours on the groundWhen on all fours on the ground, the uterus is in an optimum positi-

on (helps baby line up with the angle of the pelvis), the pelvis and

the back can move if necessary. This counteracts any back pain.

Maya stoolThe opening of the pelvis reaches its largest possible

diameter on the Maya stool.

Birthing poolWhen sitting half-upright in the birthing pool, the

pelvis can move freely and the water gives buoyancy.

On all fours on the bedThe uterus is also in an optimum position (helps baby

line up with the angle of the pelvis) when the mother

is on all fours on the bed and the pelvis and the back

can move if necessary.

Lying on your side in bedThis position works well, if the expectant mother is

tired or exhausted. It is also possible when the mo-

ther is not able to move (such as with an epidural).

While the position on the

ball is pleasant in the

opening phase, all other

positions are suitable in

the opening phase as

well as during the se-

cond stage of labour.

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A distinction is made between a primary and

secondary caesarean section. The primary

caesarean section is planned and will be carried

out before the active phase of labour has

started naturally. There are reasons, such as

the irregular position of the baby, risk of death

to the mother or baby, pre-existing medical

conditions of the mother or baby.

However, a secondary caesarean section can

be necessary due to complications that occur

during labour, which cannot be resolved with

use of forceps or suction (ventouse).

Nowadays, the caesarean section is at times

knowingly preferred to a spontaneous delivery.

Because of the fear of the unknown labour

pains or possible vaginal injuries associated

Caesarean section

with a natural birth, the caesarean section is

considered to be «a lesser evil», so to speak,

and is perceived as being more predictable.

However, it would be a fallacy to believe that

a caesarean section is completely risk-free.

A caesarean section, whether planned or not,

is always a surgical procedure performed under

general anaesthesia or regional anaesthesia and

the pain should not be under estimated.

We and the Swiss Association for Paediatrics

believe that a birth free of all complications for

the mother and the baby is the most gentle and

often also felt to be the best way to have a

child. Having fears before the birth is completely

normal. Talk it over with us! Our midwives and

doctors are always available for a talk.

A caesarean section (whereby the baby is surgi-cally removed from the womb of the mother) is now routinely used by obstetricians. In Switzer-land, approximately every third baby is brought into the world by caesarean section.

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Right after giving birth (regardless of whether

your child came into the world by means of a

natural delivery or through a caesarean section)

you should have your baby with you. Once the

finishing operations or treatments of the delive-

ry are completed, or in the best case where

none are needed, you can enjoy being together

as a family unit in the maternity ward. Now it is

just the midwife who will be looking after you.

A little later on, you can move into your room in

the postpartum ward.

Together after the birth

For parents, that initial time together with their

baby is filled with so many intense moments –

moments that they may want to experience in

private.

Comfort surcharges maternity clinicThe comfort surcharge gives you the option of

enjoying the advantages of a higher class of

insurance. This means that you will receive care

from an attending doctor and/or medical team

while staying in a room for two people or a

single room (without any further hotel services).

If a new mother is in a single room, her partner

can sleep there and have breakfast free of charge.

New mothers who have additional insurance

always take precedence. That is why we cannot

guarantee the offer of the comfort surcharge. It

all depends on the number of occupied rooms.

The comfort surcharges apply as follows (they

are flat rates i.e. they do not depend on the

length of your stay). See our website for the

current prices: https://geburten.see-spital.ch

> Birth > Preparing to go into hospital >

Comfort surcharge

More information can be found in the patient

admissions of the See-Spital: Tel. 044 728 11 03

Extras for patients with additional insuranceIf you have a semi-private policy, you will be in a

twin room, and with a private policy you can

enjoy your own room. New mothers with addi-

tional insurance enjoy the comforts of H-quality.

They also receive a Rossi’s nappies bag from us

upon their departure and, like all women who

have given birth in our clinic, – a «See-Meitli»

(Lake-Girl) or «See-Bueb» (Lake-Boy) babygro.

Although you have a basic insurance policy, you usually will be in a room for two people. It is important for us to make your experience here as comfortable as possible.

We run a «rooming in» program in our family

ward, this means that your baby can be with

you day and night. This means that you can get

to know each other in peace. But that doesn’t

mean that we won’t look after the little one

here and there, if you need time to relax.

Postpartum period

Those first special hours after giving birth

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Family roomsCouples who want to spend time together with

their new born baby in the postpartum period,

have the option of staying in our family rooms.

These rooms are also located in the postpartum

ward, but they are not set up like a hospital

room, more like a hotel room. In other words:

you don’t feel like you’re in a hospital, however,

you still benefit from all the hospital care. The

family rooms are reserved for couples only.

See our website for the current prices:

https://geburten.see-spital.ch > Postpartum

period > Your stay in hospital > Rooms

The following benefits are not included in the

price for basic insurance policies: care from

an attending doctor and/or medical team, meals

for partners (except for breakfast), TV, gift from

See-Spital, H-Quality services. Patients with

additional insurance qualify for the usual servi-

ces provided by H-Quality.

• Family rooms cannot be reserved (first-come,

first-serve basis).

• If the family room is already booked, other

rooms may be used instead (the equipment in

these rooms is typical of a hospital).

The length of your stayMothers usually stay with us for 2 to 3 days after giving

birth. If no complications are expected, and if we do not

have any reasons to the contrary, you are free to go

home earlier than this if you want to.

Straight home after giving birthYou can also give birth here as an outpatient. You

can already talk to your doctor about this during your

pregnancy if it is something you are considering. If this

is case, it is important that you organise some form of

support for when you are at home. We will gladly

provide you with the contact details of our midwives,

who can come and check on you or provide you with

some support at your home.

Your stay in hospital

During the postpartum period, we will carry out the first paediatric examinations on your baby, provide you with an introduction on how to care for and look after your baby, support you in your breastfeeding and give you some initial tips on how to get back into shape after childbirth.

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When the bubble bursts

Nearly half of all women who have given birth

suffer from “baby blues” two or three days

later. They feel low due to the hormonal

changes and the fact that their life is totally

different. This feeling passes after a few days

and does not need to be treated.

However, around 10% of all women experi-

ence more than just this low mood swing,

they suffer from postnatal depression, which

manifests itself as follows:

• fatigue, exhaustion

• problems concentrating

• lethargy and emptiness

• mood swings

• lack of or disturbed sleeping patterns and

appetite

• physical pains

• conflicting feelings towards the child

• guilt

• anxiety, panic attacks

• suicidal thoughts

Postnatal depression can affect any woman,

unfortunately it is often not recognised for

what it is since the symptoms can be attribut-

ed to the new situation with its additional

stresses and demands. Do not ignore your

feelings! Postnatal depression can be cured!

You can find someone to help you:

www.postnatale-depression.ch

VisitorsYour partner and your children may come

and visit you anytime. All other visitors have

to respect the general visiting hours of 14.00

to 21.00 pm.

Please be aware that the initial time you

spend with your baby takes a little adapting to.

We therefore advise you to restrict visits to a

minimum. By doing so, you are not just helping

yourself but also the other mothers you are

sharing with if you are not in a single room.

You can also receive your visitors at our Bella

Vista restaurant, in the dayroom or on the

garden terrace, in the warmer months.

MealsWe make a special effort to make sure you feel

good with our varied, healthy and tasty dishes.

To get you feeling fit again, we offer you a

chicken soup. Its ingredients have been specially

selected by one of our experts in traditional

Chinese medicine. This soup helps the regenerati-

on of your blood cells and keeps your lactation

at a healthy level, as well as helping your body get

back into shape and stimulating your circulation.

After the birth

The basic insurance will pay for the care you will receive

from the midwife up to the 56 day (8 weeks) after the

birth, i.e. a midwife will come to your home once a day,

if necessary. She will carry out checks on you and your

child and clarify any open issues and new questions you

may have.

Please do not delay in contacting a private / independent

midwife in your area.

www.hebammensuche.ch oder www.hebamme.ch

We wish you a wonder-ful start with your baby. Please contact us with any questions you may have even after you have left our clinic.

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geburtshilfe@see-spital.ch

http://geburten.see-spital.ch

See-Spital

Gynaecological Clinic

Asylstrasse 19

8810 Horgen

Tel. 044 728 17 02

Telephone number

for the midwives

044 728 17 00

Telephone number

for advice on breastfeeding

044 728 17 87