My wife has a high risk pregnancy, and it's looking very likely we'll need to call ambulance if she starts bleeding badly.

This means a trip from unterageri to zug.

How much is it likely to cost (we're on the basic insurance), and is it still capped at 5,000 per trip?

We're struggling to find cheaper alternatives, especially with time being of essence.

I do not know if every hospital has the same costs but anyway...
Our son had an accident in school a few weeks ago and the ambulance took him from school to Kinderspital Zurich (25 km) and the bill is 1200 chf. The basic insurance pays 50% but not more than 500 chf per year. This is with Avanex and the ambulance was from Spital Uster.
Hope this helps!

to avoid false answers, just ask your birth hospital and the insurance. Wishing you all the best for the birth!

The first baby takes a while, they do not arrive quickly.

Have you thought about driving her to the clinic in Ägeri and letting them pay for an ambulance if it is necessary. What does your doctor recommend?

http://yellow.local.ch/en/q/?what=Kl...id=directories

It could be a problem which causes bleeding as soon as the birth starts - not when the baby is actually born, in which case an ambulance from the word go might be necessary - and not all first births take all that long anyway.

yeah, or as with our 2nd one: Preavia Totalis

If so, you have 5 minutes or less when bleeding starts.
Don't wait the ambulance, mess your car!

You really need to discuss what to do/strategy when the time comes with your obstetrician/GP, midwife to know exactly what's what due to distance and possible bad winter conditions in middle of night etc. If you do not speak German fluently, as to discuss this in English. If it is not possible, make sure you find somebody who comes to interpret for you so you know exactly what to do and how to proceed. If it is a placenta previa, or something similar - everything has to be in place asap. Cost of ambulance depends on your Insurance cover. EG here they have closed the local hospital - and basic insurance does not cover cost of ambulance- so locals on basic ins are not happy.

Ask the medical team too- they should be able to advise.

Good luck and hope you get there safely and in time for a happy outcome (never mind about ambulance cost).
10km/15 mins according to tcs- but with bad roads it could be more. Not a good idea to drive it yourself if you are in a panic, in bad road conditions and without lots of snow experience and a good 4x4 with great snow tyres.

Perhaps an excellent case for an elective Caesarian or a pre-delivery stay in hospital so she is on site when it happens?

It's placenta previa. The baby is breach too.

Yes, it would be great to elect to have a c-section, but an elective is beyond our financial means, especially since we've only just arrived in CH, having spent a small fortune of our own money getting here. Likewise a pre-delivery stay; who would look after our first child? (2 yrs old)

I would ideally drive my wife, but I work in Zurich - over an hour on public transport, but only 30mins on the bike...if it's not snowed out, but that's still ages. We can't order a taxi, because of the bleeding issue. We're a wee bit stuck, and an ambulance looks the only option.

A c-section should be covered under even your basic insurance and certainly if it's an emergency. To have a PP and a breach positioned baby is probably too much risk for a hospital to take for a natural birth and your wife should speak to her gynae in more depth.

Having a high risk labour and birth with probably complications for the mother and baby is going to cost the insurance far more than an "elective" or perhaps we should say "precautionary" c-section.

Definitely get your wife to discuss the full situation with her doc.

It sounds to me like you need to speak further with your doctor/midwife about exactly what is expected with the birth, what is covered with insurance, what your likely costs may be, and any other options you have...they should be able to either talk you through the information, or tell you who to speak to so that you have it all clarified well before the birth...

I know from the experience of two friends who had placenta previa that the decision for a c-section was made only at the final stage of the pregnancy, because the placenta can grow further across the opening, or away, making a vaginal birth possible. Also, there is 'complete' placenta previa or 'partial' - and it's only 'complete' that is going to require an emergency c-section, although one of the key indicators of placenta previa is the intermittent bleeding over the pregnancy and bleeding during the labour...

For that reason, I can understand that the doctor may not be wanting to discuss an 'elective' c-section because it isn't an option you have - either it will be a vaginal birth or an 'emergency' c-section when the time comes.

Similar with the breech - a friend of mine with her fourth child went in the week she was due to find bubs was breech. The doctor recommended a c-section, booked her in for monday, and on monday morning the bubs was head down, and she was sent home and had the baby spontaneously on thursday...

I thought perhaps it was 'midwife error' - but no, she had ultrasounds both times - breech and then the morning of the planned c-section.

So, again, even though bubs is presenting 'breech' now, they could possibly flip later on, so they will cross that bridge when they come to it...

Sounds like there is more going on in the background with the distance from home to hospital, and also having a back-up plan for your older child. Perhaps you can think seriously about having someone available who can step in to help with the older child and perhaps with transport at short notice ? Is there a friend, neighbour, family member, or a professional person that you can pay to help out ?

I'm guessing from your post that you don't have a car or can't drive...the odds are you won't have an emergency situation, and you would be able to drive her to the hospital (please drive carefully and don't speed!)...

There are two important reasons to call an ambulance:
1) if they have equipment in their van which you need straight away, or
2) they can get you to hospital faster than you would get there (allowing for the fact that the ambulance has to come from the base, or from wherever it is roaming at the time it gets the call)....

I also had an emergency ambulance trip to the hospital with my pregnancy (long before the actual birth) and 100% of the cost was covered by my health insurance (I only had basic cover). So, as already mentioned, it would be a good idea to check with your insurance company.

Also, as you may already know, placenta previa can change during a pregnancy - I was also diagnosed with this at the beginning of my pregnancy, however the placenta moved over time and this was no longer an issue at the end.

All the best and best wishes!

If time is the essence, wouldn't driving/taking a taxi one way be faster than calling an ambulance that needs to drive up to unterageri and back again?

When my son bumped his head and was vomiting and looked like he was having seizures, she called a taxi to take us to the hospital as she said it will be faster than calling and waiting for an ambulance.

I would also include a discussion/planning session with the ambulance company, especially if weather could be a factor. While costs are a reasonable concern, the health issues are the primary concern.

Any chance you could work from home so that you're there instead of in Zürich?

Not sure about ambulance, but other pregnancy and birth health bills which are for a no-complications pregnancy are reimbursed 100% regardless of the franchise. So maybe the ambulance as well in this case?